Other Specified Feeding And Eating Disorder (OSFED)Treatment

Contact me about in-person and virtual treatment options for OSFED or other eating disorders.

Amelia Lindberg, MSPT, CLT

230 West 79th Street, New York, New York 10024, United States

Email: amelia@bodyfluentwellness.com Phone: 646-849-2729

What Is OSFED (Other Specified Feeding And Eating Disorder)

OSFED is a broad category of eating disorders that don’t fit the criteria for other specific diagnoses like anorexia nervosa or bulimia nervosa but still involve significant disruptions in eating behaviors, body image issues, and distress. OSFED used to be known as "EDNOS" or Eating Disorder Not Otherwise Specified. Despite varying presentations, OSFED can be just as severe and have similar physical and mental health risks as other eating disorders.

Specific OSFED Subtypes

Atypical Anorexia Nervosa: Same symptoms as anorexia, but weight remains within or above the normal range.
Bulimia Nervosa (Low Frequency): All criteria met for bulimia, except for less frequent binge/purge episodes.
Binge Eating Disorder (Low Frequency): All criteria for binge eating disorder met, but episodes occur less frequently.
Purging Disorder: Engaging in purging behaviors (e.g., vomiting, laxative use) without binge eating.
Night Eating Syndrome: Recurrent episodes of night eating, causing distress or impairment, but not meeting full criteria for another disorder.

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Signs of OSFED

Physical Signs of OSFED

Fluctuations in weight (weight may be normal, under, or over)
Digestive issues, such as constipation, bloating, or stomach pain
Frequent fatigue or lack of energy
Dizziness or fainting (often due to erratic eating patterns or malnutrition)
Dry skin, brittle nails, or thinning hair
Dehydration from insufficient fluid intake or purging behaviors
Irregular menstrual cycles or amenorrhea in females
Cold intolerance or always feeling cold
Sleep disturbances or insomnia related to eating habits
Heart palpitations, chest pain, or symptoms of electrolyte imbalances (especially in cases of purging)
Swollen glands in the neck or cheeks (from self-induced vomiting)
Calluses on knuckles or back of hands (in purging cases, known as “Russell’s sign”)
Tooth sensitivity, decay, or erosion (from vomiting)
Muscle cramps or weakness from malnutrition
Edema (swelling) in extremities, especially after bingeing or purging
Frequent headaches from dehydration or erratic eating patterns

Behavioral Signs of OSFED

Inconsistent eating patterns, including skipping meals or irregular eating times
Episodes of binge eating, but less frequently or with fewer behaviors than in binge eating disorder
Self-induced vomiting or misuse of laxatives, diuretics, or enemas after consuming small to moderate amounts of food
Restricting intake to a degree that doesn’t meet anorexia nervosa criteria
Preoccupation with body shape, size, or weight, even if weight is within normal range
Compensatory behaviors like over-exercising, fasting, or purging without meeting full bulimia criteria
Rigid food rules that govern what, when, or how food can be consumed
Labeling foods as “good” or “bad”, leading to cycles of overeating “bad” foods followed by restriction
Extreme dieting behaviors that fluctuate with periods of normal or excessive eating
Eating large quantities of food in secret, but without a sense of loss of control (unlike binge eating disorder)
Frequent checking of body parts in mirrors or obsessive body measuring
Increased use of diet pills, supplements, or other weight-control substances
Avoiding eating in front of others, even if not engaging in other restrictive behaviors
Constant calorie counting or obsessive food tracking
Eliminating entire food groups or following restrictive diets without a medical reason

Emotional and Psychological Signs of OSFED

Fear of gaining weight, even if weight is stable or within normal range
Intense body dissatisfaction or distorted body image
Guilt, shame, or embarrassment about eating habits, even when behaviors don’t meet full disorder criteria
Persistent low self-esteem, particularly tied to body shape or weight
Feelings of anxiety or distress about food choices or meal times
Mood swings related to eating habits, body image, or food intake
Perfectionistic tendencies, particularly around dieting, body image, or exercise
Feeling “out of control” during certain eating episodes, but not meeting the full criteria for binge eating
Feelings of self-loathing or extreme guilt after eating, even without purging behaviors
Extreme focus on “clean eating” that leads to social or emotional consequences

Social and Interpersonal Signs of OSFED

Avoiding social situations involving food, even if not due to fear of eating
Withdrawal from family, friends, or social activities that involve meals
Making excuses to avoid eating in public or with others
Becoming more isolated or emotionally withdrawn
Conflict with family or friends over eating habits or weight concerns
Reduced spontaneity in life, due to preoccupation with food rules or body image
Changes in relationships or social interactions related to body dissatisfaction or food control

Cognitive Signs of OSFED

Preoccupation with food, weight, and body image, despite not fitting full criteria for other disorders
Frequent thoughts about calories, weight loss, or “healthy” eating
Difficulty concentrating, often due to preoccupation with food or inadequate nutrition
Frequent mental bargaining about food intake (e.g., “I’ll eat less tomorrow to make up for today”)
Belief that self-worth is determined by body shape or weight, despite having a normal weight
Obsessive interest in diets, weight loss tips, or eating trends, even if not fully engaged in them
Viewing restrictive behaviors as a means of control, especially during stressful situations

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Amelia's Holistic Treatment of OSFED:

My approach to treating OSFED is personalized and holistic, focusing on reconnecting the mind and body while addressing both physical and emotional aspects of recovery. Here’s what it includes:

1. Personalized Assessment and Education:

I work with clients to understand their unique eating patterns, symptoms, and emotional triggers, creating a comprehensive picture of their experience.
I provide education on how different eating patterns affect the body, helping clients understand how to restore balance and overall health.

2. Body Connection and Sensory Modulation:

I use techniques like sensory modulation and posture awareness to help clients reconnect with their bodies, reducing anxiety and enhancing body awareness.
This helps clients develop a healthier perception of body signals, such as hunger, fullness, and physical comfort.

3. Flexible Eating Plans and Routine Building:

I help clients establish flexible, balanced eating routines that address their specific nutritional needs while also considering their personal preferences and lifestyle.
Clear meal timing guidelines are used to create structure and reduce fear around food, while also supporting emotional regulation.

4. Integrating Physical, Mental, and Social Health:

I promote a holistic "Active Self-Respect" approach, encouraging physical activity, mental growth, and positive social engagement as part of the recovery process.
Clients are guided to build strength and stamina, focusing on self-empowerment and well-being rather than striving for appearance-based goals.

5. Emotional Processing and Coping Strategies:

I support clients in identifying the underlying emotions and stressors contributing to their OSFED behaviors.
I guide them toward developing healthier coping mechanisms, replacing harmful behaviors with positive strategies like mindful eating, journaling, and grounding exercises.

6. Collaborative, Ongoing Care:

I often serve as the primary clinician for clients with OSFED, helping them initiate their recovery journey.
If needed, I can refer clients to other healthcare professionals in my network or collaborate with an established treatment team to ensure comprehensive support.

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Other Specified Feeding And Eating Disorder (OSFED)Treatment