The Kahm Clinic

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OSFED: What it is. What it isn’t. Understanding the diagnosis behind the acronym. 

Introduction

Other Specified Feeding or Eating Disorders (OSFED), previously termed Eating Disorder Not Otherwise Specified (EDNOS), is a categorization of eating disorder symptomatology that encompass individuals who do not meet strict diagnostic criteria for other designated eating disorders (i.e. anorexia nervosa, bulimia nervosa, binge eating disorder) but still experience a significant impairment in their daily functioning, health and wellbeing. Even though less well-known than other eating disorders, OSFED can be a serious and life-threatening disorder, if not treated. 

Diagnosis

A great part of the problem is the difficulty of diagnosing this group. Distinguishing characteristics of other eating disorders (i.e. blood work and body weight) may be within normal ranges, leading to a misdiagnosis or complete oversight of the disorder altogether. For instance, very few health care professionals are trained to spot higher weight anorexics. They are usually told their symptoms will disappear if they simply lose weight. Because they do not have the classic emaciated anorexic look, they themselves may not believe they have an eating disorder. (The Kahm Clinic)

Based on the DSM-5, to be diagnosed with OSFED an individual must present with behaviors and symptoms that cause clinically significant distress, but do not meet the full criteria for other eating disorders (i.e. anorexia nervosa, bulimia nervosa). A more specific diagnosis may then be assigned that further explains the specific disorder of the individual. A few examples of OSFED, although not all inclusive, are as follows: 

  • Atypical Anorexia Nervosa: All criteria are met, except the individual’s weight is within or above the normal range.

  • Purging Disorder: Recurrent purging behaviors to influence weight or shape, but in the absence of full binge eating criteria.

  • Night Eating Syndrome: Recurrent episodes of night eating. Eating after awakening from sleep, or by excessive food consumption after the evening meal. The behavior is not better explained by environmental influences or social norms and causes significant distress/impairment for the individual. 

(NEDA)

Warning Signs & Symptoms

As a result of the difficulty in diagnosis, this patient population has been neglected, and often does not seek help until the problem has grown very serious; indeed, the mortality rate of the OSFED group (5.2%) is higher than any other eating disorder. (The Kahm Clinic)

Based on this information, it is important to be aware of the warning signs and symptoms. Some of these include:

Emotional & Behavioral

  • Preoccupation with weight, food, calories and dieting

  • Complaints of constipation, abdominal pain, cold intolerance, lethargy and/or excess energy

  • New practice with food or fad diets, including cutting out entire food groups (i.e. no sugar, no carbs, no dairy, vegetarianism/veganism)

  • Hides body with baggy clothes  

  • Secret recurring episodes of binge eating or purging; feels lack of control over behaviors  

  • Extreme mood swings

Physical

  • Noticeable fluctuations in weight, although body weight is typically within the normal weight range; may be overweight

  • Stomach cramps, other non-specific gastrointestinal complaints (i.e. constipation, acid reflux, etc.) 

  • Menstrual irregularities

  • Difficulties concentrating 

  • Abnormal laboratory findings (i.e. anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate) 

  • Sleep problems 

  • Impaired immune functioning 

(NEDA)

At The Kahm Clinic, we utilize a combination of our expertise and state-of-the-art technology to hone in on the problem. Our Metabolic Test can show if the body is hypo-metabolic and catabolic indicating an underfed state, despite other normal lab values. With this data, evidence of OSFED becomes more clear not only to the providers, but the client. Using our Body Composition Analysis we often find that an individual with OSFED has a lean mass that is too low, despite their scale weight not causing concern to other medical professionals. Because we can see the problem so clearly, we can help you, your loved one and this population. If you think you or someone you know may have an eating problem, but are having a difficult time categorizing it, please come to us, we want to help. 

The Kahm Clinic

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802.861.1200

Resources

The Kahm Clinic

National Eating Disorders Association