Other specified feeding or eating disorder (OSFED)

Anorexia, bulimia, and binge eating disorder are diagnosed using a list of expected behavioural, psychological, and physical symptoms. Sometimes a person’s symptoms don’t exactly fit the expected symptoms for any of these eating disorders. In that case, they might be diagnosed with an “other specified feeding or eating disorder” (OSFED).

This is very common. OSFED accounts for the highest percentage of eating disorders, and anyone of any age, gender, ethnicity or background can experience it. It is every bit as serious as anorexia, bulimia, or binge eating disorder, and can develop from or into another diagnosis. People suffering from OSFED need and deserve treatment just as much as anyone else with an eating disorder. The symptoms and behaviours are distressing, and impact different aspects of someone's life.

As OSFED is an umbrella term, people diagnosed with it may experience very different symptoms. It can also be used to communicate why someone doesn't meet the criteria for another eating disorder.

Some specific examples of OSFED include:

• Atypical anorexia – where someone has all the symptoms a doctor looks for to diagnose anorexia, except their weight remains within or above the “normal” range.
• Bulimia nervosa (of low frequency and/or limited duration) – where someone has all of the symptoms of bulimia, except the binge/purge cycles don’t happen as often or over as long a period of time as doctors would use to diagnose bulimia.
• Binge eating disorder (of low frequency and/or limited duration) – where someone has 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 use to diagnose binge eating disorder.
• Purging disorder – where someone purges, for example by being sick or using laxatives, to affect their weight or shape, but this isn’t as part of binge/purge cycles.
• Night eating syndrome – where someone repeatedly eats at night, either after waking up from sleep, or by eating a lot of food after their evening meal.

Like any other eating disorder, OSFED is a very serious mental illness that is not only about the way the person treats food but about underlying thoughts and feelings. The eating disorder may be a way of coping with these thoughts, or a way of feeling in control.

People with OSFED may work to hide their illness and someone may have been ill for a long time before physical symptoms appear, if they do at all. Any of the symptoms associated with bulimia, anorexia, or binge eating disorder can be part of OSFED, and these would come with the same short-term and long-term risks as in the case of these eating disorders. As with other eating disorders, it will probably be changes in the person’s behaviour and feelings that those around them notice first, before any physical signs appear. 

Signs of OSFED to look out for might include:

• Overly focused on and/or secretive behaviour around food
• Self-consciousness when eating in front of others
• Low confidence and self-esteem
• Poor body image
• Irritability and mood swings
• Tiredness
• Social withdrawal
• Feelings of shame, guilt, and anxiety
• Difficulty concentrating

It’s not always obvious that someone has an eating disorder – remember, they are mental illnesses.  If you’re worried about yourself or someone you know, even if only some of the signs on this page are present, you should still seek help immediately, as this gives the best chance of recovery. The first step is usually to make an appointment with the GP.

OSFED or EDNOS?

Less commonly nowadays, you might also hear the term “eating disorder not otherwise specified” (EDNOS) to refer to eating disorders that don’t fit all the expected symptoms of anorexia, bulimia, or binge eating disorder. EDNOS was used in the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification system, which describes different types of eating disorders, from 1987 to 2013. In 2013 this was replaced by the current edition of the DSM, with some major changes to the section on eating disorders. The aim of the changes was to ensure people with eating disorders have a diagnosis that best describes their illness.

EDNOS isn’t in the current edition of the DSM, and people who might have been diagnosed with it previously would probably be given a different diagnosis now – that could be any of those talked about in these pages, not just OSFED. However, occasionally the term EDNOS may still be used.

Last updated May 2024