Other Specified Feeding or Eating Disorders (OSFED) is often recognized as a ‘blanket’ diagnosis that encompasses a range of symptoms that do not fit the diagnostic criteria for a particular eating disorder. Many individuals with OSFED are denied necessary treatment and insurance coverage as it is often seen as a “less serious” eating disorder diagnosis. Due to its lack of recognition, OSFED is potentially more serious and life-threatening than a full-threshold eating disorder.

By: Chella Po

Most people are familiar with anorexia nervosa, bulimia nervosa, and binge eating disorder, which get the most public health, clinical, and media attention of all eating disorders. However, a lesser-known diagnosis called OSFED is actually the most common eating disorder among adults and adolescents, thought to affect about 6% of the population or an estimated 32% to 53% of all people with eating disorders. OSFED stands for ‘other specified feeding and eating disorder,’ and is a catch-all term for a range of symptoms that fall under this broad but equally important category. Individuals with this diagnosis do not quite fit the specific criteria for the ‘main’ eating disorders set by the Diagnostic & Statistical Manual of Mental Disorders (DSM), but nevertheless still struggle with an illness that is just as serious, disruptive, and even life-threatening. 

Formerly known as ‘eating disorder not otherwise specified’ (EDNOS), OSFED is sometimes misinterpreted and overlooked as a “subclinical” or “subthreshold” diagnosis. Someone with OSFED may have parts of one eating disorder, and elements of another, so they may not think they have an eating disorder or that they are not “sick enough” to need help. Nonetheless, the impact on their physical and mental health is just as severe and disruptive, and requires the same level of professional treatment and support as the more well-known eating disorders. 

Usually, individuals with OSFED exhibit similar symptoms such as disturbed eating habits, intense fear of gaining weight, distorted body image, and a high level of anxiety or agitation around food and meals. Because OSFED has similar characteristics as the ‘main’ eating disorders, it can result in similar clinical manifestations and physical complications as well. The mortality rate is estimated to be 5.2 percent, higher than any other eating disorder, and thus warrants more attention.

Some examples of OSFED are listed below: 

• Atypical Anorexia Nervosa: All criteria for anorexia nervosa are met, except despite significant weight loss, the individual’s weight is within or above the normal range.

• Binge Eating Disorder (of low frequency and/or limited duration): All of the criteria for BED are met, except at a lower frequency and/or for less than three months.

• Bulimia Nervosa (of low frequency and/or limited duration): All of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behavior occurs at a lower frequency and/or for less than three months.

• Purging Disorder: Recurrent purging behavior to influence weight or shape in the absence of binge eating.

• Night Eating Syndrome: Recurrent episodes of night eating, excessive food consumption after an evening meal, and eating after awakening from sleep in the middle of the night. 

If you feel that you or a loved one may have an eating disorder, even without experiencing all symptoms for one disorder, it is important to remember that recovery is possible, and getting the support and treatment you need can help you begin living a healthy and satisfying life again.

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This post was written by BALANCE Dietetic Intern, Chella Po.

Chella is a graduate student pursuing her Master’s Degree in Clinical Nutrition at New York University. She received her Bachelor’s Degree from Boston College with a double major in Sociology and International Studies. Previously, Chella worked in philanthropy at a global non-profit organization focused on solving world issues by building trust and partnership. While living in busy New York City, Chella developed a passion for helping people live healthy lives through food and beyond. Originally from the Philippines, she hopes to make good nutrition and wellness more accessible in her home country. 

Resources

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OSFED Facts and Statistics. Eating Recovery Center Website. https://www.eatingrecoverycenter.com/conditions/osfed/facts-statistics. Accessed November 8, 2020.

OSFED Signs and Symptoms. Center for Discovery Eating Disorder Treatment Website. https://centerfordiscovery.com/conditions/osfed/. Accessed November 1, 2020.

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