Mini-Guide: Other Specified Feeding and Eating Disorder (OSFED)

Other specified feeding and eating disorder (OSFED) is one of the common eating disorders. Due to lack of public attention, it is one of the lesser-known types of eating disorder as compared to higher-known eating disorders such as binge eating disorder, anorexia nervosa, and bulimia nervosa.

OSFED was previously known as an eating disorder not otherwise specified (EDNOS). Research shows that OSFED nearly affects around 32% to 53% of the population struggling with eating disorders. Basically, it is categorized to identify people who generally don’t meet the diagnostic criteria for major eating disorders like anorexia nervosa and bulimia nervosa. It helps categorize people struggling with vast symptoms of an eating disorder.

What is OFSED?

Other specified feeding and eating disorder (OSFED) is one of the common eating disorders. Basically, it is categorized to identify people who generally don’t meet the diagnostic criteria for major eating disorders like anorexia nervosa and bulimia nervosa.

What is the Difference Between OFSED and EDNOS?

An eating disorder not otherwise specified (EDNOS) is referred to as an eating disorder that doesn’t fit the diagnosis criteria of major eating disorders such as bulimia, anorexia, and binge eating. EDNOS was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM).

After 2013, the term was replaced by OFSED along with major updates to the section on eating disorders. People believe that OFSED is less severe however, the case is quite the opposite. The symptoms of OFSED can be severe and dangerous.

Symptoms of OSFED

The symptoms of eating disorders can be divided based on emotional, physical, and behavioral aspects.

Below listed are the behavioral symptoms of OSFED:

• Continuously refuses to eat certain foods such as foods with high carbs, sugar, and fats
• Denials hunger calls
• Drinks excessive amounts of water or other non-caloric beverages
• Fears of eating around others
• Eats everything fast or can be seen binging constantly
• Eats small portions or skip meals regularly
• Exercises excessively
• Frequently concerned about calorie count, being overweight, or being called fat
• Hoards or steals food
• Hides body by wearing baggy clothes
• Purging behaviors such as frequent trips to the washroom
• Shows certain food rituals such as excessive chewing
• Uses excessive amounts of gums, mints, and other stuff

Below listed are the emotional symptoms of OSFED:

• Anxiety
• Depression
• Excessive irritation or anger
• Excessive self-criticism
• Lack of motivation
• Low self-esteem
• Strong need for approval

Below listed are the physical symptoms of OSFED:

• Amenorrhea or menstrual irregularities
• Anaemia
• Brittle and dry nails
• Constant fluctuations in weight
• Cold feet and hands
• Cut or calluses across finger joints (a consequence of purging or inducing vomiting intentionally)
• Dental problems such as enamel erosion, tooth sensitivity, cavities, and discoloration
• Dizziness
• Dry skin
• Fainting
• Feeling cold
• Fine hair appearance on the body
• Gastrointestinal symptoms such as constipation, acid reflux, and stomach cramps
• Impaired immune system
• Low blood cell count
• Lack of concentration
• Lack of proper sleep or sleeping issues
• Low hormone and thyroid levels
• Low potassium
• Poor wound healing
• Slow heart rate
• Swelling around salivary glands
• Swelling around feet
• Thin, brittle, and dry hair
• Weakened muscles
• Yellow skin

Below listed are the commonly co-occurring conditions with OFSED:

• Anxiety disorders
• Depression
• Impulse control disorders
• Self-help or self-injury
• Substance use disorders

Causes of OSFED

OFSED is a complicated type of eating disorder with no exact known cause yet. Research shows that environmental factors and genetics play an important role in the development of this eating disorder. There’s a famous saying about eating disorders, “Genes load the gun, but the environment pulls the trigger.”

This means that genetically vulnerable people are more prone to developing mental health issues like eating disorders because certain situations or environmental conditions may trigger them. Environmental factors such as bullying, weight stigma, abuse, dieting, illness, stress, media influence, and life transitions may play an important role in the development of OFSED.

