Persons with OSFED can often present with extremely disturbed eating habits, distorted body image, an intense fear of gaining weight and an over inflated view of both body shape and weight.  OSFED, like other eating disorders, does not appear to have a singular point of origin.  It too typically presents via a number of different influences.

• Social/cultural: –
• • the influence of social media platforms
  • Lean, toned and thin bodies are more acceptable
  • Varying degrees of dieting advice – some more extreme than others, juicing, detoxing, calorie counting to name but a few
  • Elimination of various food groups
  • Tracking and targeting of previous internet searches – especially damaging for those in the throws of an eating disorder
  • Extreme pressure to conform to peer groups, social norms and perceived idealisms surrounding the rich and famous

• Biological factors: –
  • Genetics
  • Established eating disorder history within the family
  • Overall temperament of the individual, including their susceptibility and vulnerability to ‘belong’ or ‘fit in’.
  • Neurobiological factors such as the accuracy of satiety and hunger cues

• Psychological factors: –
  • Trauma including childhood trauma
  • Feelings of hopelessness and defectiveness
  • Isolation leading to loneliness
  • Stress, anxiety and depression
  • Lack of control over one’s life
  • Fear of change and transition
  • Difficulties with developmental milestones
  • Low self-esteem
  • Victim of bullying
  • Poor interpersonal relationship skills
  • Perfectionistic personality type

Examples of OSFED include:

• Atypical anorexia nervosa – where food restrictions and other anorexic behaviours are present, but the person does not present with the criteria of low weight
• Bulimia nervosa attributed with a lesser frequency and duration of bingeing and purging behaviours
• Binge eating disorder attributed with a lesser frequency and duration of binge eating behaviours
• Night eating syndrome – occurs when an individual has repeated occurrences of night eating which cannot be explained by any other factors
• Purging disorder – not accompanied by periods of binge eating

Those suffering with OSFED all share the common characteristics of disordered thoughts and behaviours around eating and food.  Signs and symptoms of OSFED to look out for include:

• Obsessive preoccupation with food and eating
• Fixation on weight and/or body shape
• Distortions connected to their body image
• Intensive worries related to body dissatisfaction
• Self-loathing, guilt, feelings of shame and low self-esteem
• Avoidance or limitations of certain food groups/types
• Restriction of calories or self-starvation
• Increased anxiety and/or irritability at mealtimes
• Binge eating, perhaps followed by purging
• Overall low mood, signs of depression, anxiety and stress
• Ritualistic behaviours associated with food, eating and mealtimes
• Excessive exercising
• Concerns with the purity and cleanliness of food (also referred to as Orthorexia)
• Hiding or hoarding food even perhaps eating thrown out leftovers from the bin
• Misuse of insulin to encourage weight loss (also referred to as Diabulimia)

Health Implications of OSFED

• Maladaptive eating and/or exercise behaviours
• Challenges with blood pressure
• Heart issues
• Tooth decay (excessive vomiting)
• Muscle loss and weakness
• Organ failure
• Swelling of cheeks and face (excessive vomiting)
• Osteoporosis
• Lanugo hair growth from food restriction
• Chemical and electrolyte imbalance
• Constipation or bowel movement difficulties
• High cholesterol
• Extreme tiredness
• Type 2 diabetes
• Gallbladder disease
• Suicidal thoughts/ideation

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