How to cope with OSFED


Symptoms, causes and how to diagnoses OSFED, an eating disorder often overshadowed

Even if you are not intimately aware of all their nuances, you probably have some vague familiarity with Anorexia, Bulimia, and Binge Eating Disorder. You are able to loosely identify the different behaviours between the three and are capable of describing them at a high level. Anorexia, Bulimia, and Binge Eating Disorder receive a substantial amount of airtime, as they should! The dangers of these disorders are very real and very serious. But at the end of the day, the three most heavily discussed eating disorders are not representative of all. 

What does this mean for individuals who don’t display all the behaviours required to cleanly receive a diagnosis of either anorexia, bulimia, or binge eating disorder? What happens to those who maybe display some signs and symptoms of actually all three? Does it mean they don’t receive a diagnosis? They don’t receive treatment? They’re totally fine? Categorically no, and that is where Other Specified Feeding and Eating Disorder (OSFED) comes in. OSFED was previously referred to as Eating Disorder Not Otherwise Specified (EDNOS). OSFED is meant to act as a net that can capture those who suffer from a significant eating disorder, but do not meet the criteria of Anorexia, Bulimia, or Binge Eating Disorder exclusively. OSFED is less well known than other eating disorder diagnosis, but OSFED impacts the highest percentage of individuals worldwide. It is estimated that OSFED impacts between 32 – 53% of individuals with an eating disorder, making it the most common eating disorder, but also the least well known, and therefore least talked about. 

OSFED is an incredibly important reminder to everyone that those who do not definitively identify with three narrow eating disorder definitions, does not mean that they are not suffering and struggling. Those with OSFED are equally as deserving of help, compassion, and support.

What are the causes of OSFED?

Have you ever heard the saying “genes load the gun, but the environment pulls the trigger”? No truer words can be used to describe what causes eating disorders. There is no finite cause or reason for why people develop eating disorders. It is believed however, that those who develop eating disorders are genetically predisposed to them. Therefore, an individual’s environment, coupled with their predispositions are the catalyst to eating disorder development. Below is a list of particular situations, circumstances, or environments that may nudge and individual down a path that leads to ED development:

– Genetics

– History of substance abuse

– Personality type

  • Perfectionist
  • Obsessive tendencies

  Cultural + Societal pressures

  • Sexualization of Women
  • Diet Culture
  • Social Media

  Co-occurring disorders

  • Anxiety
  • Depression
  • Obsessive Compulsive Disorder
  • Borderline Personality Disorder

What is the diagnosis of OSFED?

Receiving a diagnosis of OSFED is similar to all other eating disorders. Your family practitioner or any other health care professional who feels comfortable and qualified to diagnose, can. Symptoms that may lead to an OSFED diagnosis include an overwhelming preoccupation with weight, food, calories, portions, timing, fat, sugar, carbs, dieting, and exercising.

What is the treatment for OSFED?

Treatment for OSFED follows a similar structure to all other eating disorders. Although the structure remains constant, specific treatment, timing, and professionals involved will differ vastly depending on the individual in need. Getting to the root of an eating disorder is facilitated through therapy, the most arduous albeit important step in treatment and eventual recovery. Eating disorders are mental health diagnoses, therefore working with a psychiatrist, psychologist, therapist, or social worker is a critical component of treatment. 

Related Article: What Causes Eating Disorders?


Q: Is OSFED serious?

A: All eating disorders are serious, inclusive of OSFED. Although it is the least talked about, it is the most prevalent. Eating disorders are at best serious, and at worst, fatal.

Q: How common is OSFED?

A: Amongst eating disorders, OSFED is the most prevalent. As previously stated, among those who are dealing with an eating disorder, 32 – 53% are considered OSFED. Almost ⅓ to ½ of all those with an eating disorder are suffering from OSFED, which is an incredibly high percentage, incongruent with the airtime this disorder receives.

Q: How do you tell if you have OSFED?

A: According to VeryWellMind, below are common signs and symptoms of OSFED. If you identify with any of these, please contact EatWell to speak with one of our staff today. We are here to help, in whatever way possible. We want to remind you, whenever we have the chance, that you are not alone!

  • Refusing to eat certain foods (restriction against categories of food like no carbs, no sugar, no dairy)
  • Frequent comments about feeling “fat” or overweight
  • Denial about feeling hungry
  • Fear of eating around others
  • Binge eating
  • Purging behaviors (frequent trips to the bathroom after meals, signs and/or smells of vomiting, wrappers or packages of laxatives or diuretics)
  • Food rituals (such as excessive chewing or not allowing foods to touch)
  • Skipping meals or eating small portions at regular meals
  • Stealing or hoarding food
  • Drinking excessive amounts of water (or non-caloric beverages)
  • Using excessive amounts of mouthwash, mints, and gum 
  • Hiding body with baggy clothes 
  • Exercising excessively (despite weather, fatigue, illness, or injury)

Dr. Natalie Mulligan graduated from the Canadian College of Naturopathic Medicine (CCNM). She completed her clinical internship at the Robert Schad Naturopathic Clinic with a focused interest in mental health. Prior to attending CCNM, she completed a Bachelor of Science degree at the University of Waterloo.