Other Specified Feeding and Eating Disorders
This diagnostic category encompasses eating disorders or eating behavior distortions that cause distress or interfere with family, social, and work functions, but not with those in the other categories. Sometimes this is because the frequency of the behavior does not meet the diagnostic threshold (e.g. the weight criteria for anorexia nervosa or binge behavior in bulimia or binge eating disorder) are not met. “Atypical anorexia nervosa” is an example of a specific eating disorder. Individuals who are in this category may have lost lots of weight and whose behaviors and fear of fatness are consistent with anorexia nervosa, but they are not yet considered underweight at their BMI because their baseline weight is above average.
Because the speed of weight loss is linked to medical complications, people who lose a lot of weight rapidly through extreme weight loss behaviors may be at high risk for medical complications, even if they seem normal or above average weight.
In addition to the six eating disorders listed above, there are also lesser-known or less common eating disorders. There are three main categories of these:
- Purging disorder – People with purging disorder often use purging behaviors to control their weight or shape, such as vomiting, diuretics, laxatives, or excessive exercising. They do not binge, however.
- Night eating syndrome – People with this syndrome frequently eat excessively after waking up from sleep.
Other specified feeding or eating disorders (OSFED). Despite not being listed in the DSM-5, this category includes any conditions that share similarities with eating disorders but cannot be classified into any of those categories above.
Orthorexia is a condition that may fall under OSFED. However, despite being increasingly discussed in the media and in scientific studies, orthorexia has not yet been recognized as a distinct eating disorder by the current DSM.
People with orthorexia tend to focus obsessively on healthy eating, to the point that it disrupts their daily lives. People with this condition may completely eliminate food groups, fearing that they are unhealthy. The result can be severe weight loss, malnutrition, inability to eat outside the home, and emotional distress.
Orthorexia patients rarely focus on losing weight. It is rather dependent on how well they adhere to their self-imposed dietary rules that they define their self-worth, identity, and satisfaction.