when a label means nothing

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?


3 responses to “when a label means nothing

  1. I’m diagnosed with ED-NOS. I used to be anorexic but I am no longer classed as that as my BMI is “healthy” and I now purge more than restrict.

    I can understand the almost competitive nature of which you write. But one thing I’d like to say is that this competitiveness and feeling of not being “ill enough” exists throughout eating-disorders, even when I was in hospital due to anorexia I still did not believe I was “ill enough” to get help…
    Though in many ways I think this element of validation exist in all aspects of mental health, people seem to think some disorders are worse than others, some peoples pasts are worse than others, etc, and so feel their own “issues” are not worthy of help… it is a serious issue 😦 and I am not sure how to address it… how do you convinse people that they DO deserve help and support? and that severity of actions does not nessesarially correlate with level of pain

    • I definitely understand your comment on competitiveness and think you hit it right on. I’m sorry if I miswrote, but that trait sweeps across all disorders.
      I don’t if you can truly convince someone to get the help they deserve or that they are sick enough until they see it through their own eyes. It’s one of those, you can talk until you’re blue in the face, but until they believe there needs to be a change, it won’t happen.
      I’ve been trying to help a friend through recovery the last year and finally during Christmas break, her doctor said something and it clicked. She wanted to get better. Now everyday isn’t perfect, but it’s the feeling of wanting to be better that she can build off of.
      I know I’m just one person you don’t know, but I hope whether you’re anorexic or Ednos, you’re getting the help you need. You do deserve your health and happiness to follow your dreams 🙂

  2. Very appropriate that this was the first post I happened to comment on here on your blog. I could speak endlessly on this topic, though I consider myself a very atypical case of “recovered” anorexic.

    I would never have admitted that I was anorexic at the time, but I had to go through all that sort of treatment–weigh in’s and psychiatrist and nutritionist appointments. At my lowest I was 98 lbs, which I think was when it really hit me that I had to stop. But my problem wasn’t that I starved myself (although if I ate the way I did then right now, I would definitely feel like I was starving!)–moreso I just forgot what it was like to eat to maintain. I ate vegetables and non-fat cottage cheese constantly, nothing I ate had any fat in it, everything I ate was “diet” food.

    To this day, it’s hard for me to say what made me get better (although I did explore this in a psychology paper last semester, I can email it to you if you like). Probably the biggest thing for me was setting up a realistic eating plan with my nutritionist, who focused not on calories but sort of like food group points. I was really scared to put on a lot of weight really quickly, and she made it so that wouldn’t happen. She actually preferred that I gain back weight slowly.

    Eventually, once I was at a relatively healthy weight, I realized I could eat normal amounts of food and not get huge like I always imagined I would. I had slips here and there where I went back into restricting, but generally I would only say I was in the “danger zone” for about a year. It’s funny because I can’t really pinpoint how or why or when I stopped obsessing over what I ate. It was gradual.

    Anyway, I now live a life completely not controlled by my eating disorder, though I know it’s always going to be there. I try to focus on eating good food that is nutritious and consequently have actually gained back more weight than I would have desired. But, I feel OK about this, it doesn’t rule my life, but it does bother me sometimes.

    I’m not even going to lie, sometimes, I have fleeting moments where I wish I had the ‘control’ that I used to. But then I remind myself that control was really just my compensating for a lack of control that I felt in other areas.

    Anyhow, let me know if you ever need someone to interview for any of your independent study work. I’m a pretty open book.

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