Some things in life are hard to define perfectly, including the unique struggles and symptoms someone may experience with an eating disorder. In fact, many people who have an eating disorder don’t experience every behavior, symptom or characteristic of one of the defined eating disorders – like anorexia, bulimia or binge eating.

When someone has significant struggles with eating, exercise or body image, but doesn’t fit the exact criteria for a specific eating disorder, they may be given a diagnosis of “other specified feeding or eating disorder” – which is known more simply as OSFED.

What are examples of OSFED? What are OSFED symptoms and its causes? And how is it treated? At Melrose Center, we’ve been treating a range of eating disorders for more than 35 years. Below, we answer all these questions and more.

What is OSFED? It’s common and it’s as serious as other eating disorders

OSFED is the most common eating disorder diagnosed for adults and adolescents – and affects both males and females. About 30% of eating disorder diagnoses are OSFED. This diagnosis was known as “eating disorder not otherwise specified” (EDNOS) but was redefined in 2013 by the American Psychiatric Association.

Like other eating disorders, OSFED is a serious mental health condition and is not a choice. And just because OSFED doesn’t meet the diagnostic criteria of other eating disorders, it doesn’t mean it’s any less severe.

Examples of OSFED: The five main types

The following are examples of other specified feeding or eating disorder that don’t meet the diagnostic criteria for other eating disorders:

  1. Atypical anorexia – With this type of OSFED, someone is restricting food intake and losing significant weight, but they don’t meet the low weight criteria for anorexia nervosa.
  2. Bulimia nervosa of low frequency and/or limited duration – If someone has this type of OSFED, they binge and purge but do it less often than needed for a diagnosis of bulimia nervosa.
  3. Binge eating disorder of low frequency and/or limited duration – This is when a person’s bingeing is less than the criteria for a binge eating disorder, but they still struggle with body image, isolation and loss of control.
  4. Purging disorder – When someone has a purging disorder, they may purge through vomiting, overexercising or other means, but they don’t binge eat.
  5. Night eating syndrome – This type of OSFED is characterized by waking up during the night with an uncontrollable need to eat, sometimes excessively.

OSFED symptoms: What to look for

While it’s often hard to know if someone has an eating disorder, it can be especially difficult with OSFED.

Someone with OSFED may have symptoms of anorexia, bulimia and/or binge eating disorder, but they may not be grouped together or show up in the same way. Because of this, it can take longer for people to notice the warning signs. So, it’s important to be on the lookout for even small changes and to talk to a doctor about your concerns.

The early symptoms of OSFED may include changes in behaviors and physical symptoms, such as:

  • Changing body size – This can be significant weight loss or rapid weight gain.
  • Poor body image – A person with an OSFED may have negative opinions about their body weight, shape and size.
  • Changes in eating behaviors –Changes may include new food rituals, food avoidance, being secretive about eating, skipping meals or binge eating.
  • Purging behaviors – These behaviors include self-induced vomiting, overexercising and excessive use of laxatives.
  • Social withdrawal – Someone with OSFED may withdraw from friends and family.
  • Declining physical health – If someone isn’t getting enough nutrients from their food, they may have physical symptoms associated to anorexia, such as dizziness, thinning hair or yellowish skin. People who purge by vomiting may have calluses on their knuckles.

What causes OSFED? It’s likely a combination of factors

In most cases, there’s more than one factor contributing to an eating disorder. The specific causes will vary due to the uniqueness and life experiences of each individual, but include the following:

  • Genetics – If you have a parent or sibling with an eating disorder, you’re more likely to have one
  • Environmental – A person’s feelings about food, weight and eating can be unintentionally shaped by the attitudes of their family.
  • Social – In the U.S., thinness is seen as healthy and attractive. This can influence how people feel about themselves and their behaviors.
  • Childhood trauma – If someone experienced physical or emotional abuse as a child, they are more likely to develop eating disorders at some point in their life.
  • Mental health – Eating disorders are more common in people with anxiety, depression or other mental health concerns.
  • Bullying – People who have be bullied or teased about their size are more likely to develop an eating disorder.

The potential health risks of OSFED

Depending on what eating disorder behaviors are present, OSFED can be very serious and even life-threatening.

If left untreated, OSFED may have serious health implications, including delayed onset of puberty, osteoporosis, infertility, dental damage, digestion issues, social isolation, anxiety and depression, and strained or damaged relationships.

Having OSFED can be just as damaging as other eating disorders. Research published in The American Journal of Psychiatry, shows people with OSFED have a higher mortality rate than those with anorexia or bulimia.

How OSFED is diagnosed

An other specified feeding or eating disorder diagnosis is based on behaviors, physical symptoms and mental health. The first step in getting diagnosed is talking to a doctor about the symptoms you or a loved one may be experiencing. This information will help them understand how you’re eating and if you have concerning behaviors. If you have weight loss, or have been purging or restricting, your doctor may recommend blood work and other testing.

OSFED treatment: Healing can happen

OSFED can be successfully treated. It’s best to get help at the earliest signs of an eating disorder, since it’s more likely that you’ll be able to recover more quickly and completely. But even if you’ve had OSFED for years, recovery is still possible.

OSFED treatment is tailored based on the symptoms and behaviors you have. Your recovery plan will likely include more than one type of therapy and treatment, and will support both physical and mental health. Common treatments include:

  • Therapy – Individual and group therapy can help you deal with negative emotions and build coping skills.
  • Nutrition counseling – Nutrition therapy and health education can help restore weight and create better eating patterns to support overall health.
  • Medical treatment – Specialized medical care can address physical problems caused by OSFED.

Do you think you or a loved one has OSFED? Get help today

Eating disorders aren’t a choice. The sooner you reach out, the sooner you or your loved one can start healing.

If you think you have an eating disorder, talk to a trusted friend, doctor or therapist. If you think a family member or a loved one has an eating disorder, let them know that you’re there to support them and encourage them to talk to a doctor.

At Melrose Center, your healing comes first. Our licensed psychologists, psychiatrists, medical doctors, registered dietitians and other specialists work together as a team to provide expert, individualized care.