Other Specified Feeding and Eating Disorders (osfed): How Is It Different from the Recognized Eating Disorder Categories?

Other Specified Feeding and Eating Disorders (OSFED): How is it different from the recognized eating disorder categories?

Austin Community College

Abstract

This paper examines the other specified feeding and eating disorders (OSFED) category from the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and how it differs to that of the officially recognized eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. Also, limitations and solutions of the nature of the diagnosis are discussed. While some research and analysis of OSFED suggests subtypes could be incorporated into existing eating disorder categories, other subtypes should be best recognized as distinct disorders.

        Keywords: Other specified feeding and eating disorders (OSFED); recognized eating disorders; subtypes

Other Specified Feeding and Eating Disorders (OSFED): The Neglected Category of Eating Disorders

        In the United States, approximately 20 million women and 10 million men suffer from eating disorders (Wade, Keski-Rahkonen, & Hudson, 2011). Research throughout decade indicates, out of the 30 million, around 40-60% of patients who seek treatment for eating disorder (ED) are diagnosed with other specified feeding and eating disorder (OSFED) (Bohn, K. S, 2007; Thomas, J. J., Vartanian, L. R., & Brownell, K. D, 2009). Formerly known as eating disorders not otherwise specified (EDNOS), OSFED is a prevalent ED that corresponds with many of the symptoms of other recognized ED, but will not meet the full criteria for diagnosis of these disorders: anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED). Although all ED patients associate with psychological and physiological morbidity, many OSFED patients did not differ significantly from full syndrome cases. So, what cases are considered OSFED? and what is its diagnostic criteria?

History and Evolution of Diagnosis

Classifying psychological disorders into categories is essential to psychologists and psychiatrists, as it allows researches and treatment formulation. However, due to the diverse nature of the clinical cases, many do not dovetail into the recognized categories. Therefore, starting in 1987, the third edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), the unclassifiable disorders are recognized into “not otherwise specified” (NOS) (3rd ed., rev.; DSM-III-R; American Psychiatric Association, 1987). These cases are intended to “indicate a category within a class of disorders that is residual to the specific categories in that class…” (APA, 1987). Later in 2000, in the fourth edition of DSM, anorexia nervosa, bulimia nervosa, and EDNOS, are recognized as three defined ED categories (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000). In the latest-fifth-edition of DSM, binge eating disorder is now recognized as a defined ED category (5th ed.; DSM-V; American Psychiatric Association, 2013). American Psychiatric Publishing claims, the major changes in DSM-5 was intended to minimize use of the catch-all diagnoses of OSFED and unspecified feeding and eating disorder.