Otherwise Specified Feeding and Eating Disorder (OSFED)


While some fit into the classic eating disorder categories, i.e., anorexia, bulimia, etc., many do not quite fit into these categories. They often have elements of one eating disorder combined with facets of others. They have serious disorders that need treatment, but because they don’t seem to fit neatly into any category, they often don’t think they have an eating disorder, and so they don’t seek help. As a result, 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.

A great part of the problem is the difficulty of diagnosing this group. Their blood work is often normal and their body weight is not critically low, so they are often overlooked or misdiagnosed. For instance, very few health care professionals are trained to spot higher weight anorexics. They are usually told that their symptoms will disappear if they simply lose weight. Because they do not have the classic emaciated anorexic look, they themselves don’t believe they have an eating disorder.  

With our machines at The Kahm Clinic we are exceptionally good at honing in on the problem, and because we can see the problem so clearly, we can help 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.

OSFED is a large and deliberately vague category in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorder), specifically created to provide treatment and insurance coverage for those who don’t fit the paradigmatic eating disorders but need help. Some sub-categories include, anorexics with normal or above-normal body weight, bulimics and binge eaters who have practiced these behaviors for a shorter time or perhaps less frequently, or those who purge without binging, or those who eat excessively at night. But there are many people who don’t even fit these sub-categories, who can and should seek help under the umbrella of OSFED. As a general rule, the sooner the problem is diagnosed and treatment begins, the faster recovery can happen, but this population, sadly, all too often waits far too long to seek help.