Less Prominent Eating Disorders Deserve Attention, Too

Updated on April 11, 2020

Most people are familiar with anorexia nervosa, bulimia nervosa, and binge eating disorder.  However, these eating disorders aren’t monolithic – there is a wide variety of related but dissimilar disorders as well.  Formerly referred to as Eating Disorders Not Otherwise Specified (EDNOS), Other Specified Feeding or Eating Disorders (OSFED) are no less serious and potentially deadly than their more well-known counterparts.  

The experts, including psychiatrists and therapists who maintain theDSM-V, developed this category to include people whose eating disorder doesn’t match the exact specifications of anorexia nervosa or bulimia nervosa.Because the usual symptoms may not appear, leading people to go untreated, the category of OSFED was viewed as a necessary inclusion in the latest edition of the DSM.

What Kinds Other Specified Feeding or Eating Disorders Are There?

Eating disorders appearing in men, women, or teens that don’t match the typical symptoms of anorexia nervosa, bulimia nervosa or binge eating disorder might be diagnosed with one of the following OSFEDs:

  • Purging disorder: an eating disorder defined by repeated purging intended to remove calories from the body to lose weight or change the body’s shape; unlike classic bulimia nervosa, this does not include repeated binge eating episodes
  • Atypical anorexia nervosa (AAN): The individual will meet the usual behavioral criteria for anorexia nervosa; however, they do not experience the extreme weight loss or emaciation associated with the classic form of the disorder
  • Limited duration or low-frequency binge eating disorder: individuals show the symptoms of binge eating disorder, but the binge eating episodes are much less frequent than in the classic description of BED (typically less than three or four months)
  • Limited duration or low-frequency bulimia nervosa: similar to the above disorder, individuals with limited duration bulimia nervosa show the same disordered behaviors (binge-eating episodes followed by purging) but at a less frequent rate
  • Nighttime eating syndrome: people who have repeated episodes of waking in the night and engaging in binge eating episodes might receive a diagnosis of Nighttime Eating Syndrome (NES). This can result in weight gain and related health consequences. NES can be difficult to diagnose because the individual may not remember getting up or what/how much they’ve eaten.

As with other forms of eating disorders, evidence-based treatment including mindfulness and alternative therapies can be applied to help individuals become recovered. Ongoing support provided by eating disorder treatment facilities significantly improves eating disorder recovery in those who’ve received a diagnosis of these, and any, eating disorders.

Symptoms of OSFEDs to Look Out For

Almost every eating disorder, well-known or not, have some similar symptoms, including frequent dieting, body image distortions, and low self-esteem. Other signs of OSFED include: 

  • Making frequent comments to family members and friends about “feeling” fat, “appearing” fat and being “ugly” because they think they are fat
  • Frequent illnesses, complaints of always being cold, gastrointestinal problems like hunger pangs or constipation, thinning or brittle hair
  • Discomfort at meals with others, or refusal to eat in public
  • Excusing themselves during meals to go to the bathroom, especially directly after the meal is done
  • Rarely eating out with others or making strange excuses for why they never dine at restaurants
  • Drinking large amounts of water or diet soda in lieu of eating (filling the stomach without calories)
  • Developing oral health problems such as stained teeth, chronic halitosis, gum disease, and even tooth loss

Eating disorder treatment and eating disorder recovery programs normally include medical treatments to counteract the physical toll taken by long-term eating disorders. Although the general public may not know that they’re dangerous, eating disorder facilities recognize that OSFEDs are as serious as classic cases of anorexia nervosa, bulimia nervosa, and binge eating disorder.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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