Eating Disorder NOS: What Does This Really Mean?

Most everyone has heard of the two most common eating disorders, Anorexia Nervosa and Bulimia Nervosa. Recently binge eating disorder (BED) has been added to this list of major eating disorders. For those who do not fit into any of these categories, is another, often confusing diagnosis: Eating Disorder NOS (Not Otherwise Specified). This clinical term is misunderstood by many. What does EDNOS really mean? In this article, I will explain, as well as debunk some common misconceptions about this disorder.

When a clinician (psychologist, psychiatrist, counselor, physician, etc.) diagnoses a person with any psychological disorder, the standard reference tool is the Diagnostic and Statistical Manual of Mental Disorders, or DSM. There have been several revisions of this manual, the current one being the DSM-IV-TR (forth edition, text revision). This manual is published by the American Psychiatric Association (APA). Mental health professionals use this manual as a sort-of "cookbook" for mental illness. The DSM standardizes diagnoses so that there are fewer discrepancies among professionals. The insurance companies also like this manual, as they can understand exactly what a particular diagnosis is, and subsequently decide if they will cover treatment.

The problem with this very black-and-white approach to mental illness is that humans are not that simple. It is very difficult to place people neatly into categories. This is the issue with eating disorder specifications. Each disorder in the DSM, eating disorders included, have a list of criteria required to make a specific diagnosis. For example, to be diagnosed with Anorexia Nervosa, the patient must have and intense fear of gaining weight, refusal to maintain body weight at or above a minimally normal weight for age and height (85% of ideal body weight), disturbance in the way one's body weight or shape is experienced, and in postmenarcheal females, amenorrhea (the absence of at least three consecutive periods) (DSM-TR-IV).