What are Other specified feeding or eating disorders (OSFED)

Other specified feeding or eating disorders (OSFED) was previously known as eating disorder not otherwise specified (EDNOS) in past editions of the Diagnostic and Statistical Manual (DMS-5).

OSFED is a diagnosis given when a sufferer meets some, but not all of the characteristics of a specific eating disorder such as anorexia or bulimia

For example, someone may have some symptoms of anorexia but remain within a normal weight range. Someone might have bulimic behaviours, but their binges’ frequency is reduced or chew a large amount of food but not swallow it. These individuals will fall in the OSFED category and will require eating disorder treatment to manage their condition. 

Despite being considered a ‘catch-all’ classification, research into the severity of OSFED/EDNOS shows that the disorder is just as severe as other eating disorders.

Signs and symptoms of OSFED

In general, some signs and symptoms of OSFED might include:

  • Weight loss, dieting and food are becoming primary concerns
  • Developing food rituals
  • Uncomfortable eating around others
  • Dramatic weight loss
  • Dressing in layers to hide weight loss or to stay warm
  • Withdrawing from usual activities and hobbies 
  • Experiencing constipation, stomach pains, feeling uncomfortably cold and lethargy
  • In girls or women – monthly menstrual periods become irregular or stop
  • In men or boys – erections and wet dreams stop, and testicles shrink

How can OSFED affect you?

As with all eating disorders, if an individual isn’t getting enough calories, they may experience a mix of psychological and physical consequences. 

Behavioural symptoms

  • Sleep badly
  • Find it difficult to concentrate or think clearly about anything other than food or calories
  • Feel depressed
  • Lose interest in other people
  • Become obsessive about food and eating (and sometimes other things such as washing, cleaning or tidiness)

Physical symptoms

  • Find it harder to eat because the stomach has shrunk
  • Feel tired, weak and cold as the body’s metabolism slows down
  • Become constipated
  • Not grow to their full height
  • Get brittle bones that break easily
  • Become unable to get pregnant
  • In extreme cases, death. Eating disorders have the highest death rate of any psychological disorder

If individuals practice self-induced vomiting, they may

  • Lose teeth enamel
  • Experience bloating or puffiness in the face, due to the salivary glands in the cheeks swelling
  • An irregular heartbeat or heart palpitations
  • Feel weak
  • Feel tired all the time
  • Damage the kidneys
  • Have epileptic fits
  • Be unable to get pregnant

If an individual uses laxatives regularly, they may

  • Have persistent stomach pain
  • Get swollen fingers
  • Find themselves unable to use the toilet anymore without using laxatives (as laxatives can damage the muscles in the bowel)
  • Experience fluctuating weight

Treatment of eating disorders at Nightingale Hospital

Nightingale Hospital has a Quality Eating Disorder accreditation, provided by the Royal College of Psychiatrists. This means that when you’re seeking eating disorder treatment at ​​Nightingale Hospital, you can be sure that you will be receiving trusted and effective clinical care of the highest degree.

QED - Quality Networks for Eating Disorders - OSFED

We have the expertise in eating disorders to approach the support and treatment we offer adults and adolescents in a personal and flexible way to benefit you the most in your recovery. Eating disorder treatments here in London can be outpatient, day patient or inpatient.

Based on current clinical evidence and put into practice by an experienced, multidisciplinary team of consultant psychiatrists, unit doctors, nurses, dieticians, and specialist therapists, Nightingale Hospital’s approach to eating disorder treatment is tailored to the individual.


Through intensive psychological and emotional support in group therapy sessions and individual counselling and psychotherapy, you can understand underlying factors that have contributed to your eating disorder and find strategies to overcome it.

  • Cognitive behavioural therapy can help you identify your negative thoughts and learn more positive emotional and behavioural responses to your beliefs about yourself and your eating.
  • Family therapy can improve the way family members relate to each other and communicate
  • Occupational therapy can support you practically in returning to a normal life away from your eating disorder.

Through therapy, education and alternative supportive approaches such as art and drama therapy, meditation and relaxation, life skills, sleep therapy and support groups for you and your family we aim to give you the knowledge and coping skills to recover from your eating disorder. 

Aftercare for inpatients 

It can be difficult adjusting to life after an inpatient admission, so we offer a step-down programme to our eating disorders daycare, individual counselling and free aftercare groups post inpatient treatment to sustain motivation for living free from an eating disorder.

Family support groups for inpatients 

Those nearest to the sufferer often blame themselves, going through a range of emotions from despair, depression, and guilt to anger and frustration, leaving them exhausted and having difficulty coping and feeling powerless in how to deal with the situation.

Research has shown that the involvement of families in the treatment process greatly increases the prospects of a person’s recovery.

Recent family support group feedback

  • “It was good to meet up with other people who understand the complexities of caring for a loved one with an eating disorder. The group was well-led. Joanna is very knowledgeable and took the time to listen to everyone even though there were many needs and people at different stages of the journey.”
  • “We cannot thank you enough for the education and advice this group has offered and the chance to discuss our questions with you and other careers of loved ones. We would be grateful if we could attend future Zoom meetings. We have started to read the advised book and already this is becoming of great help. Thank you again, Joanna.”

Eating disorder specialists at Nightingale Hospital

Nightingale Hospital London has several consultant psychiatrists and therapists that can help you through OSFED. You must find an eating disorder specialist that you can trust and work with on your recovery. 

Our eating disorders clinical team is led by:

  • Nightingale Hospital Lead Consultant for Eating Disorders, Consultant Psychiatrist Dr Helen Murphy
  • Nightingale Hospital Lead Therapist for Eating Disorders, Dr Joanna Silver

Please contact us confidentially on 020 7535 7700 24 hours a day.

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