Many of the chapters throughout the book attempt to provide alternative approaches to clarifying the residual eating disorder not otherwise specified category. One of the most significant problems with DSM-IV has been that as many as 60% of eating disorder patients fall into the eating disorder not otherwise specified category. The chapters in section 1 explore the limitations of the current criteria for eating disorder diagnoses, including disordered cognitions, fear of weight gain, and frequency thresholds of behaviors for diagnosis. In chapter 4, Hilbert et al. explore the validity of binge size in binge eating disorder and examine objective bulimic episodes relative to subjective bulimic episodes. The experience of loss of control while eating is discussed by Field et al. (in chapter 6) as a critical factor in binge eating disorder and bulimia nervosa. They also discuss the likely lowering of the threshold from twice a week to once a week for binge eating disorder and bulimia nervosa episodes. The second section includes studies that confirm and validate aspects of the current eating disorder classification systems but also point out challenges in classifying individuals who currently fall into the default category of eating disorder not otherwise specified. Other possible approaches to classification are defined. In chapter 7, Crosby et al. note that while the primary purpose of DSM-5 is “to inform clinical practice, the diagnostic criteria specified in these systems are also often used in research” (p. 91). In the third section (in chapter 12), a group of clinicians and researchers from the Workgroup for Classification of Eating Disorders in Children and Adolescents (Bravender et al.) discuss the importance of “modifications to adult defined boundaries of illness” (p. 169), developmental considerations, lower thresholds, and shorter durations of symptoms for diagnoses. In chapter 13, Chatoor et al. suggest differentiation of eating disorders in infancy and early childhood into five categories: sensory food aversion, infantile anorexia nervosa, posttraumatic feeding disorder, feeding disorder associated with a concurrent medical condition, and oral motor feeding disorder.