Sometimes people experience eating disorder symptoms, but don’t meet the exact diagnostic criteria of the primary eating disorder diagnoses. You may have seen the diagnosis “EDNOS” to refer to conditions that fall into this gray area. So, what is EDNOS? EDNOS, which stands for eating disorder not otherwise specified, is actually a diagnostic term that’s no longer in use, having been replaced by OSFED (other specified feeding and eating disorder). Though EDNOS is no longer an official diagnosis, it’s still used occasionally, so it’s helpful to understand what it means.

First, it’s important to note that according to the DSM-5, the clinically accepted replacement term for EDNOS is OSFED. Both acronyms mean the same thing, but EDNOS is now an outdated term, which is why we refer to the diagnosis as OSFED.

It’s also important to understand that eating disorders are complex conditions, and so a person’s symptoms don't always line up exactly with the specific symptoms of a more commonly known disorder. Having OSFED (or EDNOS) isn’t an indication that someone’s condition is any less real or serious. The conditions that can be diagnosed as OSFED can be severe and require treatment just like any other eating disorder diagnosis.

Read on to learn more about OSFED (formerly EDNOS), what conditions fall under it, and what to do if you’re concerned about yourself or a loved one.

What is OSFED (formerly known as EDNOS)?

There are many subcategories of OSFED. These categories help define the different kinds of eating disorders that might not meet the standards of other official eating disorder diagnoses. Whether your symptoms fit into one of these subcategories or not, finding the right care is essential. Below are just a few of the most common OSFED subcategories:

• Purging disorder: Purging refers to behaviors that involve intentionally purging food from your body. Laxative misuse, excessive exercise, and self-induced vomiting are all common types of purging. Bulimia is another disorder that involves purging, but a bulimia diagnosis is also dependent on the presence of “bingeing” behaviors. When someone experiences purging but not bingeing, their symptoms may align more closely with purging disorder. Purging can start out as a coping mechanism for a different condition and progress into a harmful habit.
• Binge eating disorder (of low frequency and/or limited duration): Do you sometimes eat an excessive amount of food over a short period of time and feel out of control? This behavior is called binge eating. While binge eating disorder (BED) is a separate diagnosis, some people experience binge eating that doesn’t meet the frequency or duration for BED diagnosis. Binge eating on a regular, but less frequent, basis is a form of OSFED, and is just as serious of a diagnosis as BED.
• Night eating syndrome: This condition is specifically related to disordered eating habits that take place at night. That could mean eating more heavily in the evening or in the middle of the night upon waking. Some people are even still asleep and therefore not conscious when they take part in night eating.
• Bulimia nervosa (of low frequency and/or limited duration): Bulimia nervosa is a condition that involves eating large quantities of food (binge eating) followed by purging to get rid of it. Like binge eating disorder, a bulimia diagnosis has certain frequency and duration requirements. If you do not meet these criteria, you may not be able to receive a bulimia diagnosis despite experiencing the symptoms. For low-frequency or limited duration bulimia, getting an OSFED diagnosis means that you can still receive the treatment you need.
• Atypical anorexia: A person who meets all the diagnostic criteria for anorexia except low weight is classified as having atypical anorexia. Atypical anorexia is just as serious and carries many of the same health risks as anorexia, which is why at Equip we refer to it simply as anorexia.

Effective treatments for OSFED

Treatment for OSFED includes evidence-based modalities like enhanced cognitive behavioral therapy (CBT-E), , or family-based treatment (FBT). The specific approach that’s right for you or your loved one will depend on which eating disorder behaviors are present as well as other factors, like age. Whatever treatment is used, it will have a common goal of establishing normal eating routines and building new coping skills.

Since it’s not as well known as other eating disorders, having an OSFED diagnosis can be an isolating experience. That’s why support groups can also be a key to recovery for anyone with OSFED. Connecting with others who have received similar diagnoses can help you feel less alone and serve as motivation for recovery.

Treating an eating disorder promptly and with evidence-based care is vital, even if your symptoms don’t line up with a traditional diagnosis. At Equip, we can help you find the right treatment approach for your diagnosis, including all the subtypes that fall under OSFED (previously known as EDNOS). With treatment tailored to your needs, your provider team can help you heal your relationship with food.

Get in touch with our team today for more information or to schedule an initial consultation.

About Jessie Menzel, Ph.D

Dr. Jessie Menzel, Ph.D., is the Vice President of Program Development at Equip. A clinical psychologist with over 15 years of specialized experience in eating disorders, Dr. Menzel earned her Ph.D. in clinical psychology from the University of South Florida and is also the founder and former director of the Pediatric Program at the UCSD Eating Disorders Center. She has conducted national and international training on treating eating disorders and supervising graduate students, postdoctoral fellows, and psychiatry residents. Her research experience includes the study of body image disturbance, body awareness, and the development of disordered eating interventions.