Disordered eating can be deadly, even if your habits don’t qualify as anorexia or bulimia. In fact, the deadliest eating disorder is the one that most people haven’t even heard of.
An estimated 52 percent of eating-disorder sufferers have what’s called Eating Disorder Not Otherwise Specified, or EDNOS, according to the National Association for Anorexia Nervosa and Associated Disorders. And although it’s the least commonly known ED, the mortality rate for EDNOS is highest of all eating disorders—5.2 percent of people who suffer from EDNOS ultimately die from it.
“The problem is people think that EDNOS means ‘eating disorder that’s not as bad,’” says Carolyn Costin, MFT, Executive Director of Monte Nido and Affiliates, a treatment center for eating disorders. “EDNOS is actually quite lethal, because it is underdiagnosed and undertreated,” Costin says.
The problem is that people who suffer from EDNOS tend to exhibit an atypical combination of disordered eating issues — like both fasting and purging, resulting in severe malnutrition. Or EDNOS sufferers could exhibit standard ED behaviors, but have body types that disqualify them from diagnosis: “You may have all the symptoms of anorexia, but your BMI is still in the healthy range or you are still menstruating, so you won’t be diagnosed,” Costin says. Because the symptoms are so varied from one patient to the next, doctors have a harder time settling on a diagnosis.
However, there is hope for sufferers when EDNOS is recognized early. “It can be worse than other EDs, but it also can be caught in the preliminary state before it becomes a full-blown eating disorder,” Costin says.
Take a look at the signs below, and seek help if you identify with any of them—your life could depend on it.
You may have EDNOS if:
Your diet is rigid
Daily food intake is ritualistic, and your dieting rules are rigid; maybe you only allow yourself to eat after 5 p.m., or eat the same six foods everyday.
Your diet interferes with your life
You won’t go out to dinner, because you aren’t comfortable eating any of the meals on restaurant menus, or you skip out on plans to fit in a workout.
Your diet raises eyebrows
The people closest to you mention you’ve lost too much weight, say you work out too much or point out strange food habits, like avoiding specific restaurants or food groups.
Your diet is at the forefront
You spend most of the day thinking about food; what you can eat, when you can eat next, and what’s in each dish. You may spend hours researching menus and totaling up calories.
Your diet isn’t a choice
Could you change your diet behavior? Is what you eat truly a choice? If you’ve gone vegan in the name of better health, but find you actually can’t make yourself eat a cookie, you may have EDNOS. “Some people feel obligated in their brains to eat certain foods and avoid others,” Costin says. “It’s a driven, obsessive-compulsive behavior. Asking yourself if you can eat that cookie is a good strategy. I need to see that you can allow yourself to eat a certain food.”
HOW TO GET HELP:
If you notice any of these behaviors, seek help. Check out EDreferral.com for treatment centers and eating-disorder professionals in your area, and see NationalEatingDisorders.org for more information. Also, take the pressure off labels. “Think about it as disordered eating, if that’s helpful,” says Costin. “Don’t worry about diagnosis or criteria. Just begin to talk to someone.”
More from WH:
Adult Eating Disorders
5 Eating Disorders You Haven’t Heard Of
Your Relationship With Food: Is It Healthy?
