OSFED | Symptoms, Causes and Treatment Options

When most people think of eating disorders, they picture anorexia or bulimia. But not everyone fits neatly into those boxes. Some people show disordered eating patterns that don’t fully meet the criteria for a specific diagnosis, yet their struggle is just as real. This is what’s known as Specified Feeding or Eating Disorder or simply OSFED

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What is OSFED?

OSFED is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a formal diagnosis. It applies to people who experience substantial distress or functional disruption from disordered eating but whose symptoms don’t quite meet the full criteria for anorexia nervosa, bulimia nervosa or binge eating disorder.

In many cases, individuals with OSFED experience versions of these better-known disorders at a lower frequency or intensity. But frequency isn’t the only thing that makes a disorder worth recognising. OSFED covers a wide range of behaviours and those living with it deserve support and understanding, not dismissal.

Types of OSFED

The DSM-5 outlines several examples of how OSFED can appear in real life. These types don’t define every person’s experience but they help show the variety of ways disordered eating can take shape.

Atypical anorexia nervosa: The person meets all the criteria for anorexia, except that their weight remains within or above the normal range, despite significant weight loss.
Bulimia nervosa (low frequency or limited duration): All the features of bulimia are present but binge-purge episodes occur less than once a week or for less than three months.
Binge eating disorder (low frequency or limited duration): Similar to bulimia, this refers to less frequent or shorter-duration binge episodes but still with the same emotional distress.
Purging disorder: Regular purging (such as vomiting or misuse of laxatives) occurs without binge eating episodes.
Night eating syndrome: Characterised by eating during the night or after the evening meal in a way that causes distress and isn’t explained by sleep disruptions, medication or other disorders.

Each of these types can lead to serious consequences if left untreated and all fall under the umbrella of OSFED.

What are the warning signs of OSFED?

Because OSFED includes a broad range of behaviours, warning signs can vary from person to person. Still, there are several patterns that often signal concern. These signs may appear gradually or develop quickly and they may be visible to others or only felt by the individual themselves.

Psychological warning signs might include persistent thoughts about food, guilt after eating, distorted body image or feelings of worthlessness linked to weight and appearance.
Physical warning signs could include sudden weight changes, signs of malnutrition, fatigue, gastrointestinal discomfort or, for women, menstrual irregularities.
Behavioural warning signs often include skipping meals, hiding food, using laxatives, overexercising or avoiding food-related social settings. Some people may develop rigid food rules or feel extreme anxiety in eating situations.

It’s worth noting that someone doesn’t have to show all of these signs to be struggling. If you’re worried about yourself or someone you care about, trust your instincts and reach out for support.

What causes OSFED?

Like other eating disorders, OSFED doesn’t have a single cause. It tends to develop over time through a combination of psychological, environmental and biological influences. For many, the disorder is a coping mechanism that offers a sense of control or emotional relief, at least temporarily.

Body image concerns are a common starting point. A person might not feel at ease in their body and turn to restrictive eating, purging or bingeing as a response to that discomfort. In many cases, this is fuelled by societal messages that equate thinness with success or beauty.

There may also be a genetic vulnerability. Research has shown a hereditary component to eating disorders and chemical imbalances in the brain (particularly those affecting mood and appetite) can make some individuals more susceptible.

Mental health struggles, especially depression and anxiety, can also play a significant role, either as causes or consequences of disordered eating. One study found that young women with depression or anxiety were significantly more likely to develop an eating disorder than those without.

Trauma or life stressors, such as abuse, bullying or major life transitions, are also linked to the development of eating disorders. In some cases, food becomes a way to cope, soothe or regain control.

Finally, dieting itself is often a risk factor. While it may begin with good intentions, restrictive behaviours can spiral into patterns that become increasingly difficult to break.

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How is OSFED treated?

Treatment for OSFED depends on the specific symptoms a person is experiencing but the goal remains the same: to address both the behaviours and the deeper emotional roots. Most people benefit from a combination of therapies and nutritional support, ideally delivered by professionals who understand the nuances of eating disorders.

Therapies used in OSFED treatment include:

Cognitive behavioural therapy (CBT): Helps people identify and change unhelpful thoughts related to food, self-image and control.
Dialectical behaviour therapy (DBT): Focuses on emotional regulation and reducing the behaviours that stem from intense or difficult emotions.
Family therapy: Especially useful for younger individuals, this involves family members in the treatment process to provide support, education and better communication.
Group therapy: Offers a safe space to connect with others facing similar struggles, helping to reduce isolation and foster community.
Nutrition education: Registered dietitians help develop balanced eating habits while addressing fears around food and working toward body neutrality.

Some treatment centres also provide holistic therapies like mindfulness and yoga. These can help people reconnect with their bodies in a more positive way, while offering tools for stress management that don’t involve food.

What happens next?

Living with OSFED can feel confusing and overwhelming, especially when the symptoms don’t fit neatly into a label. But that doesn’t make the experience any less valid or the need for support any less real.

If you recognise any of the patterns mentioned here in yourself or someone close to you, it’s worth speaking to a healthcare provider. With help, OSFED can be managed and recovery is absolutely possible.

Addiction Helper can connect you with professionals who understand what you’re going through. Whether the symptoms lean more toward restriction, purging, bingeing or a combination of these, you don’t have to face them alone.

Now is a good time to take that first step.

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Our compassionate team are ready and available to take your call, and guide you towards lasting the lasting addiction recovery you deserve.

Frequently Asked Questions

How is OSFED different from anorexia or bulimia?

OSFED includes disordered eating patterns that cause distress but don’t meet all criteria for anorexia or bulimia. It still requires professional support and can be just as serious if left untreated.

Can someone with OSFED recover fully?

Yes, full recovery from OSFED is possible. With tailored therapy, nutritional support and ongoing care, individuals can build healthier habits, address underlying issues and restore balance in their relationship with food and body.

Is OSFED a common diagnosis for eating disorders?

Yes, OSFED is actually one of the most frequently diagnosed eating disorders. Many people struggle with significant symptoms that don’t fit other categories, making OSFED an important and often misunderstood diagnosis.

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