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What is OSFED? or Other Specified Feeding or Eating Disorder? aka Eating Disorders Not Otherwise Specified (EDNOS)

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OSFED Other EDs EDNOS

What is OSFED? or Other Specified Feeding or Eating Disorder?


Formerly described at Eating Disorders Not Otherwise Specified (EDNOS) in the DSM-IV, Other Specified Feeding or Eating Disorder (OSFED), is a feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder.

Examples of OSFED Include:

  • Atypical anorexia nervosa (weight is not below normal)
  • Bulimia nervosa (with less frequent behaviors)
  • Binge-eating disorder (with less frequent occurrences)
  • Purging disorder (purging without binge eating)
  • Night eating syndrome (excessive nighttime food consumption)

The commonality in all of these conditions is the serious emotional and psychological suffering and/or serious problems in areas of work, school or relationships. If something does not seem right, but your experience does not fall into a clear category, you still deserve attention. If you are concerned about your eating and exercise habits and your thoughts and emotions concerning food, activity and body image, we urge you to consult an ED expert.

Symptoms associated with anorexia nervosa include:

  • Inadequate food intake leading to a weight that is clearly too low.
  • Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain.
  • Self-esteem overly related to body image.
  • Inability to appreciate the severity of the situation.
  • Binge-Eating/Purging Type involves binge eating and/or purging behaviors during the last three months.
  • Restricting Type does not involve binge eating or purging.

Symptoms associated with bulimia nervosa include:

  • Frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting.
  • A feeling of being out of control during the binge-eatingepisodes.
  • Self-esteem overly related to body image.

Symptoms associated with binge eating disorder include:

  • Frequent episodes of consuming very large amount of food but without behaviors to prevent weight gain, such as self-induced vomiting.
  • A feeling of being out of control during the binge eating episodes.
  • Feelings of strong shame or guilt regarding the binge eating.
  • Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.


There are variants of disordered eating that do not meet the diagnostic criteria for anorexia nervosa or bulimia nervosa. These are still eating disorders requiring necessary treatment. A substantial number of individuals with eating disorders fit into this category. Individuals with eating disordered behaviors that resemble anorexia nervosa or bulimia nervosa but whose eating behaviors do not meet one or more essential diagnostic criteria may be diagnosed with EDNOS. Examples include: individuals who meet criteria for anorexia nervosa but continue to menstruate, individuals who regularly purge but do not binge eat, and individuals who meet criteria for bulimia nervosa, but binge eat less than twice weekly, etc. Being diagnosed as having an "Eating Disorder not Otherwise Specified" does not mean that you are in any less danger or that you suffer any less.


Profile: "Not Otherwise Specified":
Having an "Eating Disorder not Otherwise Specified" can mean a variety of things. The sufferer may have symptoms of Anorexia but still have their menstrual cycle. It can mean the victim can still be an "average/normal weight" but still be suffering Anorexia. It can mean the victim equally participates in some Anorexic as well as Bulimic behaviors (referred to as Bulimiarexic by some).

The most important thing to remember is that Eating Disorders, Anorexia, Bulimia, Compulsive Overeating, or any combination of them, are all very serious psychological illnesses! They all have their physical dangers and complications. They all present themselves through a variety of disordered eating patterns. They stem from issues such as low self-esteem, a need to ignore emotional states such as depression, anger, pain, anger, and most of all. They have developed as a means to cope with one's current state. 

There is help and hope...

Diagnostic Criteria: EDNOS
The following definition of an Eating Disorder Not Otherwise Specified is meant to assist mental health professionals in making a clinical diagnosis. This clinical category of disordered eating is meant for those who suffer but do not meet all the diagnostic criteria for another specific disorder.

Examples Include:

1. All of the criteria for Anorexia Nervosa are met except the individual has regular menses.

2. All of the criteria for Anorexia Nervosa are met except that, despite substantial weight loss, the individual's current weight is in the normal range.

3. All of the criteria for Bulimia Nervosa are met except binges occur at a frequency of less than twice a week or for duration of less than 3 months.

4. An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies).

5. An individual, who repeatedly chews and spits out, but does not swallow, large amounts of food.

6. Recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.

Summary:
The diagnosis of an eating disorder can be difficult. The boundaries between normal and disordered eating are difficult to delineate at times. Many individuals with clearly disordered eating do not meet the formal diagnostic criteria for one of the specific disorders and are classified as having Eating Disorder NOS. The failure to meet formal criteria does not necessarily mean that the individual does not have a serious and significant disorder. Formal evaluations for diagnosis and treatment should only be made by qualified mental health practitioners.

Sources:
American Psychiatric Association (1998), Eating Disorders.
Diagnostic and Statistical Manual of Mental Disorders. (4th ed.). Washington, DC: American Psychological Association, 1994.

We cannot diagnose or treat eating disorders by email, but we can send you information and assist you in finding resources. Information provided by the Eating Disorder Referral and Information Center is not a substitute for medical treatment or psychological care. It is vital that you talk with your physician and a qualified mental health professional regarding eating disorder symptoms and treatment.

While EDReferral.com includes articles and links to sites which provide additional information on eating disorders and related topics, EDReferral.com does not endorse or recommend any site, product or service provided on these links.




In Partnership with the American Eating Disorder Association- -SINCE 1999