I’m not sure you know about this article that was run in the NYTimes last week. It’s about Ednos and has gotten quite the commentary following it, in a good way should I add, and even though I was diagnosed when I sick, I know many people who had Ednos and they didn’t know what to do.
I decided to add my thoughts about it as well as part of a conversation I had with Estela yesterday on Michelle Obama’s fight to end childhood obesity.
As it states in the article, Ednos (or “Eating disorder not otherwise specified”) is diagnosed more than anorexia or bulimia to about 4% of women a year. It remains to be the most common eating disorder and includes binge eating disorder, purging disorder (either physically or through exercise), night-eating syndrome, chewing and spitting and even picky eating.
I think this quote helped to sum up an eating problem well: “The eating has to be disordered in some way, as does the behavior relating to eating.” Behavior is the key part in having and treating an eating disorder. It’s not about the food itself, but a means to control an area of your life and using it as a coping mechanism instead of other activities.
Just because someone is not specifically diagnosed with anorexia or bulimia doesn’t mean they don’t have a problem. In fact some bulimics, or even others who suffer, can be a healthy weight and look fine.
An example that was used in the article was Kris Shock who used laxatives and restricted her food for years, but never purged and maintained a healthy weight, but until she was addicted to ephedra, she believed she wasn’t “sick enough” to get help.
“If you’re restricting yourself so much that it affects your work negatively, you might the criteria for Ednos.” But what should also be mentioned is restriction isn’t always about the food either. It can be restriction from activities, class, or anything throughout the day.
At the same time, people with Ednos are just as apt towards the same health problem as anorexics and bulimics including heart attacks, horomone and chemical imbalances and even death.
“A lot of patients feel a stigma if they know they’re diagnosed with Ednos: ‘Obviously, I’m not good enough to be anorexic.’ I’ve had many patients feel that they need to lose more weight so they lose their period so they can change the diagnosis. Patients really feel they have to get ‘better’ at their eating disorder to deserve treatment.”
This is so sad, but so true too. I’ve known people in recovery who still don’t believe they’re sick enough to get better. That someone’s always sicker and so they’re not a good enough ‘anorexic’ or ‘bulimic’ yet. Unfortunately though, those disorders aren’t the only ones to focus on as we’ve seen. But this article points out that the definition for Ednos is too big now and the American Psychiatric Association will be overhauling the definition for the next edition of the D.S.M.-5, or diagnostic manual, in 2013. Thank goodness!
(For other information on Ednos, click here!)
“Think about the diagnosis of depression. When does someone have a clinical syndrome versus a mood fluctuation? At what point should it be regarded as a condition that needs treatment? When you talk about food habits, it become extraordinarily complicated, because everybody has a relationship with food, and it’s usually a somewhat complicated one.”
But some doctors think, and I agree, that weight requirements should be completely eliminated from the diagnosis of any eating disorder. It’s a common trend throughout the fashion and eating disorder industry: numbers. The number of a size label of a dress, the number on the scale, a BMI number, a percentile number for weight and age, etc. Everything has a number. Well a numbers great, but it doesn’t show anything more than that number. It doesn’t show health, attitude or mental capacity which are the main things that differentiate one person from another, whether they’re healthy or sick.
Which leads me into part of the talk I had with Estela yesterday. Childhood obesity and obesity in general, for that matter, is a huge topic swirling around with healthcare reform right now. The idea is if we deal with obesity then other chronic illnesses and diseases that stem from someone who’s overweight will decrease. I definitely understand that, but coming from the other side, I feel that if you address the one extreme, we must address the other.
Eating disorders are a behavior. Changing the lifestyle of someone who’s obese is a behavior. But also, what we’ve learned in this article, binge eating disorder is an eating disorder as well as a few others that could cause someone to be obese. Part of obesity can be from genetics. The rest is behavior. Some are too thin in hopes of vanishing and not be looked at. Some get too big for the same desire to not be looked at and ignored.
If we want to establish a happy medium for everyone, addressing the two sides will get us there because healthy isn’t a number, just a lifestyle and a care about yourself. Because too, we wouldn’t want people going from other extreme to the next which could happen if the reasons behind the behavior aren’t talked about. Following? What do you think?
Have you ever been diagnosed with Ednos or had disordered eating? What helped you get better?