The dangers of eating disorders such as anorexia and bulimia are well-publicised. A number of high-profile public figures have even confessed to suffering from these illnesses themselves. Most recently, cricketer Freddie Flintoff revealed that he had secretly battled bulimia, and former sportswoman and Olympic reporter Clare Balding admitted to suffering from eating disorders while trying to remain the right weight to be a jockey.
However, new research suggests that the most dangerous eating disorder is one that is not well-known or even well-defined. That illness is EDNOS, which stands for 'eating disorder not otherwise specified'. It refers to those who suffer to some extent from an eating disorder but do not fully meet the criteria of, say, anorexia or bulimia.
Typically, when someone has EDNOS, they often appear healthy despite exhibiting symptoms of anorexia (drastically restricting their calorie intake) or bulimia (by purging after their meals). Most worryingly, EDNOS has a mortality rate of 5.2 per cent, which is higher than both of the more well-known eating disorders. Furthermore, up to 70 per cent of all eating disorders are classified under EDNOS.
ABC News recently reported on this illness and interviewed 20-year-old EDNOS suffer Taylor. The young woman said that she had been given a number of different diagnoses over the years.
"Originally I was diagnosed with bulimia," she told the source. "Then my symptoms didn't match bulimia. So then they diagnosed me as anorexia, binge/purge type, because there are two different types. And then I didn't meet the weight criteria for anorexia. So then they said, 'OK, you have EDNOS'. And I was like, 'Well, what is that?'"
One thing that EDNOS has in common with other specified eating disorders is the fact that many of the symptoms are to do with mental wellbeing as well as physical. Taylor described EDNOS or 'ED' as she nicknamed her illness as like having "a second person inside you".
"It's like your best friend but your enemy at the same time. It's hard to distinguish sometimes the ED talking and what's Taylor talking," she told ABC.
Douglas Bunnell, a US clinical psychologist, told the news provider that there is a danger of people underestimating the effect that EDNOS can have on the basis that the symptoms do not match up to certain criteria. Part of the problem is that there is a misconception that these are relatively benign disorders or "diets gone bad".
"These are life-threatening, serious illnesses. They have the highest mortality rate of any psychiatric diagnosis," he warned.
Indeed, there are a number of myths surrounding EDNOS, some of which can be extremely dangerous if they are believed. For example, many people think that giving sufferers an EDNOS diagnosis is less traumatic. However, it can be extremely damaging in that it might make them feel as though they are "not ill enough".
Furthermore, those who believe that EDNOS is not as severe as other eating disorders because of the less serious symptoms are wrong. Many examples of EDNOS are just as severe and can indeed be more harmful when they combine the calorie restrictions of anorexia with the purging of bulimia. EDNOS can also have long-term physical and mental effects, which is why help should be sought as early as possible.