OSFED Subtypes: The Need for Better Definitions

Other specified feeding and eating disorders (OSFED) is a diagnostic category in DSM-5 describing individuals with clinically significant eating behavioral disturbances that do not meet criteria for full-threshold eating disorder diagnoses. OSFED includes five example subgroups: atypical anorexia nervosa, sub-threshold bulimia nervosa, sub-threshold binge-eating disorder, purging disorder, and night eating syndrome. A recent review of OSFED by Dang et al. aims to examine differences between OSFED and full-threshold eating disorders as well as between OSFED and healthy populations but is limited by the lack of clear definitions of OSFED subtypes and methodological differences across studies. Clearer diagnostic definitions for OSFED subtypes are needed. Consideration should also be given to indicators of lifetime history of full-threshold conditions, diagnostic drift, and remission criteria as OSFED categories undergo further study.