OSFED refers to Other Specified Feeding or Eating Disorder and this is a classification given to a person who does not present with symptoms that would place them in another category of eating disorder such as anorexia nervosa or bulimia nervosa. This is a more recent change in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, reference guide for medical professionals to use to diagnose psychiatric disorders) under the categorization of eating disorders.
OSFED vs EDNOS
In previous editions of the DSM, anyone who presented with symptoms of an eating disorder that were not typical of one of the two primary eating disorders were diagnosed under the classification of Eating Disorder Not Otherwise Specified or EDNOS. This way, a person who presents with symptoms of an eating disorder could receive treatment for one despite their eating disorder not fitting into the classical models. A good example is person who presented with many symptoms of bulimia but was purging less frequently than required to receive a diagnosis of bulimia. This person would have then been diagnosed with EDNOS.
What happened originally was that any disorder that was not anorexia nervosa or bulimia nervosa was lumped into the same category of EDNOS. However, since then, this category has continued to be further differentiated. For example, Binge Eating Disorder was once diagnosed as EDNOS and is now in its own classification in the DSM-5. More recently, purging disorder and night eating syndrome have been recognized as examples of disordered eating behaviors that should be included within OSFED. Due to the changes that were made in the DSM-5 manual recently, we have changed the name of this page from EDNOS to OSFED
The following are some examples of presentations that would be given a diagnosis of OSFED:
- Atypical Anorexia Nervosa – The person would present with the behaviors of anorexia but without the low body weight.
- Bulimia Nervosa of lower frequency than required to meet a diagnosis of Bulimia Nervosa.
- Binge Eating Disorder of lower frequency than required to meet a diagnosis of Binge Eating Disorder
- Purging Disorder – Unlike bulimia nervosa, sufferers purge without bingeing.
- Night Eating Syndrome – People who eat abnormally low amounts during the day but eat a lot at night.
OSFED is the most common eating disorder and can be suffered by both males and females. Sufferers usually show very disturbed eating habits and an intense fear of weight gain; some have a distorted body image and are overly conscious about their weight and body shape. Physical signs may include weight loss, dehydration, a compromised immune system due to nutrient deficiency and amenorrhea (absence of a menstrual period) in females. Psychological signs can include a preoccupation with food and body shape, dissatisfaction with body shape and weight and heightened anxiety levels or stress around mealtimes. Dieting behaviors, eating food at unusual times or waking up in the night to eat, compulsive exercising and obsessive or ritualistic behavior regarding food and eating are also warning behavioral signs of OSFED.
People suffering from OSFED can experience similar complications to those that are diagnosed with other eating disorders. Kidney failure, osteoporosis, irregular heartbeat, decreased fertility and inflammation of the esophagus are all potential problems for those that suffer from long term OSFED.
Some people hold the mistaken belief that OSFED is always less serious and sufferers sometimes feel less entitled to receive help than those who meet full criteria for anorexia or bulimia. But OSFED can be every bit as serious as anorexia nervosa in the areas of eating pathology, physical complications, and other mental health problems such as depression and anxiety. If you or a loved one meets some but not all of the criteria for anorexia, bulimia, or binge eating disorder, it is still important to seek help. Similarly, if a medical professional has told you that your problems are not severe enough to warrant help, do not stop there.
Treatment For Other Specified Feeding or Eating Disorders
Recovery is possible and the sooner that treatment is given the easier and faster full recovery usually occurs. That is not to say that it is ever too late to seek treatment, as even long-term sufferers can make a full recovery. Treatment for OFSED typically is similar to that of whichever eating disorder the person presenting with OSFED most closely resembles and should be given by a professional or team of professionals that is experienced in treating eating disorders.
It is important to reiterate that all eating disorders are serious, potentially deadly and have long term complications it they remain untreated. All classifications of eating disorders, from anorexia nervosa to OSFED may be life threatening and all should be treated immediately. If you are concerned that yourself or someone that you know is suffering from OSFED it is vitally important that professional treatment is sought.
- Orthorexia Nervosa – This is a condition in which a person obsesses about eating a healthful diet. They may eat a very limited range of foods due to concerns about the healthfulness of various food items, so they may develop nutritional deficiencies. This may also lead to excessive weight loss.
- Diabulimia – People with diabetes who do not take insulin, or take less insulin then they should in an attempt to control their weight.
- Muscle Dysmorphia – This new form of eating disorder primarily affects men. Also called bigorexia or reverse anorexia, it is a pathological obsession with extreme dieting and muscle building.
- PICA – People with pica eat substances with no nutritional value. Examples include clay, coal, hair, paper, pottery, wood…
- ARFID – Avoidant/Restrictive Food Intake Disorder is where a person has an issue with certain foods. Reasons can include texture, color, etc. It also includes people that are afraid to eat, or are very slow eaters.
- Drunkorexia – Occurs when people eat less during the day to compensate for the calories they will consume later by drinking. They do this to avoid weight gain.
- Sleep Eating Disorder – This is a condition in which people eat when they are asleep. It’s similar to sleep walking. In some instances, people that eat while asleep eat strange foods, like raw meat, or non-food items like soap or dirt. It’s technically considered a sleep disorder, not an eating disorder, but people with other eating disorders may also suffer from sleep eating disorder.
- Emetophobia – This phobia is an intense fear of vomiting. Some emetophobics restrict their food intake and develop anorexia nervosa.
Written by Tabitha Farrar – 2014
Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem? (The Almost Effect) by Ph.D. Jennifer J Thomas and Jenni Schaefer