What is OSFED?

Other Specified Feeding or Eating Disorder, or OSFED, the diagnosis given to those with an eating disorder that doesn’t exactly fit with the full criteria for another eating disorder, like anorexia nervosa, bulimia nervosa or binge eating disorder, as specified by The Diagnostic and Statistical Manual (DSM-5). OSFED can affect anyone, regardless of gender, age, ethnicity or background.

People with OSFED present with disordered thoughts, feelings and behaviours around food and eating, which can manifest in many different ways. Presentations that fall under this category include:

Atypical anorexia nervosa (AAN): When someone meets all the criteria for anorexia nervosa, except despite weight loss their weight is within or above the “normal” weight range.

Bulimia nervosa (of low frequency and/or limited duration): When someone meets all the criteria for bulimia nervosa, except binge and compensatory behaviours occur less than once a week or for less than 3 months.

Binge eating disorder (of low frequency and/or limited duration): When someone meets all the criteria for binge eating disorder, except binge eating behaviours occur less than once a week or for less than 3 months.

Purging disorder: When someone doesn’t engage in binges or food restrictions, and uses purging behaviour (self-induced vomiting, laxatives or diuretics) to attempt to influence weight or shape.

Night eating syndrome: When someone recurrently eats large amounts of food just before going to bed, or wakes to eat in the night. This is diagnosed when it causes someone distress or impairs their functioning, and the behaviourcannot be better explained by something else, such as medication or another mental health disorder like BED.

When people are diagnosed with OSFED, particularly with AAN, they can often feel like their diagnosis is less valid or that they aren’t “sick enough” to deserve treatment. However, a diagnosis of OSFED does not mean an eating disorder is less severe, and these conditions still cause significant distress and impact daily life. As with any eating disorder, OSFED is not a choice, but a serious mental illness. Research has indicated that the medical complications of AAN are comparable to those of anorexia nervosa, suggesting that these complications are more strongly associated with the ED symptom of significant weight loss (at any body size), rather than with being classified as underweight.

If you have been diagnosed with OSFED, you are not alone. In fact, it is one of the most common eating disorders in Australia. As with other eating disorders, people with OSFED benefit from specialist treatment from a multidisciplinary team, including a GP, psychologist and dietitian. Early intervention is key to promote effective treatment and recovery. If you would like one of our lovely dietitians to be a part of your treatment team, feel free to use our “Contact Us” page to reach out.

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