An empirical analysis of eating disorder, not otherwise specified: preliminary support for a distinct subgroup

In recent years, there has been debate concerning whether distinct subgroups exist within the eating disorder, not otherwise specified (EDNOS) diagnostic category. One subgroup that has been suggested is binge-eating disorder (BED). While BED has received some research attention, relatively little is known about other possible subgroups within the EDNOS category. The purpose of the present study is to empirically investigate whether distinct subgroups exist within the diagnostic category of EDNOS.

Participants were 53 EDNOS patients who presented to psychotherapy clinics for treatment of an eating disorder. Information gathered from a clinical assessment, which included a clinical interview and self-report questionnaires, was used in the analyses of the study.

Using cluster analytic procedures, two subgroups of patients diagnosed with EDNOS were identified. The two subgroups differed from each other in terms of weight, binging, and body image variables. Specifically, the second subgroup (of 11 patients) appeared to be a distinct subgroup of overweight binge-eating patients, while the first subgroup appeared to be a heterogenous group of EDNOS patients. The overweight binge-eating subgroup was significantly higher in current weight, in reported highest adult weight, in reported higher lowest adult weight, and had more binges per week than the heterogenous EDNOS subgroup. Interestingly, the two subgroups did not differ in terms of self-reported purging and/or compensatory behaviors (e.g., vomiting and laxative use).

The results of the present study provide preliminary support for a distinct subgroup within the EDNOS diagnostic category. This subgroup resembles BED, with the exception of the presence of purging behaviors. The findings of the present study suggest the need to further investigate the exclusionary criteria of purging/compensatory behaviors for the BED diagnosis.