Diagnosis of OFSED

The main goal behind the categorization of OFSED is to put people who generally don’t fit into major types of eating disorder lists. OFSED is for people who struggle regularly but still fail to receive an on-point diagnosis. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 TR), people can receive a diagnosis for OFSED after recognizing the symptoms of important eating disorders such as:

Atypical anorexia nervosa

People who don’t meet the diagnostic criteria for atypical anorexia nervosa are forwarded to the diagnosis of other eating disorders. For example, people who restrict food intake and meet other symptoms of anorexia nervosa are forwarded further.

Night eating syndrome:

People who are constantly involved in night eating, eating right after waking up in the middle of the sleep, or engaged in excessive food eating even after dinner are categorized into night eating syndrome.

Purging disorder:

People who are excessively involved in calorie purging such as misuse of laxatives, vomiting, or diuretics are categorized under purging disorder. Such behaviors can have a direct influence on body shape and weight.

Subthreshold binge eating disorder:

People who meet the criteria for binge eating disorder are categorized under this type. The main symptom is binge eating, which occurs slowly or for a limited duration.

Subthreshold bulimia nervosa:

In this criteria, the frequency and duration of bulimia nervosa are basically checked and if an individual does not meet the requirements of bulimia nervosa, he/she is forwarded for further diagnosis and can be categorized under OFSED.

People believe that the symptoms of OFSED are less severe or subclinical. Meanwhile, this is not true and if you think you or your loved one might be struggling with an eating disorder, it’s always better to seek support through a certified and experienced mental health professional. To connect with a mental health professional for diagnosis and support, click below:

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The fact is that people struggling with OFSED often experience severe eating disorder-related symptoms. Therefore, understand the need of the hour and seek proper diagnosis.

Health-Related Risks of OFSED

Symptoms of untreated or misdiagnosed OFSED can be severe that they can have direct long-term effects on physical health, such as:

• Constipation
• Diarrhea
• Gastrointestinal issues
• Heart conditions
• Infertility
• Kidney damage
• Osteoporosis (weakened bones)
• Slowed growth

Treatment of OFSED

If you are experiencing stress related to exercise, weight gain, body image, eating issues, and related behaviors lately, it’s important to connect with a mental health professional.

Right now, you might not feel the need to be diagnosed, but remember that the symptoms of an eating disorder worsen with time. Coming forth to the treatment of OFSED, there’s no specific treatment for OFSED but the mental health professional is likely to customize a treatment plan according to the severity and duration of symptoms.

Therefore, it is also important to look after your health-related symptoms and be honest with your professional during counseling. Most commonly, Cognitive behavioral therapy for eating disorders (CBT-E) is generally prescribed.

Research shows that CBT is effective in treating symptoms related to eating disorders. Along with this, a mental health professional may also appoint a team to help with the recovery. A multidisciplinary team for treating eating disorders generally includes psychiatrists, psychologists, dietitians, social workers, and family therapists.

The treatment procedure is not only focused on mental health but it is also focused on your physical wellbeing. A team can help you with:

• Alternatives and delays
• Body image exposure
• Constructive restructuring
• Food Exposure
• Limited body check-up
• Meal planning
• Regular eating
• Relapse prevention
• Self-monitoring

Apart from CBT, a mental health professional can also opt for other effective treatment options such as:

• Dialectical behavior therapy (DBT): DBT is a type of CBT that teaches clients to live mindfully by teaching various coping skills. Additionally, the goal of DBT is to teach how to regulate emotions and improve relationships with yourself and others.
• Family-based therapy: Family-based therapy helps young people understand the root causes within family systems and helps people evolve together.
• Nutritional therapy: Nutritional therapy is conducted by a team of registered dietitians and mental health professionals. It helps people understand the relation between physical and mental health and helps fulfil the physical needs of people by assessing their nutritional gaps.

I hope this blog helps you understand everything you want to know about OFSED. Connect with us on social media for more such content.

Thanks for reading!