Other Specified Eating Disorders


In the realm of disordered eating, the long-anticipated 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders probably did more to muddy the waters than to clarify them. Under the heading of “Feeding and Eating Disorders,” the entries are Pica, Rumination Disorder, Avoidant/Restrictive Food Intake Disorder, Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, and Unspecified Feeding or Eating Disorder.

And then, there is OSFED, which stands for Other Specified Feeding or Eating Disorder. Amelia Tait wrote:

An individual has an OSFED if they do not meet the weight criteria for anorexia or bulimia. One of the five subtypes of OSFED is atypical anorexia, which is where individuals who have disordered eating but don’t meet the low weight associated with anorexia, fit in.

OSFEDs are broken down into Atypical Anorexia Nervosa, Binge Eating Disorder (of low frequency and/or limited duration), Bulimia Nervosa (of low frequency and/or limited duration), Purging Disorder, and Night Eating Syndrome.

Tait mentions that in the United Kingdom, there is no specialized treatment center dealing with OSFED, and cites a 2013 survey (of 500 patients) which revealed that 40% had been told that their BMI was not low enough to give them access to treatment.

It almost seems as if young people are encouraged by the system to intentionally worsen their malnourished conditions in order to qualify for health care. (Meanwhile, other patients have to make the effort to graduate from obese to morbidly obese, in order to qualify as candidates for bariatric surgery.) Tait points out,

This illogical system means doctors wait for a patient’s condition to become severe — even life-threatening—before they offer a cure.

Herd mentality and recruitment

Among all the eating disorders, Anorexia Nervosa is said to be the least commonly diagnosed, yet the number of self-proclaimed anorectics is wildly disproportionate with that statistic. As a pseudonymous writer has said,

There is a fundamental difference between disordered eating patterns and a clinical eating disorder.

One difference is the tendency to overshare details of the illness, to the point where it sounds like not a warning but an enticement. But the anti-pro-ana author of “Anorexia is Not a Diet” believes that people with genuine mental illness do not recruit, saying,

In my own experience, eating disorder sufferers generally go out of their way to protect others from suffering in a similar way to themselves.

The same writer warns that “the overwhelming majority of pro-anas still do not care about the impact their behavior is having.” In other words, whatever they call themselves doing appears to be the exact opposite of protecting.

It kind of looks like dangerously misguided energy. Overall, it seems to amount to a heap of awareness, advocacy, evangelism, encouragement, enabling, and other things that are not generally considered desirable for a weird cult to do.

Your responses and feedback are welcome!

Source: “When You’re Both Overweight and Anorexic,” Vice.com, 12/08/15
Source: “Other Specified Feeding or Eating Disorder,” NationalEatingDisorders.org
Source: “Anorexia is Not a Diet,” Tumblr.com, 2017
Photo credit: Endlisnis via Visualhunt/CC BY

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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