The eating disorder that outranks both anorexia nervosa and bulimia nervosa is called OSFED (other specified feeding and eating disorders). It’s basically the catchall for eating disorders that don’t quite qualify as either of the first two mentioned. While that may make it sound like it’s a less severe eating disorder, it is in fact more dangerous because people often regard it with less concern than anorexia or bulimia.
Because OSFED doesn’t quite fit under the major pillars of eating disorders recognized by the Diagnostic Statistical Manual (DSM), it is much harder to be diagnosed with it. This makes people who have it think they’re not nearly as sick as someone with anorexia, bulimia or binge-eating disorder, so they simply continue on with their incredibly harmful lifestyle. As such, the numbers for this elusive disorder continue to rise and now completely outrank the disorders that are most known.
Here are some frightening statistics to give you some perspective. While anorexia affects 1 out of 200 adults, symptoms of OSFED affect 1 out of 20, according to Jennifer J. Thomas on Buzzfeed, Ph.D., co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital and co-author of Almost Anorexic. That’s a terrifyingly high percentage and definitely not one we should ignore any longer.
“Regardless of diagnosis, the level of pain and distress is the same, and help is available regardless of the number on the scale,” said Thomas to Buzzfeed. “Even individuals who look ‘normal’ can die unexpectedly from complications of purging, including low potassium that causes their hearts to stop.”
The biggest problem with eating disorder diagnoses in general is the incredibly specific list of symptoms you must exhibit to fall into one of the major categories. For example, you could be doing everything someone with anorexia does (not eating, missing periods), but if you eat, say, one meal every two days, you might be above the anorexia cutoff of less than 85 percent of what someone your age and height should weigh. You still have a disease, but not one a doctor can clearly designate.
“Patients might feel they are not in need of or deserving of treatment unless they fall into a different category, which can be detrimental to recovery,” Rachel Cohen, LCSW, site director at The Renfrew Center of Northern New Jersey, told Buzzfeed.
That in a nutshell is the worst part of OSFED — it allows people who have it to let themselves off the hook, because their symptoms are just shy of a “really serious” eating disorder. But that, in effect, makes it a really serious eating disorder. People with anorexia and bulimia often live in denial of their disease even if it’s been diagnosed. Now imagine how long such justifying could go on if you fall somewhere in the grey between “normal” and “sick.” With that in mind, the best way to diagnose OSFED (either for yourself or someone you know) is to get familiar with the symptoms. It is a real disease and one that can hang on much longer under the radar than the more recognized eating disorders. Now that there’s a name for it, let’s haul it out into the open and get to know its ugly face.
1. Same symptoms as anorexia, except you still get your period
This means you’re not eating, you have an intense fear of gaining weight, and you weigh significantly less than a person of your age and size should.
2. Same symptoms as anorexia, but for some reason you’re still in the normal weight range
You may have been overweight, lost a significant amount and now appear to be a normal weight for your age and size. Doesn’t mean you don’t have an eating disorder.
3. Meets all the criteria of bulimia, except doesn’t exhibit the symptoms as often
You’re binge-eating, purging and/or using “inappropriate compensatory methods” (aka laxatives, excessive exercise, other weight loss meds, etc.), but you’re doing it less than twice a week and/or for less than three months. A short-lived and/or less extreme eating disorder is still an eating disorder.
4. You use inappropriate compensatory methods after eating to maintain “normal weight”
Purging after eating an afternoon snack is not something a healthy person does to stay looking good.
5. Tasting your food
Remember that Sex and the City episode where the girls go to LA and Miranda runs into an old writer friend who doesn’t actually swallow his food? Yeah, that’s an eating disorder, and it’s not funny at all.
6. Binge-eating without the purging
Yup, excessive eating without purging is a disease too. Usually it affects people who are trying to fill a void in another part of their lives and would likely feel much better talking to a therapist rather than a carton of Ben and Jerry’s.
How you can get help for OSFED
Please, please do not ignore any of these symptoms if you or someone you love exhibits them. There are support groups, doctors and therapists waiting to help — all you have to do is call. Here are some ways to take that first step toward recovery:
- Think you might be a compulsive exerciser? Take this handy test to find out: Compulsive Exercise Test.
- Visit The Renfrew Center, or dial 1-800-RENFREW for diagnosis and treatment.
- Get a free and confidential screening at Almost Anorexic.
- Keep track of harmful thoughts about food on the Recovery Record app.