Unspecified Feeding or Eating Disorder (UFED): Signs & Symptoms

Not all disordered eating behaviors fit the mold of anorexia nervosa, bulimia nervosa, or binge eating disorder (BED). For this reason, various diagnoses are categorized under other specified feeding and eating disorder (OSFED), formerly known as an eating disorder not otherwise specified (EDNOS), including atypical disorders.

What happens when an individual’s thoughts and behaviors do not align with these criteria? This scenario calls for an unspecified feeding or eating disorder (UFED) diagnosis, which also falls under the OSFED spectrum.

What Is Unspecified Feeding or Eating Disorder?

UFED is diagnosed when an individual’s symptoms do not align with those of another disorder or when there is insufficient information to determine a more specific diagnosis. This UFED label can change once more information is gathered or as symptoms change over time.

The presence of disordered thoughts and behaviors regarding food and body image is insufficient to warrant an eating disorder diagnosis. These thoughts and behaviors must be severe enough to cause significant distress to the individual.

Doctors use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose eating disorders. [1] Many people have eating disorder symptoms that don’t mesh with accepted definitions. In one study of eating disorders, for example, most people with disordered eating didn’t fit neatly into accepted diagnostic categories in the DSM. [2]

As Jennifer J. Thomas, Ph.D., confirms, “In our study of DSM-5 changes at the Klarman Eating Disorders Center, just 1 of 150 patients had UFED. This patient struggled with bingeing and purging but didn’t have the intense shape and weight concerns required for a bulimia diagnosis.”

Dr. Thomas also explains the reasoning behind the various changes from EDNOS to OSFED in the DSM-5, stating, “I appreciate that UFED is kind of a strange name … the new names were part of DSM-wide changes, meaning that OSFED and UFED are in good company with ‘Other Specified Depressive Disorder’ and ‘Unspecified Anxiety Disorder,’ among others.”

Eating Disorder Behaviors

Symptoms of UFED include disordered eating behaviors that cause significant distress or impairment. Disordered behaviors can vary greatly. Common behaviors include restriction, bingeing, and purging.

Restriction

Restriction is characterized by extreme caloric restrictions, which is common in many eating disorders, including anorexia nervosa. People with anorexia may only take in 500 kcal daily; the less they eat, the more in control they might feel. [3]

Bingeing

Binge eating occurs when an individual consumes a large quantity of food, typically in secret and until uncomfortably full. Bingeing is often uncontrollable and leaves the individual feeling guilty and shameful. Sometimes, this leads to compensatory behaviors, such as self-induced vomiting or laxative abuse.

Purging

An individual can engage in compensatory behaviors, otherwise known as purging, regardless of the size of the meal. Purging can take many forms, including these:

• Compulsive exercise: An individual is obsessed with burning recently consumed calories and does so through excessive exercise.
• Vomiting: The person heads to the bathroom to purge immediately after eating.
• Laxative abuse: The person uses over-the-counter products to move food quickly through the intestine.

Lesser-Known Disordered Eating Behaviors

Many disordered behaviors are less common and, therefore, not as openly discussed within the eating disorder community.

These behaviors can include the following:

• Chewing and spitting: Individuals chew their food to get the sensation of eating and then spit it out to avoid caloric intake or feeling full.
• Eating unusual items: Pica is an eating disorder characterized by eating non-food substances like carpeting or paper products. The ingestion of hair is known as trichophagia, closely connected to the hair-pulling disorder trichotillomania.
• Orthorexia: An obsession with “clean” eating and a “healthy” lifestyle can be labeled as orthorexia. This disorder is not included in the DSM-5, meaning behaviors associated with orthorexia might fall under a UFED diagnosis.

What to Do With a UFED Diagnosis

Any combination of these eating disorder behaviors that do not fit the specific diagnostic criteria for an eating disorder in the DSM-5 would be categorized as an unspecified feeding or eating disorder. Similarly, UFED can be diagnosed if combinations of these behaviors are present or if they have only recently appeared.

There is a stigma attached to any OSFED diagnosis, including UFED, even to mental health professionals and individuals struggling with associated disorders. However, it is essential to remember that UFED is as severe as any other eating disorder and that full recovery is possible.

References

1. Diagnostic and Statistical Manual of Mental Disorders. (n.d.). American Psychiatric Association. Accessed September 2022.
2. Hay P, Girosi F, Mond J. (2015). Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. Journal of Eating Disorder; 3:19.
3. Burd C, Mitchell JE, Crosby RD, Engel SG, Wonderlich SA, Lystad C, Le Grange D, Peterson CB, Crow S. (2009). An assessment of daily food intake in participants with anorexia nervosa in the natural environment. International Journal of Eating Disorders; 42(4):371-4.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on January 25th, 2023
Published on EatingDisorderHope.com