About Other Specified Feeding or Eating Disorder (OSFED)
Other specified feeding or eating disorder (OSFED)
A significant number of people have an eating disorder that has serious and debilitating symptoms but does not fit into the four main categories of eating disorder types (anorexia nervosa, bulimia nervosa, binge eating disorder and avoidant restrictive feeding and eating disorder). If this is the case, the individual may be diagnosed with OSFED (other specified feeding or eating disorder).
If you are diagnosed with OSFED, it does not mean your eating disorder is less serious than the four eating disorder types; it only means that you don’t ‘fit’ the symptom pattern of a single type. People with OSFED can be very unwell, unstable and in need of high quality, prompt treatment.
What is OSFED?
Other specified feeding or eating disorder is a relatively new term, introduced in the most recent set of guidelines to classify different conditions and the treatments they require. OSFED replaces the previously used term: eating disorders not otherwise specified (EDNOS).
Previously, it was estimated that up to half of all people seeking help for eating problems were given a diagnosis of EDNOS. It was recognised that this was too broad and meant that many people were not given an accurate diagnosis and appropriate treatment.
Subsequently, another eating disorders type, ARFID (avoidant resistant food intake disorder) has been introduced to reflect feeding issues where body image disturbance is not present and types such as binge eating disorder are now more widely recognised and diagnosed.
Therefore, a smaller number of people are expected to come into the OSFED category and these should be individuals who are accurately described as having symptoms which don’t fit within a single eating disorders type.
What are the causes of OSFED?
Like all types of eating disorders, the causes of OSFED are emotional; difficult, challenging feelings are expressed in a disordered relationship with food. Treatment for OSFED depends on understanding the emotional distress causing the disorder and finding ways to address it. For every individual, the precise causes of OSFED will be different, but in many cases, treatment based on Cognitive Behavioural Therapy will be effective (with the exception of individuals with atypical anorexia, who are likely to require other, multiple interventions).
What are the symptoms of OSFED?
Because a diagnosis of OSFED means you don’t fit the classifications of the four main eating disorders types, inevitably, there is a lot of variation in the symptoms of OSFED. To give some examples, symptoms might include:
- Someone who has the severe body image disturbance and restrictive eating that suggests anorexia, but whose weight has not (or not yet) reached the measures used to define anorexia nervosa
- Someone who has restrictive eating but not all the symptoms used to diagnose anorexia and who also has some binge and purge behaviours, but does not fulfil the classification of bulimia nervosa