Otherwise Specified Eating Disorder (OSFED) And Addiction

Medically Reviewed by Johnelle Smith, M.D on April 19, 2021

Otherwise Specified Eating Disorder (OSFED) is the most common eating disorder diagnosed for thousands of adults as well as adolescents of both genders. OSFED can co-occur with substance use disorder and requires specialized treatment.

Co-Occurring Otherwise Specified Eating Disorder And Addiction

Otherwise Specified Eating Disorder (OSFED) is the most common eating disorder diagnosed for thousands of adults as well as adolescents of both genders.

OSFED can co-occur with other medical conditions, such as substance use disorder.

When an individual has both addiction and OSFED, known as a dual diagnosis, it requires specialized treatment.

Dual diagnosis treatment often involves a combination of therapies and an integrated treatment approach to properly treat the causes and symptoms of both disorders.

Learn more about co-occurring eating disorders and addiction

What Is Otherwise Specified Eating Disorder (OSFED)?

Otherwise Specified Eating Disorder (OSFED) is an eating disorder that is less well-known than anorexia nervosa or bulimia nervosa. However, it affects more than half of all people diagnosed with eating disorders in the United States.

This eating disorder is a medical diagnosis given to people who suffer from disordered eating or distorted views of both self and food.

It is a medical diagnosis given to a group of symptoms that don’t meet the full criteria of other established eating disorders.

When an individual does not meet the full diagnostic criteria for a specific eating disorder, they would be classified as OSFED.

There are five types of OSFED, including:

  • Atypical Anorexia Nervosa: An individual’s weight may be within the normal range, and may meet all diagnostic criteria of anorexia except for abnormal weight loss
  • Binge Eating Disorder (of low frequency and/or limited duration): An individual may exhibit all symptoms of BED for less than three months, or less frequently
  • Bulimia Nervosa (of low frequency and/or limited duration): Binge eating and compensatory behaviors of the individual may occur less frequently or less than three months, while meeting all other diagnostic criteria of the disorder
  • Purging Disorder: Purging behavior to influence weight gain or body size may occur without the presence of binge eating
  • Night Eating Syndrome: This syndrome describes recurring episodes of night eating. Excessive eating after waking up from sleep, or after an evening meal, that causes significant distress and impairment are some signs of the disorder.

Symptoms Of Otherwise Specified Eating Disorder

Otherwise Specified Eating Disorder is characterized by disordered thoughts and behaviors about food and eating.

Similar to other eating disorders, OSFED symptoms may include behavioral, emotional, and physical aspects.

Symptoms can include:

  • excessive focus and preoccupation with food and eating
  • excessive focus and preoccupation with body shape or weight
  • intense dissatisfaction with body shape or weight
  • low self-esteem
  • feelings of guilt or shame involving food intake
  • distorted body image
  • depression, anxiety, and irritability
  • distress when eating or around meal times
  • avoidance of certain foods or food groups

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Signs Of Drug Or Alcohol Abuse

Unfortunately, many individuals with OSFED may also struggle with drug and alcohol abuse.
Substance use disorder may include certain signs and symptoms that would indicate an individual is suffering from addiction.

Signs of drug or alcohol abuse may include:

  • intense urges to use drugs or alcohol
  • hiding drug or alcohol use
  • over time, needing more drugs or alcohol to get the same effect
  • failing in attempts to stop using drugs or alcohol
  • taking prescription medications without a prescription
  • experiencing withdrawal symptoms when stopping drugs or alcohol
  • inability to meet social obligations and work responsibilities
  • poor hygiene or physical health
  • behavioral changes
  • weight loss
  • isolating behaviors

Common signs of substance abuse may vary and depend on the substance of abuse.

Causes Of Co-Occurring Addiction And OSFED

When addiction and OSFED occur together, the contributing factors that lead to the development of these disorders may vary.

Causes of these co-occurring disorders may differ from person to person.

Genetic And Environmental Factors

However, known causes include genetic predisposition and a combination of environmental, social, and cultural factors.

Trauma And Stress-Related Factors

In some situations, exposure to trauma or social stressors may trigger the development of addiction and OSFED. As with other eating disorders, OSFED may increase an individual’s risk of substance abuse.


Often, an individual suffering from OSFED may be seeking to self treat symptoms of anxiety, depression, or low self-esteem with substance abuse.

Unfortunately, substance abuse often leads to an increase in negative symptoms and emotions.

Shared risk factors for OSFED and substance abuse include:

  • genetic factors
  • familial mental illness or substance abuse
  • unstable background or childhood
  • exposure to trauma
  • unstable emotional health
  • inability to manage stress

Individuals with OSFED may attempt to self-treat symptoms of their eating disorder with drugs and alcohol. Drugs and alcohol may also be used to control an individual’s appetite.

How Common Is Substance Abuse And OSFED?

Otherwise Specified Eating Disorder (OSFED) is the Diagnostic & Statistical Manual (DSM-5) category that replaces the category of “Eating Disorder Not Otherwise Specified.”

Otherwise Specified Eating Disorder and addiction statistics:

  • Prevalence: Around 30%-50% of people who seek treatment for an eating disorder have Other Specified Feeding or Eating Disorder (OSFED)
  • Self-medication: Self-medicating symptoms of OSFED may be an underlying contributor to the development of a substance use disorder
  • Treatment: only about 18 percent of substance abuse treatment programs and 9 percent of mental health treatment organizations can treat dual diagnosis patients

Finding Dual Diagnosis Treatment For Addiction and OSFED

A person with both a substance use disorder and an eating disorder may find it difficult to find treatment that addresses the symptoms and causes of these co-occurring medical conditions.

Research suggests that dual diagnosis treatment with an integrated approach is highly effective at treating substance abuse and eating disorders simultaneously.

Further, OSFED patients may benefit from therapies such as Cognitive Behavioral Therapy (CBT) during outpatient and inpatient treatment.

Dual diagnosis treatment may involve:

  • medical treatment
  • psychiatric care and therapy
  • group and family therapy
  • assisted and monitored detoxification
  • medication

Several local mental health and addiction treatment centers provide dual diagnosis treatment.

Our helpline provides assistance for:

  • finding dual diagnosis treatment centers
  • verifying health insurance and benefits
  • discussing available treatment options

If you or a loved one has an eating disorder such as OSFED or a drug or alcohol addiction, contact us today to discuss dual diagnosis treatment.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D on April 19, 2021
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