What are other specified feeding or eating disorders (OSFED)?

Some eating disorders have hallmark signs and symptoms. For example, people with anorexia nervosa tend to have extremely restricted diets and an intense fear of gaining weight. But when a person shows signs of disordered eating behaviors that don’t meet the full criteria for a specific eating disorder, they may have other specified feeding or eating disorders (OSFED).  OSFED is actually one of the most common eating disorder diagnoses and just as severe as typical eating disorders. Learn how to recognize OSFED symptoms so that you can get help for yourself or a loved one.

What is OSFED?

OSFED describes a range of eating disorders that don’t meet the full diagnostic criteria for another eating disorder. For example, someone may have some of the symptoms of anorexia nervosa but not all of them. Or their condition may seem similar to another diagnosis but their symptoms are less frequent.  OSFED was previously classified as EDNOS (eating disorder not otherwise specified) but was changed in 2013 to provide more clarity about a person’s diagnosis. This distinction recognizes that the conditions within the OSFED category are still complex, life-threatening mental health conditions that are treatable with access to the right information and resources.  Some general signs that a person may be struggling with OSFED include:

• Changes in weight
• Chronic dieting behavior
• Avoiding social situations that involve food
• Wearing baggy clothing
• Loss of sex drive
• Weakened immune system
• Visiting the bathroom after meals
• Irritability during meals
• Atypical food rituals 
• Drinking excessive amounts of water
• Frequently checking the mirror for perceived flaws
• Mood swings 

Which eating disorders does OSFED include?

OSFED consists of several conditions that share symptoms with other eating disorders. These conditions include:

• Atypical anorexia nervosa: This eating disorder meets all of the criteria for anorexia nervosa except the person isn’t underweight. Instead, a person’s weight is within or above the normal range.

• Bulimia nervosa (of low frequency and/or limited duration): People with this condition meet the criteria for bulimia nervosa, but binge eating and compensatory behaviors occur less than once a week for less than three months (versus at least once a week for three months with bulimia nervosa). 

• Binge eating disorder (of low frequency and/or limited duration): Similarly, this condition meets all of the criteria for binge eating disorder. The difference is that binge eating occurs, on average, less than once a week for less than three months.

• Purging disorder: With purging disorder, people engage in purging disorders — like self-induced vomiting, excessive exercising, or misusing laxatives and diuretics — to influence their weight or body shape. Unlike bulimia, which includes both binging and purging, purging disorder involves only purging behaviors. 

• Night eating syndrome: This condition involves excessive food consumption after dinner or during the night, leading to feelings of significant distress.

Some research suggests that many people with an atypical eating disorder will eventually develop a typical eating disorder. It’s also worth noting that OSFED, similar to other eating disorders, has a high comorbidity with conditions like depression, anxiety disorders, substance use disorders, impulse control disorders, and self-harm.

What are effective OSFED treatment options?

OSFED is a serious condition that can have long-term mental and physical consequences if people don’t get proper treatment and support.  Each person’s condition may look a little different, so it’s important to meet with a healthcare professional to identify the right combination of talk therapy, medication, and nutritional counseling for your needs.

1. Talk therapy

Therapy is one of the most effective treatments for managing eating disorders, including OSFED. Through therapeutic techniques like cognitive behavioral therapy (CBT), people can learn to challenge unhealthy beliefs and behaviors around food and develop healthy coping skills to prevent relapse. Therapy can also help people manage underlying causes of disordered eating, like adverse childhood experiences.

2. Nutritional counseling 

OSFED treatment usually includes a nutritional assessment with a registered dietitian to identify any nutritional deficiencies. Nutritional counseling shows people how to create a balanced eating plan, adopt mindful eating practices, and challenge unhealthy beliefs about food and body image.

3. Medication

Although medications cannot treat OSFED, they can help people manage specific symptoms or address co-occurring conditions. For example, antidepressants can help treat symptoms of anxiety and depression.

4. Social support 

Having an eating disorder can feel isolating, but you don’t have to heal on your own. Surround yourself with a strong support system, whether it’s a trusted friend or an eating disorder support group, to empower you throughout the recovery process. 

Find a therapist with Rula

Recovering from an eating disorder is possible with access to the right resources and support. And that starts with finding a qualified mental health professional. At Rula, we can connect you with a therapist who accepts your insurance so you can get the support you need to treat your symptoms and start healing. With Rula’s easy-to-use therapist-matching program, you can find the right provider for your needs in less than 30 seconds and begin treatment as early as this week. And if medication management is part of your treatment plan, we can connect you with a psychiatric practitioner to find the right solution for you.  Get started with Rula today