What Is OSFED? (Formerly: What Is EDNOS?)

OSFED (Other Specified Feeding or Eating Disorder) is the new and updated description that replaces the eating disorder category formerly called EDNOS (Eating Disorder Not Otherwise Specified).

OSFED is an eating disorder classification for those who do not meet the diagnostic criteria for any other eating disorders. Those who fall under OSFED have features that closely resemble anorexia nervosa, bulimia nervosa or binge eating disorder. As with any other eating disorder, OSFED is a complex and serious mental illness.

 

Some sub-types of OSFED

Atypical anorexia nervosa – You may develop all of the criteria for anorexia nervosa, except that despite a significant weight loss, you are within or above the “normal” weight range.

Bulimia nervosa of low frequency and/or limited duration – You may meet the criteria for bulimia nervosa but the binge/purge cycles may only occur, on average, less than once a week and/or for less than three months.

Binge eating disorder of low frequency and/or limited duration – You would have all of the symptoms of binge eating disorder, except the binges don’t happen as often or over as long a period of time as doctors would expect.

Purging disorder – In order to change your weight or shape, you use purging behaviours without binge eating (i.e. this is not part of binge/purge cycles).

Night eating syndrome – Excessive night-time food consumption. You either eat a lot after your evening meal or when waking up after sleep.

 

Warning Signs and Symptoms of OSFED

You may display any combination of the following:

Emotional and Behavioural Signs/Symptoms of OSFED

  • Low confidence and self-esteem 
  • Self loathing
  • Preoccupation with weight, food and dieting
  • Restricting calories and/or self starvation
  • Skipping meals and saying you have already eaten
  • Dramatic weight loss
  • Wearing several layers of baggy clothing (to hide the weight loss and also to keep warm)
  • Binge eating
  • Purging – self induced vomiting, laxative abuse, diuretic abuse
  • Feelings of intense shame and guilt
  • Depression 
  • Anxiety
  • Frequently making comments about feeling fat or overweight despite losing weight
  • Distorted body image – regularly checking in the mirror for perceived flaws in appearance or pinching the skin to see how much fat you have (body dysmorphic disorder ‘body dysmorphia’)
  • Having rigid thoughts about food being good or bad
  • Orthorexic thoughts and behaviours – obsession with food cleanliness or purity. Restricting or completely cutting out whole food groups under the guise of ‘healthy eating’
  • Rituals associated with food and/or eating
  • Self consciousness when eating in front of others
  • Social withdrawal
  • Secretive behaviour around food – hoarding food
  • Drinking excessive amounts of water or non calorie beverages
  • Drinking excessive amounts of mouthwash / chewing mints or gum rather than meals
  • Excessive (obsessive) exercise.

Physical Signs/Symptoms of OSFED

  • Difficulty concentrating
  • Tiredness
  • Fainting and dizziness
  • Feeling cold all the time
  • Noticeable weight fluctuations (both up and down)
  • Stomach cramps, constipation, diarrhoea, acid reflux
  • Amenorrhea (absence of menstrual periods)
  • Getting sick more often (impaired immune system)
  • Slow heart rate
  • Muscle weakness
  • Iron deficiency (amnesia) and other vitamin and mineral deficiencies
  • Dry, brittle and thinning hair
  • Dry skin (maybe yellow)
  • Swollen cheeks or jaws
  • Calluses on knuckles
  • Dry and brittle nails
  • Dental erosion, decay and bad breath.

You may think that because you have not been diagnosed as having a specific eating disorder that there is no need to take this illness seriously but please, DO NOT LET THE VOICE OF YOUR EATING DISORDER CONTROL YOU. CHALLENGE IT AND TAKE ACTION. SEEK HELP.

If left untreated, you will be at risk of developing severe physical and psychological problems. 

 

Long term effects of OSFED

  • Inflammation and tearing of the throat and stomach
  • Constipation and diarrhoea
  • Heart disease/failure (or irregular or slow heart rate)
  • Kidney failure
  • Liver failure
  • Type 1 diabetes
  • Osteoporosis (muscle loss and weakness)
  • Slowed growth in young people
  • High levels of anxiety
  • High blood pressure
  • Amenorrhea (absence of menstruation)
  • Infertility
  • Severe hydration
  • Poor skin condition
  • Hair loss
  • Dental erosion and decay.

 

Treatment For OSFED

As cases differ greatly, there is no specific treatment plan for OSFED. We understand that OSFED begins in the mind not the body. Our approach is much more holistic and treatment should be designed to get to the root cause of the illness rather than just treating the symptoms. Regarding the symptoms of OSFED, individualised treatment plans should be devised and you should be offered the treatment for the type of eating disorder your symptoms are most similar to.

 

[Photo by Niklas Hamann on Unsplash]

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