What is OSFED: Other Specified Feeding or Eating Disorder?

Eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder are diagnosed under a list of symptoms from the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM5) that can leave many people out who may not have ALL the symptoms. According to Dr. Jennifer J. Thomas, co-director of The Eating Disorders Clinic and Research Program at Massachusetts General Hospital and co-author of Almost Anorexic, states that at least 1 in 20 people will show eating disorder symptoms that could be diagnosed as an OSFED- Other Specified Feeding or Eating Disorder.[1] Unfortunately, OSFED is a diagnosis that isn’t discussed as often as other eating disorders.

What is OSFED?

Questions still remain several years later after the DSM5 changed the classification for eating disorders that don’t meet the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder. The DSM5 changed Eating Disorder Not Otherwise Specified (EDNOS) to Other Specified Feeding or Eating Disorder (OSFED).

The change in classification from EDNOS to OSFED was significant.  It was realized that not everyone shared the same symptoms and therefore many people were getting placed into the same category, which was affecting their ability to access care and perform appropriate research. Eating disorder behaviours that weren’t previously included within EDNOS, such as purging disorder and night eating syndrome are now included under OSFED.[2]

These are examples of behaviours that are now diagnosed as OSFED subtypes:

  1. Atypical Anorexia Nervosa: Behaviours of anorexia but does not have low body weight.
  2. Bulimia Nervosa: Less frequent than what’s required to meet the criteria for diagnosing bulimia nervosa.
  3. Binge Eating Disorder: Less frequent and/ or limited duration.
  4. Purging Disorder: Contrast to bulimia nervosa, a person will purge but not binge.
  5. Night Eating Syndrome: Individual will eat very little during the day and then consume most calories in the evening or wake up in the middle of the night to eat.

How Common is OSFED?

OSFED is more common than previously believed. A study published last year in the Journal of Nervous and Mental Disease, took a look at eating disorders in adults between 18 and 75 years because most research on eating disorders has focused on adolescents. All of the participants in the study were seeking treatment for eating disorders. Almost 28% of the participants met the criteria for OSFED.

In addition, the study also revealed that those participants with OSFED may “struggle with more severe cognitive eating disorder-related symptoms and potentially more severe body image distortions” in comparison to other groups of the study who were of younger age.[3]

Characteristics of OSFED

Both males and females may develop an OSFED. People with OSFED share some common characteristics:

  • Intense fear of weight gain
  • Distorted body image
  • Overly conscious about their weight and body shape
  • Heightened anxiety or stress around food

A common misconception is that people with OSFED don’t have an eating disorder and therefore won’t seek eating disorder treatment. The truth is, OSFED can be just as serious as other eating disorders. In addition, similar health complications that are related to other eating disorders are also experienced with OSFED as a result of suffering with it for a long period of time.

If you know someone who may check off on some of the symptoms and signs of anorexia nervosa, bulimia nervosa or binge eating disorder but not all, it’s still crucial to get help. Give us a call to learn how we can help. Our calls are private and confidential: 416-495-0926.

WaterStone Clinic provides options that include outpatient treatment, residential stays and a concurrent addiction program. Our goal is to give clients the skills to build healthy, happy and meaning

[1] Massey, Alana. The Most Common Eating Disorder Is One You’ve Probably Never Heard of: BuzzFeed. February 24, 2015. Retrieved from: https://www.buzzfeed.com/alanamassey/osfed-hidden-eating-disorder?utm_term=.uoG44y3Rxo#.neMDDEYzWj

[2] Farrar, Tabitha. What is OSFED? Retrieved from: http://www.mirror-mirror.org/ednos.htm

[3] Barak-Elran, Roni PhD, et. Al. Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder in Midlife and Beyond. The Journal of Nervous and Mental Disease- Issue: Volumne 203(8), August 2015, p.583-590.