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Other specified feeding or eating disorders (OSFED) was created as a catch-all category to describe conditions with signs and symptoms similar to—but not the same as—clinically defined eating disorders.
Since the term can be so broadly applied, OSFED is actually considered one of the most common eating disorder diagnoses. And, while more vague in their presentation, symptoms of this condition can be just as life-threatening as those involved in other eating disorders.1,2
OSFED is an umbrella term, but within the designation, there are several more recognized or typical disordered eating patterns. Other specified feeding or eating disorders can also be used to describe someone whose behaviors resemble those of established eating disorders but don't check every box needed for a clinical diagnosis.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official list of all recognized mental health conditions, OSFED can present in many ways, including:1
Atypical anorexia nervosa (AAN): When a patient meets most criteria for anorexia nervosa, such as having an intense fear of gaining weight and missing menstrual cycles, but other criteria, such as extremely low body weight, are not met.
Purging disorder: This designation meets most criteria for bulimia nervosa, such as attempting to lose weight by vomiting or using laxatives, enemas, or diuretics, but without binge eating.
Night eating syndrome: Night eating syndrome occurs when an individual wakes up from sleep and binge eats, but night eating is not explained by substance abuse, shift work, or other sleep/REM disorders, and most calories are consumed in the middle of the night.
Signs and symptoms of OSFED
OSFED doesn't describe just one pattern of disordered behavior. The term is an umbrella term applying to many types of feeding and eating disorders. Therefore, the signs and symptoms of OSFED may look very different from person to person.
That said, there are some commonly occurring signs and symptoms that may point to OSFED or another type of eating disorder, including:1,2
Refusal to eat or overly self-conscious about eating in front of others
Frequently disappearing after meals, possibly to engage in purging behaviors
Low confidence and low self-esteem
Poor body image
Socially withdrawn and introverted
Overwhelming feelings of guilt, shame, and anxiety
Wearing overly loose clothing or dressing in heavy layers
Overly preoccupied with counting calories, weight, food, fat grams, and strict dieting
Sudden, dramatic weight loss
Denying feelings of hunger
Obsessive food rituals, for example, eating only at specific times during the day or frequently skipping meals
Excessive exercising to burn off calories
Unusually swollen cheeks (edema from frequent vomiting)
Discolored or stained teeth
Calluses on the backs of hands and knuckles from self-induced vomiting
Health effects of OSFED
Again, the variety of ways OSFED can present can lead to several different health effects. In the short term, these may be more mild or uncomfortable, but if left untreated, the impact of OSFED can be severe and potentially even life-threatening.1
Moderate to severe sleep disorders and sleep apnea
Esophageal cancer and oral tooth decay
High blood pressure and heart disease
Disorders related to other specified feeding and eating disorder
As with nearly all eating disorders, OSFED commonly co-occurs with other mental health conditions. These additional issues can work to help develop or maintain disordered thoughts and behaviors or may occur due to other disturbances related to the eating disorder.
Some common co-occurring disorders with OSFED include:5
Anxiety disorders
Mood disorders, including major depressive disorder (MDD)
Substance use disorders
Post-traumatic stress disorder (PTSD)
Certain personality disorders and neurodevelopmental disorders
Treatment of other specified feeding or eating disorder
The same conditions that can make OSFED challenging to diagnose or spot in others can make it a tricky eating disorder to treat.
Patients will meet with a care provider for an initial diagnosis and through this session—and possibly others—develop a treatment plan based on their personal needs, specific symptoms, and medical history, among other concerns.
If you're concerned about a loved one, reaching out can be an important first step. Most eating disorders thrive in isolation, with patients often hiding themselves or their symptoms to avoid having to face the true depth of what's going on.
Still, it's important to approach this conversation with care and consideration. Being too forceful or accusatory can make someone less likely to open up or listen to your concerns.
If you decide to approach a loved one about this situation, make sure to:
Be open and accepting
Listen without inflicting guilt or shame
Avoid making comments about their weight or eating habits
Expect to be met with resistance
Remote care is within reach
Within Health offers compassionate, highly-personalized treatment programs for people with eating disorders. Call our admissions team today to learn how we heal anorexia nervosa.
If you think you or a loved one are struggling with an eating disorder, it's essential to reach out for help. Many types of therapy are available, and receiving the appropriate care can make a big, or even life-saving, difference.
Our clinical care team will conduct a comprehensive evaluation to determine the most effective course of treatment. Treatment is tailored to each individual’s needs and is administered by a multidisciplinary team that includes a nurse, dietitian, psychiatrist, and therapist.
Within Health offers two levels of care:
Partial hospitalization program (PHP)
Intensive outpatient program (IOP)
Our clinical care team helps patients monitor vitals at home using remote patient monitoring (RPM). We follow blood pressure, heart rate, and temperature using numberless monitors to be sensitive to those with heightened anxiety around those types of markers.
If you're concerned about you or your loved one, contact us today to see how we can help.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Other specified feeding or eating disorders include those that do not meet all specific criteria within a DSM-5 diagnosis. Examples include atypical anorexia, purging disorder, or night eating syndrome.
Is OSFED serious and life-threatening?
Yes. For many years, OSFED and EDNOS disorders were thought to be less severe, which has since been disproven.2,3 Life-threatening complications are possible with OSFED.
Can you heal from OSFED?
Absolutely. With perseverance and proper treatment, recovery from OSFED and other eating disorders is possible. Contact our critical care team at Within Health today to learn how.
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