Understanding other specified feeding or eating disorders (OSFED)

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Banner Other Specified Feeding Or Eating Disorders (OSFED)

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Page clinically reviewed by Charlie Carroll, CBT Therapist at Priory Wellbeing Centre Manchester in December 2023.

What is OSFED?

Other specified feeding or eating disorders (OSFED), also known as ‘eating disorders not otherwise specified (EDNOS)’, have features that are similar to anorexia nervosa, bulimia nervosa or binge eating disorder (BED) but don’t meet all the diagnostic criteria. It’s estimated that 50% of people with an eating disorder fall into this group.

Examples of what OSFED might look like include:

The person might show signs of anorexia nervosa but their weight might be slightly above the anorexia nervosa diagnosis threshold - known as ‘atypical anorexia nervosa’
Binge eating and purging may occur infrequently - known as ‘bulimia nervosa of low frequency and/or limited duration’ or ‘binge eating disorder of low frequency and/or limited duration’
Having an obsession with weight and body shape, with no other symptoms
The person might engage in purging behaviours such as vomiting and laxative misuse to control their weight, but this isn’t part of a binge/purge cycle - known as ‘purging disorder’
A person might binge eat after their evening meal or eat when they wake up in the middle of the night - known as ‘night eating syndrome’. This can cause significant distress and isn’t explained by other disorders or circumstances

Lots of people who have OSFED have experienced anorexia nervosa, bulimia nervosa or BED in the past or may be diagnosed with one of these conditions in the future.

Types of OSFED

OSFED is an umbrella term and people experience this condition differently. There are a number of distinct eating disorders that fall under this umbrella that have their own tell-tale signs, without the classical symptoms of anorexia nervosa, bulimia nervosa or BED.

Pica

Pica causes someone to consume substances that aren’t meant to be eaten and have no nutritional value. Examples might include things like chalk, paint, soap and paper. People with pica will usually eat normal foods too, which means they tend to get the nutrients they need. However, many of the additional substances they consume can be dangerous and can cause a range of problems such as poisoning, cracked teeth, infections and sickness.

Rumination disorder

Rumination disorder is a condition that causes people to regurgitate (spit up) food that hasn’t been digested. They may then either re-chew and re-swallow the food, or spit it out. Those with rumination disorder may experience malnutrition, weight loss or dental erosion due to bringing up partially digested food.

This behaviour isn’t caused by a sickness bug or any other physical problem that would lead to vomiting, and the person doesn’t feel sick before they regurgitate food.

Avoidant restrictive food intake disorder (ARFID)

ARFID is when a person avoids and/or restricts the amount they eat of certain foods.

However, unlike with anorexia nervosa, a person with ARFID doesn’t restrict the amount they eat because they're concerned about their weight or shape. They might avoid or restrict their food for a number of other reasons. These include:

Having a traumatic experience with a certain type of food
Having sensitivities to food smell, taste, texture or temperature
Having a low interest in eating

Causes of OSFED

As with other eating disorders, research shows there may be a number of potential causes of OSFED. These include:

Genetics – having a close relative who has OSFED can increase your chances of having one too
Gender and age – research shows that girls and women between the ages of 14 and 25 are more likely to develop anorexia-like symptoms than males
Personality – certain personality traits may have an influence on whether someone develops an eating disorder. Things like perfectionism and low self-esteem may increase your chances of developing a condition like OSFED
Mental health – if you already struggle with a mental health condition such as depression, anxiety or obsessive compulsive disorder (OCD), this might mean you’re more susceptible to developing an eating disorder
Environment – stressful life events like going through a bereavement or being the victim of abuse can make it more likely you’ll develop unhealthy eating habits
Society – today’s society, including things like social media, can put lots of pressure on us to look a certain way. This can be a factor in the development of an eating disorder

Signs and symptoms of OSFED

The symptoms of OSFED are not always clear-cut. Changes in your eating habits and your relationship with food are obvious signs, but as everyone is unique, this might look different for different people.

Some of the symptoms of OSFED may be similar to the symptoms of eating disorders such as anorexia nervosa, bulimia nervosa and BED, so it’s useful to familiarise yourself with their symptoms too.

One of the most effective ways to identify if you’re struggling with OSFED is by keeping a meal diary. Then you can start to look for signs that suggest you may have an eating disorder. Ask yourself:

Have you experienced significant weight loss, gain, or fluctuations over time?
Have your eating habits changed?
Do you obsess over food?
Do you have a negative body image?
Do you prefer to eat alone or hide your eating habits from others?

If any of these sound familiar, it may be that you’re struggling with an atypical eating disorder. OSFED can have just as severe an impact on people’s lives as anorexia, bulimia and BED. That’s why it’s important that you get professional help if you’re concerned about your health and wellbeing.

Introducing eating disorder treatment at Life Works

Life Works in Surrey, is known for its expert inpatient eating disorder service, helping those struggling with OSFED get their life back on track. Day treatment services and outpatient services are also available at Priory.

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Treatment for OSFED

Treatment for atypical eating disorders at Priory is similar to the treatment we offer for anorexia, bulimia nervosa and BED.

Treatment at Priory takes place in supportive, compassionate and therapeutic environments. Our dedicated teams are here to help you every step of the way towards resolving your unhealthy relationship with food, and regaining control of your life.

Support for families and loved ones

We also provide support for the families, carers and loved ones of our eating disorder patients. Our family support sessions can help you to:

Develop an understanding of your loved one's eating disorder and how you can support them moving forwards
Learn to manage your own experience of your loved one's eating disorder

For more information about our family support sessions, please visit our approach to eating disorder treatment page.

Get help for OSFED

At Priory, we recognise that OSFED sufferers have difficulties that are no less genuine than other eating disorder diagnoses. Our specialists can offer tailored OSFED treatment packages at our hospitals and wellbeing centres.

It’s important to understand that without specialist eating disorder treatment, your OSFED may become worse over time and have a negative impact on your quality of life. Without support, it could deteriorate and you many struggle on your recovery journey.

At Priory, we understand that reaching out for help can be daunting, but it really is the most important step you can take. Eating disorders are treatable. Over the years, we have helped thousands of people address their challenges, reduce their symptoms and take steps towards a positive future.