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Eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder are diagnosed under a list of symptoms from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) that can leave many people out who may not have ALL the symptoms. According to Dr. Jennifer J. Thomas, co-director of The Eating Disorders Clinic and Research Program at Massachusetts General Hospital and co-author of Almost Anorexic, at least 1 in 20 people will show eating disorder symptoms that could be diagnosed as an OSFED – Other Specified Feeding or Eating Disorder. Unfortunately, OSFED is a diagnosis that isn’t discussed as often as other eating disorders.
What is OSFED?
Questions still remain several years after the DSM-5 changed the classification for eating disorders that don’t meet the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder. The DSM-5 changed Eating Disorder Not Otherwise Specified (EDNOS) to Other Specified Feeding or Eating Disorder (OSFED).
The change in classification from EDNOS to OSFED was significant. It was realized that not everyone included in the EDNOS category shared the same symptoms. Placing individuals with different symptoms in the same category was affecting their ability to access care. As well, it hindered the ability to perform appropriate research. Eating disorder behaviours that weren’t previously included in EDNOS, such as purging disorder and night eating syndrome, are now included under OSFED.
The following are examples of behaviours that are now diagnosed as OSFED subtypes:
- Atypical Anorexia Nervosa: Behaviours of anorexia but excluding low body weight.
- Bulimia Nervosa: Less frequent than what is required to meet the criteria for diagnosing bulimia nervosa.
- Binge Eating Disorder: Less frequent and/ or limited duration.
- Purging Disorder: Contrasted with bulimia nervosa, a person will purge but not binge.
- Night Eating Syndrome: Individual will eat very little during the day and then consume most calories in the evening or wake up in the middle of the night to eat.
How Common is OSFED?
OSFED is more common than previously believed. A study published last year in the Journal of Nervous and Mental Disease took a look at eating disorders in adults between the ages of 18 and 75 because most research on eating disorders has focused on adolescents. All of the participants in the study were seeking treatment for eating disorders. Almost 28% of the participants met the criteria for OSFED.
In addition, the study also revealed that those participants with OSFED may “struggle with more severe cognitive eating disorder-related symptoms and potentially more severe body image distortions” in comparison to other groups of the study who were of a younger age.
Characteristics of OSFED
Both males and females may develop an OSFED. People with OSFED share some common characteristics including:
- An intense fear of weight gain
- A distorted body image
- Overly conscious about their weight and body shape
- Heightened anxiety or stress around food
A common misconception is that individuals with OSFED don’t have an eating disorder and therefore won’t seek eating disorder treatment. The truth is OSFED can be just as serious as other eating disorders. In addition, similar health complications that are related to other eating disorders are also experienced with OSFED as a result of suffering with it for a long period of time.