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What is OSFED?

OSFED, which stands for Other Specified Feeding or Eating Disorder, is an eating disorder in which individuals may have symptoms of anorexia, bulimia or binge eating disorder, but the symptoms do not fit neatly into one diagnostic category.

Individuals with OSFED typically have extremely disordered eating habits, distorted body image, an intense fear of gaining weight and self-esteem tied to their shape or weight.

Though individuals with OSFED don’t meet the full criteria for a diagnosis of anorexia, bulimia or binge eating disorder, that doesn’t mean that OSFED is less serious or “not as bad” as other eating disorders. The psychological and medical consequences of OSFED may be just as great as for other categories of eating disorders. OSFED may also progress to anorexia, bulimia or binge eating disorder.

And as with all eating disorders, the sooner an individual with OSFED receives treatment, the more likely it is that he or she will achieve full recovery.

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Examples of OSFED

According to the American Psychological Association’s DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), OSFED includes feeding or eating behavior that causes significant distress and impairment in areas of functioning, but does not meet the full criteria for other feeding and eating disorders. These may include what are considered “atypical” or “subthreshold” disorders.

OSFED, which used to be called Eating Disorder Not Otherwise Specified (EDNOS), is the most common eating disorder diagnosed for men, women and adolescents. Many individuals with OSFED also have dual disorders such as depression, anxiety and trauma disorders.

The DSM offers five examples of OSFED:

  • Atypical anorexia nervosa: The individual has nearly all of the symptoms of anorexia, except weight is still within or above the normal range despite weight loss.
  • Binge eating disorder of low frequency and/or limited duration: All of the criteria for binge eating disorder 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 are met, except that the binge eating occurs at a lower frequency and/or for less than three months.
  • Purging disorder: Recurrent purging to lose weight, without binge eating.
  • Night eating syndrome: Repeated episodes of consuming large amounts of food at night or after awakening from sleep. Night eating syndrome isn’t occasional late night snacking; individuals with night eating syndrome often consume 25% or more of the daily caloric intake during night eating sessions.

The DSM also has a category called Unspecified Feeding or Eating Disorder (UFED), for individuals with disordered eating that don’t fit the criteria for anorexia, bulimia, binge eating disorder or OSFED. Whatever the specific diagnosis, all of these conditions are highly treatable, but can cause serious emotional and psychological suffering if allowed to continue.

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Complications of OSFED

The complications of OSFED are the same as for other eating disorders. Eating disorder complications can impact every organ and system in the body – the brain, bones, heart, hair, skin, stomach, kidneys, liver and teeth, among others. Complications may include:

  • Irregular heartbeat
  • Iron deficiency (anemia) and other vitamin and mineral deficiencies
  • Malnutrition
  • Heart failure
  • Kidney infection/failure
  • Liver failure
  • Osteoporosis
  • Weakness & fatigue
  • Hair loss
  • Lanugo
  • Dental erosion & decay
  • Amenorrhea (absence of menstruation), decreased fertility
  • Dehydration, electrolyte imbalance

Warning Signs for Anorexia

  • Dramatic weight loss, hiding weight loss.
  • Intense fear of weight gain and extreme behavior to prevent weight gain, even if very thin.
  • Refusing to eat certain foods or whole categories of foods.
  • Intense focus on weight and body image.
  • Secretive about eating habits.
  • Rituals around eating.
  • Maintaining an excessive, rigid exercise schedule.
  • Changes in personality or social withdrawal, no longer finding enjoyment doing activities once enjoyed.
  • Inability to appreciate the severity of the situation.
  • May include food restriction only, or may also include binging and purging.

Warning Signs for Bulimia

  • Frequent episodes of consuming very large amount of food followed by self-induced vomiting, excessive exercise or laxatives.
  • A feeling of being out of control during the binge eating episodes.
  • Intestinal problems, such as constipation.
  • Swollen glands in the neck.
  • Damaged tooth enamel.
  • Dehydration.

Warning Signs for Binge Eating Disorder

  • Frequent episodes of consuming very large amounts of food.
  • A feeling of being out of control during the binge eating episodes.
  • Feelings of guilt or embarrassment after binge eating.
  • Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.

Help for OSFED

If you or someone you know may have OSFED, please contact us for a confidential consultation. Our team is experienced in treating patients with eating disorders and co-occurring conditions

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