When it comes to eating disorders, everyone has heard of Anorexia Nervosa and Bulimia Nervosa. However, these are not the only types of eating disorders that exist.
EDNOS (eating disorder not otherwise specified) or now recognised as OSFED (other specified feeding or eating disorder) is the most common type of eating disorder and the most deadly – but no one seems to know about it or its consequences!
A person with OSFED may present with many of the symptoms of other eating disorders such as Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder but will not meet the full criteria for diagnosis of these disorders. Diagnoses that fit within this criteria include atypical anorexia (anorexic behaviours but a normal weight), atypical bulimia (less frequent behaviours), purging disorder (vomiting without binging), and night eating syndrome (excessively eating after bed time).
This does not mean that the person has a less serious eating disorder.
OSFED is the most common eating disorder and the most deadliest.
It has a mortality rate of 5.2 percent — higher than both anorexia and bulimia — despite the fact its sufferers often look healthy.
Signs that a person is struggling with OSFED
The warning signs of OSFED can be physical, psychological and behavioural. It is possible for someone with OSFED to display a combination of these symptoms:
- Weight loss, weight gain or weight fluctuations
- Loss of or disturbance of menstrual periods in girls and women and decreased libido in men
- Compromised immune system (e.g. getting sick more often)
- Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
- Fainting and dizziness as a result of dehydration
- Preoccupation with food and eating
- Preoccupation with body shape and weight (in men this can be a preoccupation with increasing muscle bulk)
- Extreme body dissatisfaction
- Having a distorted body image (e.g. seeing themselves as overweight even if they are in a healthy weight range for their age and height)
- Sensitivity to comments relating to food, weight, body shape or exercise
- Heightened anxiety and/or irritability around meal times
- Depression, anxiety or irritability
- Low self esteem and feelings of shame, self loathing or guilt
- ‘Black and white’ thinking – rigid thoughts about food being ‘good’ or ‘bad’
- Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates)
- Evidence of binge eating (e.g. disappearance or hoarding of food)
- Frequent trips to the bathroom during or shortly after meals which could be evidence of vomiting or laxative use
- Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)
- Eating at unusual times and/or after going to sleep at night
- Changes in food preferences (e.g. claiming to dislike foods previously enjoyed, sudden preoccupation with ‘healthy eating’, or replacing meals with fluids)
- Obsessive rituals around food preparation and eating (e.g. eating very slowly, cutting food into very small pieces, insisting that meals are served at exactly the same time everyday)
- Anti-social behaviour, particularly around meal times, and withdrawal from social situations involving food
- Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms)
- Increased interest in food preparation (e.g. planning, buying, preparing and cooking meals for others but not actually consuming; interest in cookbooks, recipes and nutrition)
- Increased interest and focus on body shape and weight (e.g. interest in weight loss websites, books, magazines or images of thin people)
- Repetitive or obsessive behaviours relating to body shape and weight (e.g. weighing themselves repeatedly, looking in the mirror obsessively and pinching waist or wrists)
- Increased isolation, spending more and more time alone and avoiding previously enjoyed activities
Where to go for help:
If you suspect that you or someone you know has OSFED, it is important to seek help immediately. The earlier you seek help the closer you are to recovery. While your GP may not be formally trained in detecting the presence of an eating disorder, he/she is a good ‘first base.’ A GP can refer you on to a practitioner with specialised knowledge in eating disorders.