Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
Other specified feeding and eating disorder (OSFED), formerly known as eating disorder not otherwise specified (EDNOS) in previous versions of the DSM, is less well known than higher-profile diagnoses likeanorexia nervosa,bulimia nervosa, andbinge eating disorder. Despite its lack of public attention, as a catch-all category that includes a wide range of symptoms.
OSFED is actually the most common eating disorder diagnosis, representing an estimated 32% to 53% of all people with eating disorders.It was developed to encompass people who did not meet the full diagnostic criteria for anorexia nervosa or bulimia nervosa but still had a significant eating disorder.
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Like other eating disorders, symptoms include behavioral, emotional, and physical aspects.
Behavioral symptoms of OSFED often include a preoccupation with weight, food, calories, fat grams, dieting, and exercise,including:
The emotional symptoms of OSFED can include:
Understanding the Fear of Eating in Front of Others
The physical symptoms of OSFED include:
OSFED is a complex illness, and while we don’t know the exact cause, genetics and environmental factors both appear to play a role. When it comes to eating disorders, it’s often said that “genes load the gun, but the environment pulls the trigger.”
In other words, in those who are genetically vulnerable, certain situations and events contribute to or trigger the development of an eating disorder.
Environmental factors include:
The Different Causes of Eating Disorders
One problem with psychiatric diagnoses, in general, is that many patients do not fit neatly into the typical diagnostic categories. It’s not always clear-cut. Sometimes people meet most but not all of the criteria for a diagnosis.
In the case of eating disorders, a person who does not qualify for a specific eating disorder diagnosis would be classified as OSFED. TheDiagnostic and Statistical Manual of Mental Disorders(DSM-5-TR) includes five examples of patients who would be classified as OSFED:
One misconception about OSFED is that it is less severe or subclinical. This is not necessarily true, and it keeps many people from seeking help.
Many of the people with OSFED have as severe an eating disorder as those who meet the criteria for clearly defined disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder.OSFED, along withunspecified feeding or eating disorders(UFED), replaces the EDNOS category.
People with OSFED will experience health risks similar to those of other eating disorders, including:
At least one previous study showed the mortality rate for OSFED (at the time, known as EDNOS) was as high as for people who meet the defined thresholds for anorexia.
Furthermore, since eating disorder diagnoses are not stable over time, it is not uncommon for people to meet the diagnosis of OSFED on their way to a diagnosis of anorexia, bulimia, or binge eating disorder or on their way to recovery.
It’s Now Easier to Be Diagnosed With an Eating Disorder
Even if your symptoms and experience don’t seem to fit a specific diagnosis, if you are experiencing distress related to eating, exercise, body shape, and weight, you should consult a professional as soon as possible. Research supports that early intervention makes a big difference in OSFED recovery.
In general, treatment recommendations will be based on the eating disorder that most closely resembles your symptoms. For example, if you’re mostly showing symptoms of lower frequency bulimia, your treatment plan will involve the same therapies and medications used for bulimia.
Because eating disorders are mental illnesses, your treatment team should include a psychologist, psychiatrist, social worker, or other licensed counselor, as well as a primary care physician or pediatrician and registered dietitian.
The Best Online Therapy and Support Services for Eating Disorders
Medications
While there are no prescription drugs specifically designated to treat OSFED, there are drugs that can be used to help manage symptoms and co-occurring depression or anxiety.
Medication is almost always used in conjunction with psychotherapy and nutrition therapy.
Medications Used to Treat Eating Disorders
Cognitive Behavioral Therapy
Cognitive behavioral therapy(CBT) is one of the most successful treatments for bulimia nervosa and binge eating disorder and is also used to treat OSFED, especially in people who have symptom profiles similar to bulimia and BED.
CBT for eating disorders commonly includes the following:
Dialectical behavior therapy (DBT), a type of CBT that teaches skills to live in the moment, cope with stress, regulate emotions, and improve relationships, has also been found effective in people with eating disorders, especially in those with binge eating disorder and bulimia nervosa. In DBT, the patient and therapist work together to resolve the seeming contradiction between self-acceptance and change in order to bring about positive changes.
