Other Specified Feeding Or Eating Disorder

Other specified feeding and eating disorder is referred to as “specified” because when it is diagnosed, one of five subtypes is selected, each with distinct symptoms.

Atypical anorexia nervosa

In the atypical anorexia nervosa subtype, a client meets all of the criteria for anorexia nervosa except the symptom of being significantly or dangerously underweight. A person with atypical anorexia nervosa may have experienced noteworthy weight loss. However, their weight is still within or above what is medically expected based on their height, age, and other relevant factors.

Note that weight does not necessarily signify whether someone is living with an eating disorder. Studies show that people often gain weight initially after restricting food intake. Anorexia is characterized by a desire to lose weight to the point that one severely limits what they eat and may participate in purging behaviors like excessive exercise. 

Bulimia nervosa of low frequency or limited duration

In this subtype of bulimia, the individual exhibits all the symptoms of bulimia nervosa, primarily binge eating and compensatory behaviors. However, their binging and purging either does not happen frequently (defined as no more than once a week), or the behavior occurs frequently but doesn’t last for more than three months.

Binge eating disorder of low frequency or limited duration

Like the above listed bulimia nervosa subtype, this variant of binge eating disorder involves problematic binge eating that does not occur often or does not last for a significant period. In some cases, binge eating episodes may happen once every few months, with breaks between them. 

Purging disorder

Purging disorder is similar to bulimia nervosa in that it involves purging behavior such as misusing laxatives or diuretics or forcing oneself to vomit. However, unlike bulimia nervosa, purging disorder does not include binge eating.

Night eating syndrome

Night eating syndrome involves eating after waking up in the middle of the night or eating excessive food after dinner. To meet diagnostic criteria for this OSFED subtype, the nocturnal eating behavior can’t be linked to substance use, cultural or social norms, or a significant change in a person’s sleep cycle, like starting to work a graveyard shift. Night eating must also cause distress. However, unlike other eating disorders, the distress is not primarily related to weight gain or body shape concerns.

Other specified feeding and eating disorders, like all eating disorders, are thought to be caused by various biological, psychological, social, and cultural influences. 

Environmental OSFED risk factors

Below are some of the environmental OSFED risk factors: 

• Experiencing a significant life change or stressor — for example, some people’s OSFED symptoms may be incited by moving away for college or experiencing a divorce
• Growing up in a culture or setting where thinness is valued, such as Western culture or a family system that emphasized dieting and fat-shaming
• Working in an occupation that highlights thinness, such as modeling, athletics, acting, or singing
• Having a parent or sibling who has an eating disorder
• Experiencing physical or sexual abuse in childhood
• Lacking meaningful and supportive relationships
• Past experiences with bullying

Psychological OSFED risk factors

A few psychological risk factors for developing OSFED include the following: 

• A history of anxiety or obsessive thinking
• Loneliness
• Low self-esteem
• Poor interpersonal skills
• A perfectionistic personality 
• A sense of being out of control
• Other mental health conditions, particularly obsessive-compulsive disorder (OCD), depression, and social anxiety disorder³

Biological OSFED risk factors

Below are some of the biological risk factors for OSFED: 

• Early onset puberty
• Childhood obesity
• Specific neurobiology, such as how one’s body reacts to being hungry or full

The goal of treatment for other specified feeding and eating disorders is to reduce or eliminate problematic eating behaviors, which often involves developing alternative coping mechanisms for processing negative emotions. 

Medication

The only medications that the US Food and Drug Administration (FDA) has approved to treat any form of eating disorder are fluoxetine, specifically to treat bulimia nervosa, and lisdexamfetamine for binge-eating disorder. 

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that is also used to treat depression and other mental health conditions. Lisdexamfetamine is a stimulant that is used to treat attention-deficit/hyperactivity disorder (ADHD) and binge-eating disorder. 

