Food for Thought: What is an Eating Disorder?

| 6/4/2010 2:38:34 PM

Stephanie Small

Stephanie Small is founder of Three Sisters Nutrition, a phone-based practice helping women improve their relationship with food, and blogs for holistic weight loss site 9 Weight Loss.

These days it seems as though most women have some sort of problematic relationship with food and their bodies. They may avoid carbs, fat, or calories. Perhaps they’re in the gym three hours a day to burn off their breakfast, or they’re vomiting, or using appetite suppressants. Perhaps they look in the mirror and see a large, bloated stomach and monstrous thighs while in reality an average or even slim build is reflected.

Some restrictive behaviors can be normal for the health-conscious. But when does it cross the line? How do you know if your behaviors are cause for concern?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV),  the American Psychiatric Association’s guidebook, describes eating disorders as “severe disturbances in eating behavior.” While anorexia nervosa is characterized as “a refusal to maintain a minimally normal body weight,” the hallmarks of bulimia nervosa are “repeated episodes of binge eating followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.” The DSM-IV goes on to list many other features of each disorder, as they are not one-dimensional.

An “Eating Disorder Not Otherwise Specified”  (EDNOS) is indicated when someone engages in a few, but not all, of these behaviors. For example, if your cousin eats very little, is afraid of gaining weight, and has irregular periods, yet remains within a normal weight range, she likely falls under this category. Similarly, your friend who binges without purging also may have EDNOS.