Eating Disorder not Otherwise Specified (EDNOS)


Overview


Eating Disorder not Otherwise Specified (EDNOS) is defined by the Diagnostic and Statistical Manual (DSM) of Mental Health as a “types of disorders of eating that do not meet the criteria for any specific eating disorder”[1] . The three main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating, as proposed by the DSM 5th edition”[2] . Essentially EDNOS is certain eating patterns and behaviors that are a detrimental to an individual’s overall health, but do not ‘fit’ the clinical standards and definition of a specific eating disorder (ED).

According to the National Alliance on Mental Illness, a few examples of EDNOS are: all of the criteria for Anorexia Nervosa are met except the individual has regular menses or all of the criteria for Anorexia Nervosa are met except, despite substantial weight loss, the individual's current weight is in the normal range[3] .

There are a multitude of factors that influence the development and persistence of eating disorders and EDNOS, including, but not limited to; interpersonal, biological, social, and psychological factors. According to the Alliance for Eating Disorders Awareness: More than 90 percent of those who have eating disorders are women between the ages of 12-25, in the US. Annually, at least 50,000 individuals will die as a direct result of their eating disorder, according to Substance Abuse and Mental Health Services Administration[4] [5]

Health Impact


In the US, EDNOS typically develop during adolescence or early adulthood but can occur at any time throughout a person’s life. EDNOS is far more common in females; however, males exhibit the binge eating symptom of EDNOS more frequently [6]
Since EDNOS has not been studied as extensively as EDs, like anorexia and bulimia, it is more difficult to determine the prevalence of this disorder among different race/ethnicities and socioeconomic statuses.

EDNOS can lead to low blood pressure, slower heart rate, disruption of hormones, bone growth, loss of electrolytes, sudden death, perforation of stomach, an array of oral systemic issues such as loss of enamel, perimolysis, candidiasis [7] , to list a few.
The importance of understanding the cause of EDNOS is significant because the long term mental effect can become permanent. These individuals do not receive treatment are not properly diagnosed to the lack of understanding and knowledge associated with EDNOS. Therefore, as a result the emotional outcome for these individuals can be very detrimental to their mental health status.

Medical Anthropology Research


Not many anthropologists are tackling the issue of EDNOS, especially in the US, however, there is some research being conducted regarding the globalization of Eating Disorders and the impact that westernization and the spread of western media has impacted the meaning of beauty in other cultures, thus leading to the rise of EDs and EDNOS among females around the world[8].Other research has examined how EDNOS can be constructed as an anthropological configuration where “personal structure which is characterized by a vulnerability of the identity dialectic between ‘self/other-than-self ‘” [9]

Goodlin has explored “the embodied process of being anorexic and the moral repertoires within which this process is entangled”. Goodlin utilizes ethnographic methodology to understand these processes and lived experiences. By understanding the phenomenology of anorexia as an embodied experience will contribute toward extending the overarching conceptualization of the ways in which “culture” becomes present and embedded in anorexia [10] .

Applied Work


The current research being conducted is limited to just eating disorders and these methods and theoretical lenses could be applied to further understand the perceptions and underlying causes of EDNOS. There has been a multitude of research, from many different disciplines, regarding EDs, the causes, interventions and treatment options. Since specific diagnosis standards are in place to diagnose EDs, there are easily and more readily diagnosable than EDNOS. However, medical anthropologists have a specialized ability to approach these issues from an interdisciplinary perspective. Furthermore, anthropologists have a unique ability, and certain skill set, which could lead to a deeper understanding of the causes of EDNOS. In turn these findings to be used to provide recommendations or a profile of individuals prone to EDNOS for better diagnosis and access to treatment.

Online Resources


The following links provide more information about EDNOS.

www.nami.org

www.something-fishy.org/whatarethey/ednos.php

www.eatingdisordersonline.com/explain/ednos.php

Further Reading


Edquist, Kristin. “Globalizing Pathologies? Eating Disorders and the Global Deterritorialization of Authority.” Paper presented at the annual meeting of the Western Political Science Association, Marriott Hotel, Portland, Oregon Online. 2009-05-26

Makino, Mariko, Koji Tsuboi, and Lorraine Dennerstein. “Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.” MedScape Today. September 27, 2004

Becker, A. E. (2004, December). New Global Perspectives on Eating Disorders. Culture, Medicine & Psychiatry. pp. 433-437. doi:10.1007/s11013-004-1063-9.

References



  1. ^ Fairburn, C. G., & Bohn, K. (2005). Eating disorder NOS (EDNOS): An example of the troublesome "not otherwise specified" (NOS) category in DMS-IV. Behavior Research and Therapy, 43(6), 691-701
  2. ^ http://www.disordered-eating.co.uk/eating-disorders-statistics/eating-disorders-statistics-us.html
  3. ^ http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=65849
  4. ^ http://www.idph.state.il.us/about/womenshealth/factsheets/eat.htm
  5. ^ http://www.eatingdisordersonline.com/explain/ednos.php
  6. ^ http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=372#
  7. ^ Goldbloom DS, Kennedy SH. 1995. Medical Complications of Anorexia Nervosa. In Brownell, KD, Fairburn CG, eds. Eating Disorders and Obesity: A Comprehensive Handbook. New York: The Guilford Press,:266-270
  8. ^ http://www.globalization101.org/globalization-and-eating-disorders-2/#.T3UXTIOfP7E.gmail
  9. ^ Brogna, Patrizia, and Emanuele Caroppo. 2010. The body as a simulacrum of identity: the subjective experience in the eating disorders. Annali dell'Istituto Superiore di Sanità 46:427-435.
  10. ^ Gooldin, S. (2008). Being Anorexic: Hunger, Subjectivity, and Embodied Morality. Medical Anthropology Quarterly, 22(3), 274-296