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Understanding OSFED (Formerly EDNOS)
Other Specified Feeding or Eating Disorder (OSFED), formerly known as EDNOS (Eating Disorder Not Otherwise Specified), is a formally recognised eating disorder that describes individuals who experience significant disordered eating behaviours but do not meet the full diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder.
Despite being less widely known, OSFED is just as serious as other eating disorders and can involve life-threatening health risks and psychological distress.
What Is OSFED?
OSFED is a diagnostic category used when someone’s symptoms cause significant physical or emotional harm but do not fit neatly into a single eating disorder category. For example, someone may:
- Meet all the criteria for anorexia but still have a weight within or above the “normal” range
- Experience purging without binge eating (sometimes referred to as purging disorder)
- Have infrequent binge episodes or other irregular behaviours
- Show signs of orthorexia (obsession with healthy eating) or night eating syndrome
- Struggle with body image, control, or food-related anxiety in less typical patterns
OSFED is the most commonly diagnosed eating disorder, yet often misunderstood or under-recognised.
Common Signs and Symptoms
- Distorted body image or intense fear of weight gain
- Restrictive eating, frequent dieting, or calorie counting
- Binge eating episodes with feelings of shame or guilt
- Purging behaviours without consistent binging
- Over-exercising to compensate for food intake
- Eating rituals, avoidance of food groups, or food anxiety
- Preoccupation with food, body weight, or appearance
- Emotional distress or social withdrawal related to eating
Because the behaviours vary widely, OSFED can be harder to spot — especially if someone does not appear underweight or if their behaviours are less extreme than other diagnoses.
Health Risks and Emotional Impact
The physical and mental health risks associated with OSFED are very real. These can include:
- Malnutrition
- Electrolyte imbalances
- Digestive problems
- Hormonal disturbances
- Menstrual irregularities
- Heart complications
- Anxiety, depression, and low self-worth
- Risk of progression to anorexia, bulimia, or BED
People with OSFED are just as likely to need professional treatment as those with more “defined” disorders.
Causes and Risk Factors
As with other eating disorders, the causes of OSFED are complex and often include:
- Perfectionism or obsessive personality traits
- Low self-esteem and body dissatisfaction
- Cultural or media pressures around body image
- History of trauma or bullying
- Family dynamics or genetic predisposition
- Co-occurring mental health issues (e.g., anxiety, depression, OCD)
Many people with OSFED struggle in silence, feeling they are “not sick enough” to seek help — a dangerous and untrue belief.
Treatment and Recovery
OSFED is treatable, and recovery is possible with the right care. Treatment is often very similar to that used for other eating disorders and may include:
- Cognitive Behavioural Therapy (CBT or CBT-E)
- Nutritional support with a registered dietitian
- Medical monitoring for physical health concerns
- Family therapy or support groups
- Compassionate guidance toward balanced eating and self-acceptance
Recovery involves recognising that any level of disordered eating is valid and deserving of support — regardless of body size or how symptoms appear from the outside.
Supporting Someone With OSFED
- Don’t compare their experience to other disorders
- Acknowledge their distress as valid and serious
- Encourage open dialogue and emotional safety
- Guide them toward professional help and resources
- Remind them they are not alone and recovery is possible
Helpful Resources
- BEAT Eating Disorders (UK) – www.beateatingdisorders.org.uk
- NHS Eating Disorder Support – www.nhs.uk
- First Steps ED – www.firststepsed.co.uk
- Mind UK – www.mind.org.uk
Sources
BEAT. (2024). OSFED – Other Specified Feeding or Eating Disorder. Retrieved from: https://www.beateatingdisorders.org.uk
NHS. (2023). Types of Eating Disorders. Retrieved from: https://www.nhs.uk
NICE. (2020). Eating disorders: recognition and treatment (NG69). Retrieved from: https://www.nice.org.uk/guidance/ng69
Fairburn, C. G. (2008). Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press.