Dialectical Behavior Therapy for Eating Disorders
Family-Based Therapy
Family-based treatment (FBT)is a leading treatment for adolescent eating disorders, including OSFED. In FBT, therapists don’t try to analyze why the eating disorder developed nor do they blame families for the disorders. Instead, FBT views the family as experts on the child and an essential part of the treatment team.
Family-Based Treatment for Eating Disorders
Nutritional Therapy
Staying healthy physically and emotionally will go a long way toward helping you cope with an eating disorder. In addition to talking to a therapist or joining a support group (likeEating Disorders Anonymous), enlist a trusted friend or family member who can help you along your path to recovery.
Another productive way to cope is to identify a few healthy distractions you can turn to when you find yourself obsessing about food and weight or experiencing the urge to turn to disordered eating or behaviors. Here are a few to consider:
Best Eating Disorder Support Groups
Final Thoughts
Recovery from OSFED can be challenging, and while it will take courage, it is possible, especially with the right support system in place. There’s no shame in getting professional help and reaching out to loved ones as you begin the journey toward a healthy relationship with food and yourself.
If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.
For more mental health resources, see ourNational Helpline Database.
Quieting the Food Noise and Managing Your New Relationship With Food
7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Machado PP, Gonçalves S, Hoek HW.DSM-5 reduces the proportion of EDNOS cases: Evidence from community samples.Int J Eat Disord. 2013;46(1):60-65. doi:10.1002/eat.22040National Eating Disorder Association.Other specified feeding or eating disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Thomas JJ, Vartanian LR, Brownell KD.The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: Meta-analysis and implications for DSM.Psychol Bull. 2009;135(3):407-433. doi:10.1037/a0015326Crow SJ, Peterson CB, Swanson SA, et al.Increased mortality in bulimia nervosa and other eating disorders.Am J Psychiatry. 2009;166(12):1342-1346. doi:10.1176/appi.ajp.2009.09020247Agras WS, Crow S, Mitchell JE, Halmi KA, Bryson S.A 4-year prospective study of eating disorder NOS compared with full eating disorder syndromes.Int J Eat Disord. 2009;42(6):565-570. doi:10.1002/eat.20708Costandache GI, Munteanu O, Salaru A, Oroian B, Cozmin M.An overview of the treatment of eating disorders in adults and adolescents: pharmacology and psychotherapy.PPN. 2023;32(1):40-48. doi:10.5114/ppn.2023.127237Additional ReadingKeel PK, Brown TA, Holm-Denoma J, Bodell LP.Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders: Reduction of eating disorder not otherwise specified and validity.Int J Eat Disord. 2011;44(6):553-560. doi:10.1002/eat.20892Ornstein RM, Rosen DS, Mammel KA, et al.Distribution of eating disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating disorders.J Adolesc Health. 2013;53(2):303-305. doi:10.1016/j.jadohealth.2013.03.025
7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Machado PP, Gonçalves S, Hoek HW.DSM-5 reduces the proportion of EDNOS cases: Evidence from community samples.Int J Eat Disord. 2013;46(1):60-65. doi:10.1002/eat.22040National Eating Disorder Association.Other specified feeding or eating disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Thomas JJ, Vartanian LR, Brownell KD.The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: Meta-analysis and implications for DSM.Psychol Bull. 2009;135(3):407-433. doi:10.1037/a0015326Crow SJ, Peterson CB, Swanson SA, et al.Increased mortality in bulimia nervosa and other eating disorders.Am J Psychiatry. 2009;166(12):1342-1346. doi:10.1176/appi.ajp.2009.09020247Agras WS, Crow S, Mitchell JE, Halmi KA, Bryson S.A 4-year prospective study of eating disorder NOS compared with full eating disorder syndromes.Int J Eat Disord. 