What Are Other Specified Feeding or Eating Disorders (OSFEDs)?

Previously referred to as Eating Disorders Not Otherwise Specified (EDNOS), Other Specified Feeding or Eating Disorders (OSFED) are serious mental health issues requiring professional eating disorder treatment.  Psychiatrists and other mental health specialists responsible for writing the Diagnostic and Statistical Manual of Mental Disorders developed this category to include individuals diagnosed with an eating disorder who failed to meet strict symptomatic criteria for bulimia nervosa or anorexia nervosa. With eating disorder facilities reporting a wide variety of eating disorder symptoms affecting teens and young adults who did not exhibit significant weight loss, the category of OSFED was viewed as a necessary inclusion in the latest edition of the DSM.

Examples of Other Specified Feeding or Eating Disorders

Eating disorders in women that do not meet criteria describing classic signs of anorexia nervosa, bulimia nervosa or binge eating disorder may be diagnosed with one of the following OSFEDs:

  • Atypical anorexia nervosa (AAN): patients will meet all criteria for an anorexia nervosa diagnosis but weigh within or above their normal weight range
  • Limited duration or low-frequency binge eating disorder: patients meet all criteria for binge eating disorder but engage in BED behaviors at a reduced frequency (typically less than three or four months)
  • Limited duration or low-frequency bulimia nervosa: patients meet all criteria for a diagnosis of bulimia nervosa except that abnormal compensatory behaviors and binge eating episodes occur for less than three or four months
  • Purging disorder: an eating disorder characterized by recurring purging (vomiting) behavior intended to influence shape and weight; self-induced vomiting by someone with purging disorder is not accompanied by binge eating episodes
  • Nighttime eating syndrome: people who have repeated episodes of getting up in the middle of the night and eating an excessive amount of food may be diagnosed with Nighttime Eating Syndrome (NES). Weight gain, health issues, depression and anxiety are symptoms of NES. This particular eating disorder is especially hard to detect since people with NES may not remember getting up to eat or remain unaware of exactly how much they are eating at night. Consequently, eating disorder treatment for NES may be delayed, causing the disorder to worsen and become more difficult to treat.


Eating disorder facilities offer evidence-based treatment involving cognitive behavioral therapy and dialectical behavioral therapy for all OSFEDs. Ongoing support provided by these facilities significantly improves eating disorder recovery in patients who are eventually discharged from their treatment plan.

Symptoms of Other Specified Feeding or Eating Disorders in Women

Primary concerns of women with an OSFED are dieting, weight loss and food obsessions (counting fat grams, calories, weighing food portions). Other signs of an OSFED include:

  • Making frequent comments to family members and friends about “feeling” fat, “appearing” fat and being “ugly” because they think they are fat
  • Complaining about being sick more than usual; complaints usually involve gastrointestinal problems, intolerance to cold, fatigue, dizziness, inability to concentrate and nausea
  • During meals with others, they may proclaim proudly that they are “never hungry” and proceed to move food around on their plate without taking a bite
  • Excusing themselves during meals to go to the bathroom multiple times
  • Rarely eating out with others or making strange excuses for why they never dine in restaurants
  • Drinking excessive amounts of diet sodas and water; always looking bloated and puffy in the face, hands and feet
  • Constantly chewing gum or sucking on mints
  • Developing oral health problems such as stained teeth, chronic halitosis, gum disease and even tooth loss

Eating disorder treatment and eating disorder recovery programs may need to include extensive medical treatment depending on the health consequences caused by the specific eating disorder affecting a patient. Eating disorder facilities recognize that OSFEDs are as serious as clinical anorexia nervosa, bulimia nervosa and binge eating disorder and should not be underestimated or trivialized. Since health problems associated with an OSFED are often difficult to immediately identify, family and friends of women they suspect may have an eating disorder who watch for signs listed above as well as abnormal mood disturbances or sudden, drastic weight loss.

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