OSFED: Understanding the Overlooked Eating Disorder and Its Impact

OSFED, or Other Specified Feeding or Eating Disorder, is a classification within the spectrum of eating disorders used to identify individuals who experience significant eating-related issues that do not meet the full criteria for disorders like anorexia nervosa, bulimia nervosa or binge eating disorder. 

This category was established to ensure that those who exhibit serious symptoms of eating disorders, but do not meet the diagnostic criteria for the more commonly known categories, still receive appropriate diagnosis and treatment.

What is OSFED?

OSFED (Other Specified Feeding or Eating Disorder) is a special title for a disorder that does not meet the diagnostic criteria for other specific eating disorders like bulimia, binge eating or anorexia. But that does not mean that those suffering from OSFED have a clinically less significant disorder.

According to the National Eating Disorder Association, “Research into the severity of OSFED shows that the disorder is just as severe as other eating disorders based on the following:

• Adolescents with OSFED were just as likely to be hospitalized as adolescents diagnosed with anorexia nervosa.
• Individuals diagnosed with OSFED exhibit similar eating disorder symptom severity and cognitive, genetic and environmental risk factors to anorexia nervosa, bulimia nervosa and binge eating disorders.
• People with EDNOS/OSFED were just as likely to die as a result of their eating disorder as people with anorexia nervosa, bulimia nervosa, or binge eating disorder. Furthermore, one study found that approximately 33% of the deaths attributed to eating disorders were associated with OSFED, higher than any other type of eating disorder.”

The creation of OSFED highlights the complexity and diversity of eating disorders. People with OSFED may exhibit a mix of symptoms from different eating disorders, or they may experience symptoms at a lower frequency or intensity than is required for a full diagnosis of a specific disorder. Despite the variation, individuals with OSFED often suffer from significant distress and impairment in daily functioning, making it crucial to acknowledge and address their condition.

How does OSFED manifest?

OSFED can manifest in numerous ways, reflecting the varied nature of eating-related issues. Some common presentations include:

1. Atypical anorexia nervosa where individuals may exhibit all the symptoms of anorexia nervosa, such as intense fear of gaining weight and restrictive eating, but without the low body weight criterion.

2. Bulimia nervosa of low frequency and/or limited duration which involves engaging in binge eating and purging behaviors, but at a frequency or duration that is less than what is required for a full diagnosis of bulimia nervosa.

3. Binge eating disorder of low frequency and/or limited duration which is similar to bulimia, but involves episodes of binge eating without compensatory behaviors and occurs less frequently than required for a full diagnosis.

4. Purging disorder which includes purging behaviors, such as vomiting or misuse of laxatives, in the absence of binge eating.

5. Night eating syndrome, which is characterized by excessive eating at night, leading to sleep disturbances and possibly unwanted weight fluctuations.

Since each of these different manifestations are unique in that they cause deep anxiety among individuals, recovery programs designed to address all forms of disorders – both common and rare – are needed. 

What are signs of OSFED? 

Because OSFED is an eating disorder that does not meet the diagnostic criteria of any other eating disorder, it has a wide range of signs. If you are concerned about a loved one, or are worried you yourself are slipping into unhealthy behaviors, it is important to know the signs of OSFED to be able to identify its present. 

Signs of this disorder include:

• Obsession with weight/calories – A serious preoccupation with weight loss and trying to not eat many calories is a primary sign of OSFED. Restricting foods like carbs, drinking low calorie beverages and cutting out entire food groups just to lose weight can all be additional signs.
• Attitude changes – Behavioral changes such as wearing baggy clothes, withdrawing from friends and activities, never being hungry and mood swings are all indications of OSFED. Compulsive exercise and always being exhausted can be signs as well.
• Seeing signs of binging and purging – A pattern of binge eating and purging is very common for people with OSFED. Signs of binge eating include lots of empty wrappers, packaging or containers. Purging behaviors may include the use of laxatives or diuretics and frequent trips to the bathroom. Teeth problems such as cavities, a swollen jaw, and excessive use of gum and/or mints can also be signs of purging.
• General physical signs – There are many overt physical signs linked to this eating disorder. Examples such as dizziness, fainting, difficulty concentrating and brittle hair/nails are all associated with nutritional deficiencies which is a key issue of OSFED.
• Difficulty retaining body heat – While there are a range of different physical signs, trouble keeping warm is a very common one. Cold extremities, dressing in layers and complaints of not being able to warm up can mean a lack of body fat from malnutrition.

While one of these symptoms by itself may not point to OSFED, combined signs could be a strong indicator of this eating disorder. 

Do you need help identifying and treating OSFED?

If you have noticed behaviors linked to OSFED, have struggled with mental health surrounding food and are ready to start recovering, Seeds of Hope is here to help. Contact us today to get started by filling out an online contact form or giving us a call at (610) 268-9245.