2009;42(6):565-570. doi:10.1002/eat.20708Costandache GI, Munteanu O, Salaru A, Oroian B, Cozmin M.An overview of the treatment of eating disorders in adults and adolescents: pharmacology and psychotherapy.PPN. 2023;32(1):40-48. doi:10.5114/ppn.2023.127237Additional ReadingKeel PK, Brown TA, Holm-Denoma J, Bodell LP.Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders: Reduction of eating disorder not otherwise specified and validity.Int J Eat Disord. 2011;44(6):553-560. doi:10.1002/eat.20892Ornstein RM, Rosen DS, Mammel KA, et al.Distribution of eating disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating disorders.J Adolesc Health. 2013;53(2):303-305. doi:10.1016/j.jadohealth.2013.03.025
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Machado PP, Gonçalves S, Hoek HW.DSM-5 reduces the proportion of EDNOS cases: Evidence from community samples.Int J Eat Disord. 2013;46(1):60-65. doi:10.1002/eat.22040National Eating Disorder Association.Other specified feeding or eating disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Thomas JJ, Vartanian LR, Brownell KD.The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: Meta-analysis and implications for DSM.Psychol Bull. 2009;135(3):407-433. doi:10.1037/a0015326Crow SJ, Peterson CB, Swanson SA, et al.Increased mortality in bulimia nervosa and other eating disorders.Am J Psychiatry. 2009;166(12):1342-1346. doi:10.1176/appi.ajp.2009.09020247Agras WS, Crow S, Mitchell JE, Halmi KA, Bryson S.A 4-year prospective study of eating disorder NOS compared with full eating disorder syndromes.Int J Eat Disord. 2009;42(6):565-570. doi:10.1002/eat.20708Costandache GI, Munteanu O, Salaru A, Oroian B, Cozmin M.An overview of the treatment of eating disorders in adults and adolescents: pharmacology and psychotherapy.PPN. 2023;32(1):40-48. doi:10.5114/ppn.2023.127237
Machado PP, Gonçalves S, Hoek HW.DSM-5 reduces the proportion of EDNOS cases: Evidence from community samples.Int J Eat Disord. 2013;46(1):60-65. doi:10.1002/eat.22040
National Eating Disorder Association.Other specified feeding or eating disorders.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787
Thomas JJ, Vartanian LR, Brownell KD.The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: Meta-analysis and implications for DSM.Psychol Bull. 2009;135(3):407-433. doi:10.1037/a0015326
Crow SJ, Peterson CB, Swanson SA, et al.Increased mortality in bulimia nervosa and other eating disorders.Am J Psychiatry. 2009;166(12):1342-1346. doi:10.1176/appi.ajp.2009.09020247
Agras WS, Crow S, Mitchell JE, Halmi KA, Bryson S.A 4-year prospective study of eating disorder NOS compared with full eating disorder syndromes.Int J Eat Disord. 2009;42(6):565-570. doi:10.1002/eat.20708
Costandache GI, Munteanu O, Salaru A, Oroian B, Cozmin M.An overview of the treatment of eating disorders in adults and adolescents: pharmacology and psychotherapy.PPN. 2023;32(1):40-48. doi:10.5114/ppn.2023.127237
Keel PK, Brown TA, Holm-Denoma J, Bodell LP.Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders: Reduction of eating disorder not otherwise specified and validity.Int J Eat Disord. 2011;44(6):553-560. doi:10.1002/eat.20892Ornstein RM, Rosen DS, Mammel KA, et al.Distribution of eating disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating disorders.J Adolesc Health. 2013;53(2):303-305. doi:10.1016/j.jadohealth.2013.03.025
Keel PK, Brown TA, Holm-Denoma J, Bodell LP.Comparison of DSM-IV versus proposed DSM-5 diagnostic criteria for eating disorders: Reduction of eating disorder not otherwise specified and validity.Int J Eat Disord. 2011;44(6):553-560. doi:10.1002/eat.20892
Ornstein RM, Rosen DS, Mammel KA, et al.Distribution of eating disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating disorders.J Adolesc Health. 2013;53(2):303-305. doi:10.1016/j.jadohealth.2013.03.025
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