Other Specified Feeding or Eating Disorder (OSFED)

Anorexia, bulimia, and binge eating disorder are diagnosed according to 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 three specific eating disorders. In that case, they might be diagnosed with an “other specified feeding or eating disorder” (OSFED).

OSFED is every bit as serious as anorexia, bulimia, or binge eating disorder, and people suffering from OSFED are every bit as deserving and in need of treatment – their eating disorder is just presenting in a different way. It is common for symptoms to not fit with the exact diagnostic criteria for anorexia, bulimia, or binge eating disorder – OSFED accounts for a large percentage of eating disorders.

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 a “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 expect.
  • 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 expect.
  • 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 that they present in the case of these specific 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 to look out for might include:

  • Preoccupation with 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. The first step is usually to make an appointment with the GP.

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 from 1987 to 2013. In 2013 this was replaced by the new (fifth) edition of the DSM, with some significant changes to the section on eating disorders. Before 2013, around 50% of all people diagnosed with an eating disorder were diagnosed with EDNOS, and studies have suggested that a significant proportion of the people who were diagnosed with EDNOS under the fourth edition of the DSM would now be given a diagnosis of binge eating disorder under the fifth edition of the DSM. The aim of the changes to the classification system in 2013 was to ensure more people with eating disorders have a diagnosis that accurately describes their symptoms and behaviours. However, the term EDNOS may still be used in some circumstances.

Issue date: September 2017  Review date: September 2020 Version 2.0 Sources used to create this information are available by contacting Beat. We welcome your feedback on our information resources.