Medication is often not the sole treatment option prescribed for OSFED. Therapy is typically the mainstay of treatment, in addition to medication in some cases. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Other treatment options 

Other treatment options for OSFED may include the following: 

• Hospitalization: In some cases, when an individual has lost a significant or dangerous amount of weight, they may be admitted to the hospital to implement a nutrition plan, tube feeding, or inpatient psychiatric care. 
• Rehabilitation centers: Rehabilitation centers for eating disorders allow individuals to live in a residential building and receive care from a team of doctors, nutritionists, and therapists.⁴ 
• Support groups: A support group may be beneficial for people with eating disorders, as it can allow them to connect with others experiencing similar challenges. 

Self-care

Because OSFED results in unhealthy eating patterns, it is associated with several physical health impacts. One of the most effective ways to combat these effects may be prioritizing physical health in OSFED recovery. Besides developing a regular eating schedule, self-care for OSFED patients could involve ensuring they are drinking enough water and sleeping between seven and nine hours a night. 

Some people living with OSFED may benefit from mindfulness practices, such as awareness of one’s five senses, observing the present moment, and focusing on breathing. Since OSFED behaviors such as binging, purging, or restricting are often incited by internal thoughts and emotions, techniques that move a person’s focus from their brain to their body may be helpful.

Recovering from eating disorders can be a complicated process involving various treatment providers, including physicians, dieticians, family therapists, social workers, and peer support groups. It may be helpful to make an individual’s one-on-one meetings with their therapist as convenient as possible. Online therapy through a legitimate platform like BetterHelp can enable OSFED clients to talk to their counselors from the comfort and convenience of their homes. 

There are various organizations dedicated to providing resources and support for people experiencing eating disorders, including OSFED. The National Eating Disorder Association features screening tools and blogs on topics related to eating disorder recovery. The US Substance Abuse and Mental Health Services Administration (SAMHSA) recently designated a new National Center for Excellence for Eating Disorders at the University of North Carolina, Chapel Hill. The center includes a treatment provider search tool and resources for people with eating disorders and their loved ones.

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Incorrect beliefs about OSFED persist in the medical and therapeutic community, including that it is a less severe condition than any of the named eating disorders in the DSM-V and that it is more challenging to treat. Misinformed beliefs about treatment efficacy may stem from the fact that care providers may not take OSFED as seriously as other eating disorders, so they may not recommend treatment until the disorder has progressed to the point where treatment is less effective. Another misconception about eating disorders, including OSFED, is the belief that each disorder requires specialized treatment plans, and what works to treat one eating disorder may not be effective in treating another.

One study sought to address these misconceptions. The researchers found that individuals with OSFED and people who met the criteria for one of the named eating disorders had similar levels of functional impairment and emotional distress, as well as depressive symptoms, decreased self-esteem, and concerns about eating, weight, and body shape. Additional results indicated that people with OSFED responded to CBT-E treatment at similar rates to people with named eating disorders, which supports a “transdiagnostic” model in which all eating disorders are thought to share the same causes and risk factors and respond to the same treatments.  

Eating disorders, including OSFED, are associated with high rates of dropout from treatment plans. Hence, exploring ways to make treatment more effective in both the short and long term is often a priority for eating disorder researchers and treatment providers. One study assessing several eating disorder treatment options, including those addressing OSFED, found that providing internet-based treatment may enhance treatment adherence and outcomes. Treatment through software programs, email, text, and telemedicine appointments were all found to increase the effectiveness of therapeutic interventions.

Below are several statistics on eating disorders and other specified feeding or eating disorder:

• Together, the five subtypes of OSFED make up most of all eating disorder diagnoses.
• A study found that almost 14% of adolescent girls meet or have met diagnostic criteria for an eating disorder, including OSFED, by the time they are 20.  
• Roughly one in four people with an eating disorder also demonstrate symptoms of post-traumatic stress disorder (PTSD).
• A study assessing the use of CBT-E in the treatment of eating disorders found that around two-thirds of the clients who completed treatment were able to resolve their eating disorder symptoms fully.