You’ve probably heard of anorexia, bulimia, maybe even binge eating disorder. They’re classic examples of eating disorders that consume a person’s life.
But, like most things in life, eating disorders don’t always fit into a neat little box. Sometimes there’s a gray zone. Having a few, but not all, of the symptoms of a disorder doesn’t mean you can safely ignore the signs.
We talked to OhioHealth sports medicine dietitian Dawn Holmes, MS, RD, CSSD, and primary care and sports medicine physician Marguerite Weston, MD, to gain a better understanding of OSFED, or “other specified feeding or eating disorder,” a catchall diagnosis for eating disorders that don’t check all the traditional boxes.
What is OSFED?
Other specified feeding or eating disorder includes behaviors that cause you significant distress and can impair your physical or emotional health, but do not meet all the criteria of well-defined eating disorders like anorexia, bulimia or binge eating disorder. OSFED can be just as life-threatening as these more commonly recognized eating disorders.
Five examples of this disorder include:
- Atypical anorexia nervosa – People with this disorder meet all diagnoses criteria of anorexia, except they do not experience significant weight loss, or their weight is within a normal range.
- Atypical binge eating disorder – People with this disorder binge less frequently than once a week for three months. They may be in the early stages of a binge eating disorder, or they may just binge in short bursts, such as in reaction to stressful situations.
- Atypical bulimia – People with this disorder may only binge, and not purge, or haven’t been binging and purging long enough to be considered bulimic.
- Purging disorder – Like those with bulimia, people with this disorder purge regularly through vomiting or exercise to influence their weight or shape, but they do not binge eat. They may also lack secretive eating habits.
- Night eating syndrome – People with this syndrome experience recurrent episodes of night eating. They may eat large amounts of food after an evening meal or wake up in the middle of the night to eat, and this behavior is accompanied by psychological distress that impacts their quality of life and sleep patterns.
What are the warning signs and symptoms of OSFED?
People with OSFED may exhibit unique warning signs, but in general, they share challenges controlling how or what they eat, psychological distress associated with eating, withdrawal from family and friends, and difficulty achieving a fully balanced and functional lifestyle. Specific symptoms are similar to those exhibited by people with anorexia, bulimia, binge eating disorder or orthorexia.
How does OSFED affect the body?
Even though people with OSFED don’t have classic diagnoses, it’s just as common as better-known eating disorders, and just as dangerous because of the shared symptoms. For example, people with atypical anorexia may still consume inadequate calories to support their body’s needs, resulting in the same symptoms of brittle hair, muscle weakness, dizziness, menstrual irregularities and other medical complications.
How is OSFED diagnosed?
If you suspect someone in your life has an eating disorder, start by asking the questions on the SCOFF Questionnaire, which is used in the evaluation of all eating disorders. If the answer to one or more questions is yes, seek help from a psychologist who can make a medical diagnosis.
How do you treat OSFED?
As with all eating disorders, the longer symptoms persist, the harder the disorder is to treat. Early intervention with a multidisciplinary care team is critical.
Find a physician who is knowledgeable about eating disorders. This will help them tailor your care to your needs and address any associated medical complications.
A psychologist will explore the underlying causes of the disorder and provide you with coping techniques that address your triggers in healthy ways.
And finally, a dietitian will develop a structured meal plan that provides appropriate nutrition. This is particularly important for someone who has night eating syndrome. Often, these people are not consuming enough food during the day.
Overcoming any eating disorder is challenging, and relapses are not uncommon. But with proper guidance, you can recover and live a healthy life.