OSFED: The “Other” Eating Disorder Diagnosis
Do you restrict what you eat to small quantities and a narrow variety of foods, but you aren't sure If it's anorexia? Do you wake up frequently, feeling you need to eat before you can go back to bed? Do you purge without binge eating? If you are experiencing eating disorder behaviors that don’t quite fall into the categories of Anorexia Nervosa, Bulimia Nervosa, or Binge Eating Disorder, you may have a condition that is classified as Other Specified Feeding and Eating Disorder (OSFED). Formerly known as Eating Disorder Not Otherwise Specified (EDNOS), OSFED was developed to encompass conditions that did not meet diagnostic criteria for Anorexia Nervosa or Bulimia Nervosa but were still significant feeding or eating disorders (American Psychiatric Association, 2013).
Some examples of OSFED include:
- Atypical Anorexia: when someone meets many, but not all, of the diagnostic criteria for anorexia nervosa. For example, an individual might be restricting food intake but may not meet the low weight criteria.
- Bulimia Nervosa of low frequency and/or limited duration: when an individual binges and purges with less frequency than required for a diagnosis of Bulimia Nervosa.
- Binge Eating Disorder of low frequency and/or limited duration: when someone binges less often than typically seen in Binge Eating Disorder.
- Purging Disorder: when an individual engages in purging but does not engage in binge eating.
- Night Eating Syndrome: frequent waking and eating. Can also be when a person engages in excessive food consumption during nighttime.
The warning signs of OSFED are similar to those of other eating disorders and may include:
- Skipping meals
- Developing food rituals
- Weight loss
- Preoccupation with food, weight and body image
- Excessive exercising
- Social withdrawal
- Muscle weakness
- Sleep problems
Because OSFED houses a variety of eating disorders, it is often misunderstood and seen as less severe than other eating disorders. However, OSFED is actually the most common category of eating disorders, “represent[ing] an estimated 32% to 53% of all individuals with eating disorders” (“OSFED: The Other Eating Disorder,” 2018). In addition to being common, it also has a higher mortality rates than Anorexia and Bulimia. (Crow et al., 2009).
The health consequences of OSFED depend on the specific disordered eating behaviors present. So, it is typically recommended that OSFED treatment closely mimic the treatment for the eating disorder it is the most similar to. For example, if a patient suffers from Atypical Anorexia, the treatment used would be similar to treatment used for Anorexia Nervosa. As with any eating disorder it is recommended that those experiencing symptoms work with a specialized team consisting of a therapist and dietician and seek treatment as soon as possible. If you or someone you know is experiencing symptoms of OSFED, please reach out to us at 1-888-363-5977. We would be happy to be a part of your recovery.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing
Crow, Scott J., et al. (2009). “Increased Mortality in Bulimia Nervosa and Other Eating Disorders.” American Journal of Psychiatry, vol. 166, no. 12, pp. 1342–1346., doi:10.1176/appi.ajp.2009.09020247.
Muhlheim, L., & Gans, S. (2018, January 20). OSFED: The Other Eating Disorder. Retrieved from http://www.verywellmind.com/osfed-the-other-eating-disorder-1138307
Other Specified Feeding or Eating Disorders. (n.d.). Retrieved from http://www.nedc.com.au/eating-disorders/eating-disorders-explained/types/other-specified-feeding-or-eating-disorders/.