Other Specified Feeding or Eating Disorder (OSFED)
Eating Disorders Not Otherwise Specified (EDNOS) from the DSM-IV has been transformed into OSFED (Other Specified Feeding or Eating Disorder. OSFED is a feeding or eating disorder that causes significant distres or impairment, but does not meet the criteria for another feeding or eating disorder. Eating disorders are not always black and white, and individuals can exhibit disordered eating patterns even if they don’t meet the threshold for a full-blown diagnosis.
OSFED has five subtypes:
1. Atypical Anorexia Nervosa: Restrictive behaviors and features without meting the low weight criteria.
2. Bulimia Nervosa: Meets the criteria for Bulimia Nervosa but at a lower frequency and/or limited duration. Episodes of eating, in a discrete period of time an amount of food that is larger than what most individuals would eat with a feeling of lack of control. This followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, excessive exercising, fasting.
3. Binge Eating Disorder: Meets the criteria for Binge Eating Disorder but at a lower frequency and/or limited duration. Episodes of eating, in a discrete period of time an amount of food that is larger than what most individuals would eat with a feeling of lack of control.
4. Purging Disorder: Recurrent purging of calories by self induced vomiting, misuse of laxatives and diuretics, excessive exercising. This subtype does not include binge eating.
5. Night Eating Syndrome: Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. There is awareness and recall of the eating.
The risks associated with OSFED are severe. Individuals with OSFED will experience risks similar to those of the other eating disorders. Some previous studies show the mortality rate of EDNOS as high as individuals who meet the thresholds for Anorexia.
Avoidant/Restrictive Food Intake Disorder
The main feature of this type of eating disorder is avoidance or restriction of food intake that interferes with minimum nutritional intake of food to sustain the individual, i.e. significant weight loss, significant nutritional deficiency, dependence on oral supplements or other feeding, and marked interference with psychosocial functioning.
It usually develops in infancy or early childhood and may persist in adulthood.
For some individuals, food avoidance may be based on sensory characterizes of quality of food with sensitivity to appearance, color, smell, texture, or taste.
According to the DSM V, there is currently insufficient evidence directly linking avoidance /restrictive food intake disorder and subsequent onset of an eating disorder.
Unspecified Feeding or eating disorder UFED
This category is used as a preliminary diagnosis when insufficient information is available to make a specific diagnosis. Symptoms include all disordered eating patterns that cause significant distress or impairment.
It is important to realize that not everyone who is of low weight has an eating disorder; it is important to recognize that it is the intense fear of gaining weight or of becoming fat, along with persistent behaviors that interferes with normal weight gain that is the key factor.
The DSM V continues to use BMI as a means to diagnosis Anorexia Nervosa and specify current severity:
Mild: BMI >17
Moderate: BMI 16-16.99
Severe: BMI 15-15.99
Extreme: BMI <15
Eating Disorders Not Otherwise Specified (EDNOS)
Eating Disorder Not Otherwise Specified (EDNOS) is no longer considered a valid diagnosis, according to the Diagnostic and Statistical Manual of Mental Disorders-V. For those previously diagnosed with EDNOS you would now be under the eating disorder diagnosis of Other Specified Feeding or Eating Disorder (OSFED).
EDNOS was the category for people who did not meet the strict criteria for either Anorexia or Bulimia Nervosa, but who have significant concerns about eating and body image. For example, a person who shows almost all of the symptoms of anorexia nervosa, but who still has a normal menstrual cycle and/or body mass index, can be diagnosed with EDNOS. One may experience episodes of binging and purging, but may not do so frequently enough to warrant a diagnosis of bulimia nervosa.
For those with EDNOS: all of the criteria for anorexia nervosa are met except that, despite substantial weight loss, the individual’s current weight is in the normal range; all of the criteria for bulimia nervosa are met except that binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of fewer than three months.
This category has been shown in some studies to have the highest death rates of any category of eating disorder. 52 % of eating disorder sufferers may have EDNOS. Most patients do not have pure forms of eating disorders, and they may cross over from one disorder to the other over time.