Other Specified Feeding and Eating Disorders (OSFED)

Help to understand and recover from unhealthy choices

Other Specified Feeding and Eating Disorders (OSFED), previously known as EDNOS, is when people have symptoms that are typical of a feeding or eating disorder but do not meet the full criteria for anorexia, bulimia or binge eating disorder. These symptoms cause significant distress or difficulty in the important areas of your life. They commonly go undetected and under the radar for some time. Those experiencing these difficulties may not emerge until they report physical health symptoms such as insomnia, muscle weakness, gastrointestinal problems, and other related complaints.
The physical health risks and associated poor mental health can be as severe as those with the previous mentioned eating disorders.

OSFED - a connection to emotional distress

As with other eating disorders, there is not one definitive cause for OSFED. However, there are certain risk factors that can increase the likelihood of one having an eating disorder.

OSFED symptoms

The symptoms of OSFED are highly variable but will be similar to the disorder that it most-resembles. The wide range of symptoms are therefore very variable and may differ in severity. This adds to the potential for the diagnosis to be delayed.

Causes of OSFED

  • Genetic vulnerability: sometimes illustrated by family history of eating disorders or other mental health disorders
  • Societal or occupational pressure to look a certain way
  • Experience of trauma, including abuse
  • Experience of anxiety, obsessional or perfectionistic traits
  • Experience of depression or low self-esteem
  • Experience of criticism of own food intake, weight or bodily appearance, i.e. bullying

Examples of diagnoses within the OSFED category

  • Atypical Anorexia Nervosa: All of the criteria for anorexia are met, except that weight is above or within a normal range despite major weight loss.
  • Bulimia Nervosa (of low frequency and/or limited duration): All the criteria for bulimia are met, but the frequency of bingeing or purging is below the diagnostic threshold (i.e. less than once a week for three months).
  • Binge-Eating Disorder (of low frequency and/or limited duration): All the criteria Binge-Eating Disorder is met, except the frequency of bingeing is below the diagnostic threshold (e.g. less than once a week for three months).
  • Purging Disorder: Recurrent purging behaviour to influence weight or shape (e.g. self-induced vomiting, laxative misuse, or misuse of other medications) without the bingeing of bulimia or other notable associated symptoms of anorexia.
  • Night Eating Syndrome: Recurrent episodes of night eating: eating after waking from sleep or following the evening meal. There are awareness and memory of the episode. The night eating must not be better explained by Binge-Eating Disorder, external influences (e.g. changes to sleep cycle).
  • Avoidant Resistant Food Intake Disorder (ARFID): It has been introduced to reflect feeding issues where body image disturbance is not present. ARFID is often associated with mental health conditions such as anxiety and obsessive-compulsive disorder. It differs from anorexia as there is little drive to lose weight and to be thin.

A personalised plan care based on your individual needs

We provide a very comprehensive and holistic range of interventions and support. This means we are able to find the mechanisms for recovery, which will be different for each patient. Everyone will have a highly personalised treatment programme.

Depending on the severity of your symptoms and the context of any additional mental health, wellbeing, or physical health needs; we will co-design your care and support. Treatment may be provided in outpatient, day patient and inpatient settings and we will recommend the best approach for you following our assessments together. OSFED can start in childhood and adulthood like any other eating disorder.

Inpatient care

It is uncommon for people with OSFED to require a hospital admission although may be necessary if you have poor physical health due to your experience of bulimia. Treatment may include:

  • Physical health stabilisation – your good physical health is important for your mental health to improve and our medical and nursing team will help you monitor this. They will also offer psychoeducation around the impact of your OSFED on your physical health.
  • Psychological therapies – we offer range of group and individual therapies that help you connect with yourself and others, improve your self-awareness around the triggers and stressors that maintain your eating patterns and help you make positive changes in your life.
  • Medication management – if you have attributable mood and or anxiety symptoms we will prescribe and check your medication to support your recovery.
  • Healthy eating support – supervised meals for those that require this, following assessment and planning with a dietician.
  • Family work – opportunity to work with you and your family in a safe place. This can often help you develop stronger and more positive relationships with your family and they with you.

Outpatient care

Outpatient care can support you well if your physical health is not compromised and you are managing to continue to manage day to day tasks and activities such as work, learning, etc.

  • Medical support for prescribed medications.
  • 1:1 Therapy sessions - you will be referred to an individual therapist to work on a 1:1 basis for a time limited programme.

Day patient

Our day programme is a stepped increase from an outpatient clinic for those people who maybe feel that they are becoming unwell enough to require hospital or that they want to have a focus on themselves to reduce their OSFED symptoms. At Schoen Clinic Chelsea we offer an intensive and supportive environment in our small sized groups to help you on your recovery journey and seek to prevent an admission to hospital.
Our eating disorder specialists work in multidisciplinary teams that provide an extensive and holistic perspective of each unique person they consider for treatment. Once they have developed care plans with you, they work in partnership with you to support you throughout.

The programme is reviewed every week by the multidisciplinary team, encompassing the different professionals involved in their care. The team consist of: consultant psychiatrists, psychotherapists/psychologists, family therapists, occupational therapists, dieticians, nurses and experienced assistants. They are at the centre of our approach, ensuring all the progress made across the programme is understood, built upon and applied.
Our model provides consistency and continuity. We provide the following therapies and interventions. These may be delivered on a 1:1 or group basis by members of the multidisciplinary team.

  • Psychological therapies – both psychotherapy and cognitive behavioural approaches.
  • Mindfulness and relaxation to help you better manage stress and triggers.
  • Eating support – supervised meals and after meals to provide you with support to eat at regular times and reduce risk of physical health problems.

Leading specialists for OSFED treatment

Our team of experts consists of consultant psychiatrists, clinical psychologists, therapists, dieticians and specialist nurses who work together as a multidisciplinary team for the benefit of every patient in the treatment of OSFED.

Our specialised clinics for OSFED treatment

Our specialised clinics offer you a personalised treatment programme in the treatment of OSFED with three different locations across the country — central London, Midlands and North England.