Other Specified Feeding & Eating Disorders (OSFED)
What is Other Specified Feeding and Eating Disorder? (OSFED)
This category applies to presentations in which symptoms characteristic of a feeding and eating disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the feeding and eating disorders diagnostic class. The other specified feeding or eating disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific feeding and eating disorder. This is done by recording “other specified feeding or eating disorder” followed by the specific reason (e.g., “bulimia nervosa of low frequency”).
Examples of presentations that can be specified using the “other specified” designation include the following:
- Atypical anorexia nervosa: All of the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual’s weight is within or above the normal range.
- Bulimia nervosa (of low frequency and/or limited duration): All of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behaviours occur, on average, less than once a week and/or for less than 3 months.
- Binge-eating disorder (of low frequency and/or limited duration): All of the criteria for binge-eating disorder are met, except that the binge eating occurs, on average, less than once a week and/or for less than 3 months.
- Purging disorder: Recurrent purging behaviour to influence weight or shape (e.g., self-induced vomiting: misuse of laxatives, diuretics, or other medications) in the absence of binge eating.
- Night eating syndrome: 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. The night eating is not better explained by external influences such as changes in the individual’s sleep-wake cycle or by local social norms. The night eating causes significant distress and/or impairment in functioning. The disordered pattern of eating is not better explained by binge-eating disorder or another mental disorder, including substance use, and is not attributable to another medical disorder or to an effect of medication
How is Other Specified Feeding and Eating Disorder (OSFED) Treated?
Due to the overlap with anorexia, bulimia, and binge eating disorder, the evidence-base to date recommends the use of CBT-E, and DBT protocols adapted for eating disorders in the treatment of OSFED. It is extremely important to recognize that individuals who fall in this diagnostic category are at the same elevated risk of medical and physical problems as other eating disorders. Specialized treatment is essential.