Examples of Other Specified Feeding and Eating Disorders
Eating disorders are more common than many people realize. Some statistics suggest as many as 30 million Americans of all ages and genders have at least one eating disorder. Without help from a professional treatment program like The Meadowglade, the long-term effects of eating disorders can lead to dangerous, potentially fatal consequences. Unfortunately, a great deal of stigma and misunderstanding continues to surround eating disorders and eating disorder treatment. As a result, few of the millions who could benefit from therapy never seek or receive the help they need.
This ongoing lack of beneficial treatment leads to a staggering death toll linked to complications stemming from an eating disorder. Recent research shows one person every 52 minutes dies from symptoms related to their eating disorder. Despite all that has been learned about eating disorders, the mortality rate linked to eating disorders outpaces all other mental health conditions except opioid-related overdose. Eating disorders affect all races, ages, genders, and ethnic groups although, current research indicates a disproportionate number of LGBTQ individuals have an eating disorder.
Other Specified Feeding or Eating Disorders Explained
Eating disorders are characterized by several behaviors, symptoms, and challenges that vary from person to person. Most people are familiar with eating disorder diagnoses, including anorexia and bulimia. For many years, the Diagnostic and Statistical Manual for Mental Disorders (DSM) has provided specific diagnostic criteria for eating disorders that are statistically more prevalent. However, this left several conditions without diagnostic criteria or treatment guidance.
Recently, another category was introduced called Other Specified6 Feeding or Eating Disorders (OSFED). Other Specified Feeding or Eating Disorders is an eating disorder category for those with symptoms that do not meet the diagnostic criteria for another eating disorder diagnosis based on the DSM. The DSM listing for OSFED has five subcategories. They are “atypical anorexia nervosa, bulimia nervosa with less frequent behaviors, binge eating disorder with less frequent behaviors, purging disorder, and night eating syndrome.” OSFED is challenging because each condition shares similarities with a primary diagnosis (for example, atypical anorexia nervosa shares symptoms with anorexia nervosa, however, the differences associated with each illness result is the need for an alternate classification.
Creating this category as part of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was vital to improving access to mental health treatment for individuals with conditions not previously classified. Previously, the dangerous misconception that unspecified eating disorders were subclinical or less significant than a primary eating disorder led to diagnostic problems and delays.
It is essential to understand that someone with an “other specified eating disorder” is equally at risk for medical and psychological consequences as someone who meets the diagnostic criteria for a primary condition. Research from the National Eating Disorders Association (NEDA) states that children hospitalized for OSFED had equally as many severe medical complications as children hospitalized with an anorexia nervosa diagnosis. Additionally, people with OSFED are equally likely to die from complications related to their eating disorder as those with bulimia or anorexia. Even though the diagnosis is uncommon, their diagnosis is valid. They can benefit from professional support and treatment at an eating disorder treatment program like The Meadowglade to help improve their mental and physical health.
Other Specified Feeding or Eating Disorder Types
The challenge to mental health diagnosis is that many conditions are classified into specific categories with detailed symptoms or diagnostic criteria. This would be perfect if all conditions fit neatly into one category or another. But like humans in general, many people with a mental (or physical) health condition present with symptoms that are not part of the list in the DSM. This makes the diagnosis process less clear-cut as sometimes people meet some criteria but not all of the criteria required for a particular diagnosis.
For many years, using the Diagnostic and Statistical Manual for Mental Disorders to diagnose eating disorders left a large gap for people who did not meet all of the necessary criteria for an anorexia or bulimia diagnosis. Unfortunately, a lack of diagnosis also meant a lack of treatment, allowing medical and mental health complications to develop further. Today, someone who does not qualify for a specific eating disorder diagnosis is diagnosed as Other Specified Feeding or Eating Disorder or OSFED. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists five examples of OSFED.
Atypical anorexia nervosa
Someone with atypical anorexia nervosa meets many of the diagnostic criteria for anorexia nervosa except for significant weight loss. They will restrict food intake and the other features of anorexia nervosa; however, their weight is within or even above the normal range for someone with their build.
