Equip: What is OSFED?
OSFED is a general name given to eating disorders that don't meet the specific criteria of other disorders. There are several specific subdiagnoses that fall under OSFED, such as purging disorder and night eating syndrome. While it’s a more general diagnosis, OSFED can be just as serious as other eating disorders and can result in hospitalization for the same medical complications as anorexia and bulimia.
Prior to the 2013 publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), OSFED was previously known as EDNOS, or eating disorder not otherwise specified. OSFED is the new official diagnostic term, and the two acronyms mean basically the same thing.
OSFED symptoms
Eating disorders look different for everyone, and this is especially true for those struggling with OSFED. Since many OSFED symptoms overlap with symptoms of other eating disorders, it can be tough to differentiate OSFED from other diagnoses.
That said, some potential symptoms of OSFED include
- Preoccupation with food, weight, or body size and shape
- Frequent dieting
- Obsession with "clean" eating
- Rigid rules and rituals about food, including, when, what or how to eat
- Sudden weight loss or gain
- Binge eating, or eating objectively large amounts of food in a short amount of time while feeling a loss of control
- Self-induced vomiting, excessive laxative use, or extreme exercise
- Social withdrawal
- Depression, anxiety, or irritability
Types of OSFED
Unlike anorexia, bulimia, binge eating disorder, and ARFID, OSFED doesn’t have one particular set of symptoms. It varies from person to person, and one manifestation of OSFED can look completely different from another. However, there are a few specific subdiagnoses that fall under the OSFED umbrella that can be helpful to know about.
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Atypical anorexia
An eating disorder in which someone meets all the diagnostic criteria for anorexia except for low weight. While this separate diagnosis technically falls under OSFED, it can be misleading, and at Equip, we treat atypical anorexia the same as anorexia nervosa.
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Limited or infrequent binge eating disorder
An eating disorder in which someone experiences recurrent binges, but not frequently enough or for long enough to be diagnosed with binge eating disorder.
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Limited or infrequent bulimia
An eating disorder in which someone experiences recurrent episodes of binge eating and purging, but not frequently enough or for long enough to be diagnosed with bulimia.
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Purging disorder
An eating disorder in which someone experiences recurrent episodes of purging without bingeing beforehand.
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Night eating syndrome
An eating disorder in which someone binge eats at night, unconsciously eats while they’re sleeping, or eats upon waking in the middle of the night.
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Common questions about OSFED
What are the causes of OSFED?
As frustrating as it is, there is rarely one identifiable cause of OSFED. Instead, it typically stems from a combination of neurobiological and environmental factors. This means someone may have a genetic predisposition to certain disordered eating behaviors, which are then “activated” by environmental influences. Read more about what causes eating disorders here.
What does OSFED treatment look like?
Because there is a range of how OSFED presents, the treatment approach will be personalized to a patient's unique symptoms. However, typically the initial focus of treatment is on normalizing eating habits, stopping eating disorder behaviors, and weight restoration, if necessary.
We focus on these behavioral and nutritional goals first in order to ensure the patient is adequately nourished. When the body and brain are under or malnourished, people may experience depressed mood, anxiety, and difficulties paying attention. Once a patient has made progress with normalizing their eating and gaining weight (if necessary), the focus of treatment can shift to other areas. That might mean working on interpersonal relationships, setting goals outside of the eating disorder, learning to handle triggers, or understanding potential root causes of the eating disorder.
To accomplish all this, our clinicians use a variety of different evidence-based treatment modalities, including CBT-E (a form of cognitive behavioral therapy designed specifically for eating disorders), DBT (dialectical behavioral therapy), and ERP (exposure and response prevention). For younger patients who live with their family, we generally use FBT (family-based treatment).