What is OSFED, and how is it treated

What is OSFED, and how is it treated

A new eating disorder classification, Other Specified Feeding and Eating Disorder (OSFED), has replaced “Eating Disorder Not Otherwise Specified” in The Diagnostic & Statistical Manual. OSFED is an effective way for people who do not meet the criteria of any other disorders to be diagnosed with anorexia nervosa or bulimia, respectively, even when partial symptoms are present.

OSFED is an eating disorder classification that encompasses all eating disorders not classified as ANOREXIA NERVOSA, BULIMIA NERVOSA, or BINGE -EATING DISORDER.

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What are examples of OSFED?

OSFED includes:

  • An individual with low body weight and fears putting on weight, but whose weight is not low enough for a diagnosis of ANOREXIA NERVOSA.
  • A person with binge–eating disorder who has frequent episodes of uncontrolled overeating. OSFED may also apply to people experiencing frequent periods of uncontrolled hunger or lacking the ability to stop eating (and sometimes drinking) during those binges. OSFED can also be applied to those who eat very little in public, with no compensation via purging or excessive exercise

How common is OSFED? OSFED was first introduced as a diagnostic category by The Diagnostic and Statistical Manual-(DSM -5), the official diagnostic manual for psychiatric disorders. OSFED is estimated to affect 2-5% of adults in the United States (Seal et al., 2017), while other sources put that portion at 20-25% (Thomas, Bratman, Norman & Halmi, 2018). OSFED is more commonly found in males than females and more prevalently found in people who are at a healthy weight or overweight rather than underweight

What are the symptoms of OSFED?

Individuals with OSFED all share the common trait of having disordered thoughts and behaviors about food and eating. Here are a few of the warning signs of OSFED:

  • Refusal to maintain a healthy body weight
  • Intense fear of gaining weight, even when underweight
  • Distorted body image
  • Engaging in behaviors such as chewing and spitting out food or obsessively exercising to prevent weight gain.
OSFED Infographic

How is OSFED treated?

Eating disorders are complex conditions that require multidisciplinary treatment; specialties typically involved include psychiatry, psychotherapy, nutrition education, group therapy, and medical monitoring. Treatment for OSFED is tailored to each case and may involve:

A variety of therapeutic skills aimed at resolving dysfunctional thoughts and behaviors related to eating and food issues such as cognitive-behavioral therapy

Individuals with OSFED may present a greater risk of developing ANOREXIA NERVOSA or BULIMIA. Therefore, treatment must focus on disordered eating behaviors and underlying mental health issues such as depression, anxiety, and post-traumatic stress disorder. OSFED is treated with a combination of eating disorder-specific therapeutic modalities as well as psychological therapies that can be generalizable to OSFED treatment, such as

  • Cognitive-behavioral therapy (CBT),
  • Dialectical behavior therapy (DBT),
  • Interpersonal psychotherapy (IPT)
  • or mindfulness.

OSFED treatment should also address the patient’s medical needs through assessment, monitoring, and management of physical conditions related to OSFED behaviors, including but not limited to osteoporosis, dental erosion/caries, gastroesophageal reflux illness (GERD), constipation, abnormal uterine bleeding, hypokalemia, electrolyte abnormalities and amenorrhea in females.


Eating disorders can be a frightening and overwhelming experience. The thought of what to eat, when not too much is enough for your body type- all the confusing rules that apply just as much in life outside of this topic leave you feeling exhausted with little control over anything at all! Let Springsource Psychological Center help by providing an alternative approach: one where we work together, so each person’s needs are met without judgment or criticism.

We look forward to hearing from you. 

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