What is OSFED: Other Specified Feeding or Eating Disorder?

Eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder are diagnosed under a list of symptoms from the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM5) that can leave many people out who may not have ALL the symptoms. According to Dr. Jennifer J. Thomas, co-director of The Eating Disorders Clinic and Research Program at Massachusetts General Hospital and co-author of Almost Anorexic, states that at least 1 in 20 people will show eating disorder symptoms that could be diagnosed as an OSFED- Other Specified Feeding or Eating Disorder.[1] Unfortunately, OSFED is a diagnosis that isn’t discussed as often as other eating disorders.

What is OSFED?

Questions still remain several years later after the DSM5 changed the classification for eating disorders that don’t meet the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder. The DSM5 changed Eating Disorder Not Otherwise Specified (EDNOS) to Other Specified Feeding or Eating Disorder (OSFED).

The change in classification from EDNOS to OSFED was significant.  It was realized that not everyone shared the same symptoms and therefore many people were getting placed into the same category, which was affecting their ability to access care and perform appropriate research. Eating disorder behaviours that weren’t previously included within EDNOS, such as purging disorder and night eating syndrome are now included under OSFED.[2]

These are examples of behaviours that are now diagnosed as OSFED subtypes:

  1. Atypical Anorexia Nervosa: Behaviours of anorexia but does not have low body weight.
  2. Bulimia Nervosa: Less frequent than what’s required to meet the criteria for diagnosing bulimia nervosa.
  3. Binge Eating Disorder: Less frequent and/ or limited duration.
  4. Purging Disorder: Contrast to bulimia nervosa, a person will purge but not binge.
  5. Night Eating Syndrome: Individual will eat very little during the day and then consume most calories in the evening or wake up in the middle of the night to eat.

How Common is OSFED?

OSFED is more common than previously believed. A study published last year in the Journal of Nervous and Mental Disease, took a look at eating disorders in adults between 18 and 75 years because most research on eating disorders has focused on adolescents. All of the participants in the study were seeking treatment for eating disorders. Almost 28% of the participants met the criteria for OSFED.

In addition, the study also revealed that those participants with OSFED may “struggle with more severe cognitive eating disorder-related symptoms and potentially more severe body image distortions” in comparison to other groups of the study who were of younger age.[3]

Characteristics of OSFED

Both males and females may develop an OSFED. People with OSFED share some common characteristics:

  • Intense fear of weight gain
  • Distorted body image
  • Overly conscious about their weight and body shape
  • Heightened anxiety or stress around food

A common misconception is that people with OSFED don’t have an eating disorder and therefore won’t seek eating disorder treatment. The truth is, OSFED can be just as serious as other eating disorders. In addition, similar health complications that are related to other eating disorders are also experienced with OSFED as a result of suffering with it for a long period of time.

If you know someone who may check off on some of the symptoms and signs of anorexia nervosa, bulimia nervosa or binge eating disorder but not all, it’s still crucial to get help. Give us a call to learn how we can help. Our calls are private and confidential: 416-495-0926.

WaterStone Clinic provides options that include outpatient treatment, residential stays and a concurrent addiction program. Our goal is to give clients the skills to build healthy, happy and meaning

[1] Massey, Alana. The Most Common Eating Disorder Is One You’ve Probably Never Heard of: BuzzFeed. February 24, 2015. Retrieved from: https://www.buzzfeed.com/alanamassey/osfed-hidden-eating-disorder?utm_term=.uoG44y3Rxo#.neMDDEYzWj

[2] Farrar, Tabitha. What is OSFED? Retrieved from: http://www.mirror-mirror.org/ednos.htm

[3] Barak-Elran, Roni PhD, et. Al. Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder in Midlife and Beyond. The Journal of Nervous and Mental Disease- Issue: Volumne 203(8), August 2015, p.583-590.

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10 Important Facts About Eating Disorders in Canada

-Are eating disorders a significant health problem in Canada? Eating disorders affect more Canadians than you think. According to National Eating Disorder Information Centre (NEDIC) one million people are diagnosed with an eating disorder at any given time. Yet, a study recently conducted by NEDIC revealed that one in two people know someone, including themselves, who has or had an eating disorder. There is a huge gap between what people THINK eating disorders are and what they actually are.

Certainly more research is still needed on eating disorders to have a better understanding of how to treat them. Nonetheless, some studies have allowed us to identify several factors that can contribute to the development of eating disorders and the severity of them.

What are eating disorders?  How serious is this mental illness in North America? Here are ten quick and important facts about eating disorders in North America that will help you understand how critical they REALLY are:

  1. Eating Disorders are NOT caused by mass media’s obsession with slimness. They are mental illnesses that can be traced back to genetics, biology and environmental factors.
  2. Eating disorders are not a female-only problem. Men develop eating disorders too. According to the American Journal of Psychiatry on the Review of Bulimia Nervosa, 10-15% of males suffer from eating disorders.
  3. Eating disorders are often accompanied by substance abuse or other psychiatric disorders such as depression.
  4. People with bulimia nervosa are more likely to have experienced childhood physical or sexual abuse.
  5. Binge eating disorder affects more women and men than anorexia and bulimia combined.
  6. Both male and female athletes are at higher risk of developing an eating disorder than non-athletes.
  7. The number of girls hospitalized for eating disorder treatment has increased by 42% in the past two years and our Canadian system CAN’T KEEP UP!
  8. Without the appropriate treatment, eating disorders can be fatal. In fact, Anorexia Nervosa is the most deadly mental illness in existence.
  9. Early intervention saves lives. The sooner a person with an eating disorder receives treatment, the better chance they have at physical and emotional recovery.
  10. There is not enough research, appropriate resources, access and availability to treatment programs available in Canada to help more Canadians recover from an eating disorder.

Eating disorder treatment and support is scarce in Canada. The WaterStone Clinic for eating disorders is a premier eating disorder clinic that offers treatment programs for anorexia nervosa, bulimia nervosa and binge eating disorder. WaterStone Clinic offers a unique blend of therapeutic approaches, skill development and life coaching. To learn more about our programs, contact us via email or give us a call 416-495-0926. Together, we can build lives worth living.


Carlos M. Grilo, James E. Mitchell (2010) The Treatment of Eating Disorders: A Clinical Handbook, The Guilford Press, New York.

NEDA- Get the Facts

Mirror Mirror Eating Disorders


House of Commons Chambre Des Communes Canada- Eating Disorders Among Girls and Women in Canada

Carlat, D.J., Camargo. Review of Bulimia Nervosa in Males. American Journal of Psychiatry, 154, 1997.

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