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Other specified feeding or eating disorders (OSFED)

OSFED stands for ‘other specified feeding or eating disorder’. People with OSFED have symptoms that are similar to one or more eating disorders, but may not meet all the criteria for these conditions.

What is OSFED? OSFED stands for ‘other specified feeding or eating disorder’. People with OSFED have symptoms that are similar to, but not exactly the same as, those for other. OSFED was previously referred to as ‘eating disorders not otherwise specified’ (EDNOS).

OSFED is more frequently diagnosed than other eating disorders. It is a complex and serious mental health condition, not a lifestyle choice. OSFED occurs in people of all ages and genders and is one of the most common eating disorders.

If left untreated, OSFED can significantly impact a person’s physical and Eating disorders cover a spectrum of conditions and people with OSFED do not fit neatly into a specific group.

If you are concerned you may be experiencing an eating disorder, you should visit your doctor as soon as possible.

A doctor who has experience with eating disorders is a good first point of contact.

Other healthcare professionals can recognize eating disorders, but may not be able to give you a physical check-up. There are different diagnoses that can be made within OSFED. These include:

  • except that despite significant weight loss
  • the individual’s weight is within or above the normal range

A person with atypical anorexia nervosa can experience many of the same physiological complications as someone with anorexia nervosa. are met, except that binge eating and compensatory behaviors occur, on average, less than once a week and/or for less than 3 months. are met, except that the binge eating occurs, on average, less than once a week and/or for less than 3 months.: Recurrent purging behavior to influence weight or shape (such as self-induced vomiting, misuse of laxatives, diuretics, or other medications) in the absence of binge eating.: Recurrent episodes of night eating as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal.

There is awareness and recall of the eating and the eating causes significant distress to the individual.

Your doctor will need to make sure that any changes in body weight are not caused by another undiagnosed health condition. People with OSFED may have many of the symptoms of anorexia nervosa, bulimia nervosa or binge eating disorder but do not meet the full criteria to be diagnosed with these conditions.

People experiencing OSFED are likely to be engaging in disordered eating, are experiencing body dissatisfaction or overvaluation of weight and shape, and may fear gaining weight. Physical signs and symptoms of OSFED include:

  • signs of damage from frequent vomiting such as swelling around the cheeks damaged teeth
  • bad breath or dizziness

Psychological signs and symptoms of OSFED include:

  • Behavioral signs symptoms of OSFED include dieting behavior – dieting
  • counting kilojoules reporting new food allergies avoiding food groups increased interest in food preparation – such as planning
  • preparing food for others but not eating it themselves obsessive rituals around food – for example
  • cutting food into very small pieces or eating very slowly behavior related to body image – constantly checking in the mirror
  • pinching parts of the body to measure fat

Ongoing and untreated OSFED carries the risk of a variety of problems, including: Like other eating disorders, recognizing the warning signs and seeking support early will give you the best chance of a quick and full recovery. Recovery is possible, even for people who have been living with OSFED for many years.

For OSFED, your individual treatment will depend on the type of symptoms you have.

In general, treatment recommendations will be based on the eating disorder that most closely resembles your symptoms (such as anorexia nervosa, bulimia nervosa, binge eating disorder). Examples of treatment approaches include Cognitive Behavior Therapy for eating disorders (CBT-E) and Family Based Treatment (FBT).

Current evidence suggests that: It is best to get treatment started as early as possible.

Using a team of professionals with expertise in different fields is the best way to get results. Once OSFED is diagnosed, your doctor will organize a multidisciplinary team to help you on the journey to recovery. The types of healthcare professionals who might be involved include:

  • Treatment should focus on both your physical
  • psychological health

Your healthcare professionals will need to ask a series of questions to help you work out the link between the way you think and your eating behavior. Support groups can be helpful as an additional source of support, alongside treatment from healthcare professionals. Other treatment options include medications and supplements to help with any physical problems and, in some cases, medication for your mental health (for example, antidepressants).

Diagnosis of OSFED Atypical anorexia nervosa: All of the criteria are met for anorexia nervosa Bulimia nervosa of low frequency and/or limited duration: All of the criteria for bulimia nervosa Binge eating disorder of low frequency and/or limited duration: All of the criteria for binge eating disorder Purging disorder Night eating syndrome To diagnose an eating disorder, a doctor will need to do a full physical check-up, carry out blood tests Symptoms of OSFED Physical symptoms of OSFED fluctuating body weight, or significant loss or gain of body weight absence of periods or change in menstrual cycle for women loss of sex-drive ( libido ) getting sick more often than usual – a possible sign of a distressed immune system fainting Psychological symptoms of OSFED preoccupation with eating, dieting, exercise or body image sensitivity to comments about food, eating, dieting, exercise or body image feelings of shame, guilt and disgust, especially after eating increased anxiety or irritability around meal times distorted body image or dissatisfaction with body size, shape or particular body parts/areas low self-esteem, depression, anxiety, suicidality Behavioral symptoms of OSFED saying they have eaten when they haven’t becoming socially withdrawn and/or not engaging with activities once enjoyed eating alone or in secret, avoiding other people at meal times hiding or hoarding food self-induced vomiting chewing and spitting of food frequent trips to the bathroom during or after eating preoccupation with body shape/size and weight loss compulsively exercising, even when unwell or injured use of laxatives, enemas, diuretics or appetite suppressants Long-term effects of OSFED gastrointestinal issues (including damage to the esophagus and stomach) constipation and diarrhea kidney damage weakened bones ( osteoporosis ) slowed growth (in young people) infertility in men and women heart conditions, including irregular heart rate and low blood pressure Treatment of OSFED psychiatrist psychologist dietitian family therapist social worker

Where to get help#

Key Points#

  • People with OSFED have symptoms that are similar to, but not exactly the same as, those for other
  • OSFED occurs in people of all ages and genders and is one of the most common eating disorders
  • There is awareness and recall of the eating and the eating causes significant distress to the individual
  • and ask questions to find out what symptoms you are experiencing
  • Your doctor will need to make sure that any changes in body weight are not caused by another undiagnosed health condition

Sources & further reading

For evidence-based global guidance on this topic, consult authoritative public-health bodies such as the World Health Organization (WHO), CDC, NHS, and ECDC.

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