EDNOS vs. OSFED vs. UFED: What’s the difference?

Written By Allie

*Trigger warning: This post contains references to specific behaviors such as bingeing and purging. Please read at your own discretion.

EDNOS, OSFED, UFED—navigating eating disorders classifications can feel like doggy-paddling through an alphabet soup of E’s and D’s until you come up for air, just as lost as you were before you dove in. So let’s break down these initialisms and acronyms and explore how they can be useful for those in recovery, their families, and clinicians.

What is EDNOS?

EDNOS refers to an “Eating Disorder Not Otherwise Specified.” This term was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and served to diagnose patients whose disordered eating behaviors didn’t match those defined by more specific DSM entries like anorexia nervosa or bulimia nervosa.

An ABC News article from 2012 stated that at the time, 70% of all diagnosed eating disorders met the criteria for EDNOS. This diagnosis used to be given to individuals whose symptoms didn’t necessarily align with all the signs and symptoms of other disorders, so instead they were lumped into one catchall category.

In the past decade or so, this definition has evolved, new eating disorders have emerged, and we now have a better understanding of what it means to have an “unspecified” eating disorder. Read more below.

OSFED definition

OSFED stands for “Other Specified Feeding and Eating Disorders” and replaced EDNOS in the DSM-5 in the early 2010s.

According to the National Eating Disorders Association, OSFED “was developed to encompass those individuals who did not meet strict diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder but still had a significant eating disorder.”

For example: A person may purge after meals (a symptom of bulimia nervosa) but this purging episode doesn’t necessarily follow a binge episode, and therefore this person would not meet the diagnostic criteria of bulimia nervosa.

OSFED signs and symptoms

Behaviors that can be associated with OSFED might include the following.*

(This is by no means an exhaustive list. Please consult your primary care provider to discuss individual symptoms.)

collection of fruits and a fruit smoothie

  • Preoccupation with weight and appearance, which may lead to engaging in dieting behaviors to lose weight

  • Preoccupation with weight, food, calories, nutritional information, and diets

  • Engagement in food rituals to help maintain “control” over food

  • Follows a strict exercise regimen regardless of social plans, weather, or other deterrents

  • May engage in compensatory behaviors like purging, excessive exercise, fasting, or diuretic use

  • Fear of eating in public or unfamiliar places, possibly leading to social withdrawal and isolation

As you can see, OSFED symptoms are fairly vague and can mimic those of other eating disorders, like anorexia or binge eating disorder. In order for a person to be diagnosed with OSFED, the individual’s behaviors must have reached a level of significant mental and physical distress, but not meet the criteria of other eating disorders.

Read: How a fear of gaining weight can spiral into disordered eating.

As far as physical symptoms of OSFED, there may not be any discernable indications that a person is suffering, which makes this disorder even more dangerous. However, an individual may experience severe gastrointestinal distress (i.e., bloating, cramps, indigestion, constipation), dizziness, trouble sleeping, thinning hair, feeling cold all the time, and/or menstrual irregularities in female-identifying individuals.

*Source: National Eating Disorders Association

OSFED examples

OFSED can be narrowed more specifically based on a person’s exact behaviors. The following are just a few examples:

  • Atypical anorexia nervosa—All the symptoms of anorexia nervosa except a low body weight

  • Night eating syndrome—The majority of an individual’s daily food consumption occurs at night*

  • Purging disorder—Purging food after eating (but not necessarily after binge eating)

  • Bulimia or binge eating disorder (of low frequency or limited duration)

*Source: National Library of Medicine

What is UFED?

Now that you have a better grasp of what constitutes OSFED, let’s explore its cousin: UFED.

When an individual presents with disordered eating symptoms that don’t match any of the symptoms of OSFED mentioned above, they can then be diagnosed with UFED, or an Unspecified Feeding or Eating Disorder.

The National Library of Medicine differentiates OSFED and UFED as follows:

  • OSFED includes atypical anorexia, subthreshold bulimia nervosa, and binge eating disorder, among others.

  • UFED is assigned when full criteria for other eating disorders are not met or insufficient information about the symptoms is available.

An important note about OSFED and UFED diagnoses

Just because OSFED has “other” in its name does not mean it should be considered any less serious than the more well-known disorders.

And just because a person presents with symptoms that might not match the neatly packaged definitions for other eating disorders does not mean their behaviors shouldn’t be taken seriously.

While their behaviors might not have a clearly defined name, they are still dangerous and have a severe impact on a person’s daily life, as well as physical and mental health.

Read more about eating disorders classifications here.

How to interpret OSFED and UFED eating disorders

As evidenced by this blog post, eating disorders can be confusing, not only for those who suffer from them but also for their loved ones and care providers. It’s not always possible to apply someone’s behaviors to a diagnosis that comes with a step-by-step recipe for recovery.

It’s also human nature to want a precise explanation and solution for what we’re doing—categorizing things can help us feel a sense of comfort, less alone.

But achieving this certainty isn’t always possible with eating disorders.

Lines are blurry, definitions aren’t definitive, and all this murkiness means most people never see their disordered behaviors as something they need to address.

Eating disorders research has come a long way in the last few decades in terms of naming new disorders, educating practitioners about these disorders, and making care more available. But we still have a long way to go.

Until then, if a loved one expresses concern about their eating habits or if you start to notice your own behaviors become more intense with time, take them/yourself seriously and talk to a healthcare provider, preferably one who has experience with eating disorders.

notepad and pen next to a candle and a cup of tea

Pause & Prompt

What I wish people understood about eating disorders…

What I wish I could understand about eating disorders…

Allie https://www.recoverywrites.com
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