Other Specified Feeding and Eating Disorders (OSFEDs): Past, Present, and Future

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), replaced the eating disorder not otherwise specified (EDNOS) category first introduced in DSM-III-R with a new category termed other specified feeding and eating disorders (OSFEDs). A major difference between EDNOS and OSFEDs is that OSFEDs provide specific examples of eating disorder presentations, including night eating syndrome, purging disorder, atypical anorexia nervosa, and subthreshold presentations of bulimia nervosa and binge-eating disorder. This chapter provides a critical narrative review of the DSM-5 OSFEDs and a brief narrative review of the unspecified feeding and eating disorders (UFED) category. First, some of the rationale behind the DSM-5 Eating Disorders Work Group’s reasons for replacing OFSEDs with EDNOS is provided. Next, each of the DSM-5 OSFED examples is described, including history, proposed criteria, correlates, epidemiology, and assessment and other presentations to consider. Potential future directions for the nosology of eating disorders that do not neatly fit into one of the formally recognized eating disorder diagnoses are provided at the conclusion of the chapter.