Subthreshold bulimia nervosa
Like atypical anorexia nervosa, someone with subthreshold bulimia nervosa will meet most of the criteria for bulimia nervosa. However, in these cases, the binging (binge eating) and/or purging behaviors occur at a lower frequency or limited duration (less than three months) required for a bulimia nervosa diagnosis as per the DSM. Subthreshold bulimia nervosa may also be called bulimia nervosa (of low frequency and/or limited duration).
Subthreshold binge eating disorder
Again, someone with this diagnosis will meet the criteria for binge eating disorder but at a lower frequency or duration than binge eating disorder. They will either binge eat at a reduced frequency, or the binges will occur for less than three months. This diagnosis may also be rereferred to as Binge Eating Disorder (of low frequency and/or limited duration).
Someone with purging disorder will engage in purging activities (excessing exercising, forced vomiting, misuse of laxatives, and/or diuretics) to maintain weight or shape. However, someone with purging disorder will not binge eat, which is the characteristic that distinguishes purging disorder from bulimia nervosa.
Night eating syndrome
Night eating syndrome is a type of eating disorder characterized by recurrent episodes of night eating. They may overeat after an evening meal or eat after waking from sleep during the night. Unlike some conditions, someone with night eating syndrome will remember eating episodes. The night-eating behavior causes significant impairment and distress and is not better explained by another mental health condition or eating disorder (such as binge eating disorder).
Treatment Models for OSFED
Behavioral therapies are widely used to address eating disorders, including those classified as Other Specified Feeding or Eating Disorder or OSFED. Although several different behavioral treatments are used, some are more common than others. Like other mental health conditions, eating disorders affect each person in unique ways, and their treatment needs to match their needs and goals as they begin therapy. The treatment team at The Meadowglade will work with you to determine the course of treatment that helps best alleviate your specific symptoms and puts you on the path towards a safe and healthy relationship with food.
Cognitive-behavioral therapy or CBT is a behavioral therapy that focuses on one’s thoughts, behaviors, and feelings related to food. After helping you develop healthy eating behaviors, your treatment team at The Meadowglade will work with you to uncover the roots of harmful eating behaviors. Once you understand these, it is possible to recognize them should you face triggering thoughts in the future. This can help to prevent a relapse in symptoms after achieving recovery. Family-based therapy is another behavioral therapy used as part of eating disorder treatment. Family-based therapy encourages family members to help their loved ones restore safe eating habits and a healthy weight. Family-based therapy is highly beneficial for parents or guardians learning how to help their teen manage eating disorder symptoms.
Acceptance and Commitment Therapy focuses on changing behaviors and actions rather than feelings and thoughts, as with CBT. During acceptance and commitment therapy sessions, you learn to identify core values and commit to setting goals to achieve these values. Another behavioral therapy model is dialectical behavior therapy, (DBT). DBT is a behavioral treatment supported by empirical evidence for treating binge eating disorder, anorexia nervosa, and bulimia nervosa. DBT explains that the most effective place to begin therapy is focusing on behavioral change. DBT sessions focus on developing skills to replace maladaptive eating disorder behaviors with safer, healthier alternatives.
The most successful programs for eating disorders are those designed around your unique needs. Therefore, the intensity and duration of treatment will depend on what you need from your time at The Meadowglade. For some, the therapeutic process can last for a few months, whereas for others, achieving recovery may take more than a year. Each type of treatment offers a different level of care and support for the individual, ensuring you leave treatment with the guidance and tools you need to maintain lasting recovery.
Eating disorders lead to millions of lives lost each year. If you or a loved one struggles with an eating disorder, seeking treatment is the best way to safely and effectively overcome your symptoms. Without help from a treatment center like The Meadowglade, an eating disorder’s lasting medical and emotional effects can lead to dangerous, and even fatal, complications. Our team of skilled, caring, and compassionate treatment providers will work with you or your loved one to develop a treatment plan focused on helping you put eating disorder challenges in the past.
Depending on your health and treatment needs, the first step in your recovery might be medical care. It is not uncommon for a range of medical complications to exist due to chronic eating disorder behaviors. It is crucial to address these conditions to ensure your physical health is stable before starting a therapeutic program. If you are concerned, contact us at The Meadowglade today to learn more about how we can help you begin your recovery journey.