Other Eating Disorders

The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has made several changes to the categorisation of eating disorders. The category that was known as Eating Disorder Not Otherwise Specified (EDNOS), has been removed, and there are two new categories; Other Specified Feeding or Eating Disorder (OSFED) and Unspecified Feeding or Eating Disorder (UFED). These new categories are intended to more appropriately recognise and categorise conditions that do not more accurately fit into Anorexia Nervosa, Bulimia Nervosa, BED, or the other eating and feeding disorders.

It is important to note that these new categories are not an indication of a less severe eating disorder, simply a different constellation of symptoms. Another significant change is the inclusion of some types of ‘Feeding Disorders’ that were previously listed in other chapters of the DSM, and now listed together with eating disorders.

For more information on the DSM-5 click here.

Other Specified Feeding or Eating Disorder (OSFED)

According to the DSM-5 criteria, to be diagnosed as having OSFED a person must present with a feeding or eating behaviours that cause clinically significant distress and impairment in areas of functioning, but do not meet the full criteria for any of the other feeding and eating disorders.

A diagnosis might then be allocated that specifies a specific reason why the presentation does not meet the specifics of another disorder (e.g. Bulimia Nervosa- low frequency). The following are further examples for OSFED:

• Atypical Anorexia Nervosa: All criteria are met, except despite significant weight loss, the individual’s weight is within or above the normal range.
• Binge Eating Disorder (of low frequency and/or limited duration): All of the criteria for BED are met, except at a lower frequency and/or for less than three months.
• Bulimia Nervosa (of low frequency and/or limited duration): All of the criteria for Bulimia Nervosa are met, except that the binge eating and inappropriate compensatory behaviour occurs at a lower frequency and/or for less than three months.
• Purging Disorder: Recurrent purging behaviour to influence weight or shape in the absence of binge eating
• 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. The behavior causes significant distress/impairment. The behavior is not better explained by another mental health disorder (e.g. BED).

Unspecified Feeding or Eating Disorder (UFED)

According to the DSM-5 criteria this category applies to where behaviours cause clinically significant distress/impairment of functioning, but do not meet the full criteria of any of the Feeding or Eating Disorder criteria. This category may be used by clinicians where a clinician chooses not to specify why criteria are not met, including presentations where there may be insufficient information to make a more specific diagnosis (e.g. in emergency room settings).