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Identifying and Treating OFSED in the Pediatric Patient
Contributor: Crystal Karges, MS, RDN, IBCLC, Special Projects Coordinator at Eating Disorder Hope/Addiction Hope
Eating disorders among pediatric patients can range in severity and in behaviors, and understanding the types of eating disorders that can occur can help with early identification and intervention among caregivers and professionals.
Not Meeting Diagnostic Criteria
Some eating disorders may not present with the classical criteria used to diagnose anorexia nervosa, bulimia nervosa, and binge eating disorder. The term OSFED, which stands for Other Specified Feeding or Eating Disorders, represents the feeding and eating disorders that are clinically severe but do not meet diagnostic criteria for another type of eating disorder.
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), OSFED includes five specific disorders:
- Atypical anorexia nervosa
- Bulimia nervosa of low frequency and/or limited duration
- Binge eating disorder of low frequency and/or limited duration
- Purging Disorder
- Night Eating Syndrome
The Types of Eating Disorders
Understanding the disorders that fall under OSFED can help define what a child might be struggling with, particularly if symptoms do not present as typical anorexia, bulimia, or binge eating disorder. With atypical anorexia nervosa, the restrictive eating behaviors of anorexia would be present without meeting the low weight criteria.
Similarly, with atypical bulimia nervosa and binge eating disorder, all the criteria for bulimia would be met with the exception of the frequency criterion.
In purging disorder, purging behavior, such as self-induced vomiting, is typically intended to influence weight or body shape but occurs in the absence of binge eating. Lastly, with night eating syndrome, an individual may have recurrent episodes of excessive eating at night along with significant changes in the normal sleep-wake cycle.
If at any point, a parent or caregiver feels concerned about their child’s eating habits, food behaviors, and growth, it is crucial to seek out professional help and development. Even if signs and symptoms that are observed do not seem to fall into a classic pattern of an eating disorder, it may be helpful to have a specialist assess and determine if another form of an eating disorder is present.
Identification can lead to more effective forms of treatment, which can ultimately help improve prognosis and outcome for a child who may be struggling.
Community Discussion – Share your thoughts here!
What do you think are the benefits of including the criteria for OSFED in the latest edition of the DSM-5?
About the Author: Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing, Crystal serves as the Special Projects Coordinator for Eating Disorder Hope/Addiction Hope, where her passion to help others find recovery and healing is integrated into each part of her work.
As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH/AH and nutrition private practice.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on January 28, 2016
Published on EatingDisorderHope.com
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
