Many of us are familiar with eating disorders like bulimia and anorexia, but there are instances where people may exhibit some signs of an eating disorder without meeting all the criteria. In this case, they may be diagnosed with Other Specified Feeding or Eating Disorder, known as OSFED. Regardless of the number of symptoms people may or may not show, OSFED is still classified as a category of eating disorders and requires professional medical attention in order to attain full recovery.

What is OSFED?

OSFED, an acronym for Other Specified Feeding or Eating Disorder, is a diagnostic classification employed in the realm of eating disorders, featured in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

This category is used to classify eating disorders that deviate from the criteria established for specific disorders such as anorexia nervosa, bulimia nervosa, or binge-eating disorder. OSFED encompasses a spectrum of eating behaviours and symptoms that lead to considerable distress or impairment, yet do not fully align with the criteria for other specified eating disorders.

What are the different types of OSFED?

The DSM-5 states that OSFED may encompass a variety of eating behaviours and symptoms. Here are some examples:

  • Atypical anorexia nervosa: Meets all the criteria for anorexia nervosa, except that despite experiencing considerable weight loss, the individual’s weight remains within or above the normal range.


  • Bulimia nervosa (of low frequency and/or limited duration): Meets all the criteria for bulimia nervosa, except for the occurrence of binge eating and inappropriate compensatory behaviours, which happen, on average, less than once a week and/or for a duration of fewer than 3 months.


  • Binge-eating disorder (of low frequency and/or limited duration): Satisfies all the criteria for binge-eating disorder, except that the frequency of binge eating is, on average, less than once a week and/or lasts for less than 3 months.


  • Purging disorder: Involves recurring purging behaviours aimed at influencing weight or shape (e.g., self-induced vomiting, misuse of laxatives, diuretics, or other medications) without the presence of binge eating.


  • Night eating syndrome: Marked by repetitive instances of eating after waking from sleep or consuming an excessive amount of food following the evening meal, the person is conscious of and can recall these eating episodes. Night eating cannot be sufficiently accounted for by external factors such as alterations in the individual’s sleep-wake cycle or local social norms. This eating pattern leads to substantial distress and/or impairment in functioning. It is not more effectively clarified by conditions like binge-eating disorder or other mental disorders, including substance use, and is not attributable to another medical condition or the effects of medication


Source: DSM-5 (American Psychiatric Association, 2013)

What are the warning signs of OSFED?

It should be emphasised that OSFED is a comprehensive category that includes various eating disorders. Consequently, when observing for warning signs, it is important to recognise that different subtypes of OSFED exhibit distinct features and individuals may display diverse patterns of behaviour and symptoms.

However, here are the general symptoms of OSFED broken down into three main categories: psychological, physical and behavioural:


Psychological warning signs of OSFED

  • Constantly thinking about food, dieting, or body appearance.
  • Excessive concern about weight, shape and size.
  • Mood swings, irritability, or increased anxiety related to food and eating.
  • Feeling guilt or shame after eating.
  • Perceiving one’s body size or shape inaccurately.
  • Engaging in negative self-talk related to body image.
  • A persistent sense of low self-worth, often tied to body weight and shape.
  • Seeking validation and self-worth through appearance.


Physical warning signs of OSFED

  • Significant weight loss or fluctuations that do not align with a healthy or stable pattern.
  • Physical signs of malnutrition, such as brittle nails, thinning hair, or dry skin.
  • Lack of energy, tiredness and weakness.
  • Difficulty concentrating or focusing.
  • For females, irregular or absent menstrual cycles.
  • Disruption in reproductive health due to nutritional deficiencies.
  • Gastrointestinal problems, such as constipation, bloating, or stomach cramps.
  • Irregular bowel movements or signs of malabsorption.


Behavioural warning signs of OSFED

  • Following restrictive diets, cutting out entire food groups, or severely limiting caloric intake.
  • Obsessive calorie counting or tracking food intake.
  • Engaging in excessive exercise as a means of compensating for food intake.
  • Using laxatives, diuretics, or other methods to control weight.
  • Developing strict rituals or rules around eating, such as eating only at certain times or avoiding specific foods.
  • Expressing distress or anxiety when faced with situations involving food.
  • Avoidance of social gatherings that involve food.
  • Withdrawal from friends and family, especially if food-related activities are involved.



If you suspect someone may be struggling with OSFED or any eating disorder, it is crucial to encourage them to seek professional help from healthcare providers, therapists, or nutritionists.

What are the causes of OSFED?

Again, it must be stated that the cause of a person’s specific type of OSFED could differ depending on the diagnosis. However, OSFED is still classed as an eating disorder and below are some of the most common causes of eating disorders in general:

  • Body image concerns: Individuals with OSFED may have distorted body image perceptions, feeling dissatisfied with their bodies and striving for an unrealistic or unhealthy body shape.


  • Sociocultural factors: Pressures related to societal standards of beauty, thinness, or body image can contribute to the development of OSFED. Media portrayal of idealised body types and cultural expectations may influence individuals negatively.


  • Genetic and biological factors: There may be a genetic predisposition to eating disorders, with studies estimating a range anywhere between 28%-84% depending on the type of eating disorder. Certain biological factors, such as neurotransmitter imbalances, may also play a role.


  • Mood disorders: Mood disorders can contribute to the development or maintenance of an eating disorder. A study showed that 15-25-year-old females were four times more likely to suffer from a lifetime eating disorder if they also suffered from a major depressive disorder or anxiety disorder.


  • Trauma or life events: Traumatic experiences, such as abuse, bullying, or other life stressors, may contribute to the development of an eating disorder. Eating behaviours can sometimes be a way for individuals to regain a sense of control or cope with difficult emotions.


  • Dieting and weight-related behaviours: Restrictive dieting, excessive exercise, or other weight-related behaviours may contribute to the development of an eating disorder. These behaviours can escalate and become disordered eating patterns.

How is OSFED treated?

Typically, the guidance for treatment will be determined by aligning with the specific eating disorder that most closely mirrors your symptoms, such as anorexia nervosa, bulimia nervosa, or binge eating disorder.

Treatment centres will usually treat OSFED through a combination of therapy and nutritional support. Here are some of the main options;

  • Cognitive behavioural therapy (CBT): CBT is a form of talk therapy that helps with recognising and challenging negative thoughts and behaviours linked to food, body image and self-esteem.



  • Family therapy: This collaborative therapy involves your family to bolster support for your OSFED recovery. It focuses on strengthening familial bonds, educating loved ones about OSFED, improving communication and relationships and promoting healthy eating habits.


  • Group therapy: By creating a supportive environment, group therapy enables the sharing of experiences and connections with others facing various conditions. This encourages a sense of community and facilitates learning from others’ experiences.


  • Nutrition education: In-house nutritionists can offer education and guidance on cultivating healthy eating habits. They will usually cover topics such as balanced meals, portion control and working on a positive body image.


Additionally, some treatment centres provide a variety of recreational and holistic activities, including yoga and mindfulness exercises, to support both physical and mental well-being.

What are the next steps?

We recognise that seeking help for any eating disorder may seem intimidating, but it’s crucial to remember that effective treatment is available, and you can access the support you need. Taking the step to consult with a healthcare professional opens the door to recovery, offering the prospect of a life free from the challenges of an eating disorder. Don’t hesitate to reach out for assistance today and take the first step toward reclaiming your life.

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What does OSFED stand for?
OSFED stands for “Other Specified Feeding or Eating Disorder.” It is a category of eating disorders that includes individuals who have disordered eating patterns and behaviours but do not meet the specific criteria for anorexia nervosa, bulimia nervosa, or binge-eating disorder.

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