Understanding Other Specified Feeding and Eating Disorders (OSFED) in Males: Signs, Symptoms, and Treatment

1. Introduction

   1. What is Other Specified Feeding and Eating Disorders (OSFED)?

      OSFED is other specified feeding and eating disorders. It includes individuals who experience distress and impairment related to their eating behavior and attitudes but do not meet the full criteria for specific eating disorders such as anorexia nervosa, bulimia nervosa, or binge eating disorder.

      A person can be given the diagnosis of OSFED if they have symptoms of anorexia but the body mass index is not in the underweight category. They may also alternatively have a binge eating disorder.

      OSFED is one of the most common eating disorders and can be as serious as other types. ⁽¹⁾ People with OSFED may have many thoughts about food and their weight just like people with other eating disorders.
      Sometimes people with OSFED are misinterpreted as term subclinical eating disorder, which is less severe. ⁽²⁾ It should be known that OSFED can be similar to other eating disorders in severity. It may affect people in many aspects of life. Also, if not addressed, it can progress to other diagnoses.

   2. Types of Other Specified Feeding and Eating Disorders (OSFED)

   OSFED has several subtypes based on specific patterns of disordered eating behavior and attitudes. These include:

   • Atypical Anorexia Nervosa: In this, the individual has significant weight loss or restriction of food intake but does not meet the low weight criteria for diagnosis of anorexia nervosa. Despite not being underweight there is an intense fear of weight gain, body dissatisfaction, and altered perception of their body shape and size.

   • Bulimia Nervosa of Low Frequency and/or Limited Duration: There are recurrent episodes of binge eating and inappropriate compensatory behavior with lower frequency or shorter duration than required for bulimia nervosa.
   • Binge Eating Disorder of Low Frequency and/or Limited Duration: This may involve recurrent episodes of binge eating with no compensatory behavior. The frequency and duration of these episodes are lower than the diagnostic criteria for binge eating disorder.
   • Purging Disorder: In this disorder, the individuals engage in purging behavior to influence their weight or shape by engaging in binge eating disorder. Purging disorder does not involve the presence of binge eating.
   • Night Eating Syndrome: In this, an individual may consume a significant portion of the daily food intake at night. They also have difficulty with sleep and lack of appetite during the morning. There is also a sense of lack of control over eating during the nighttime.

   3. Prevalence of Other Specified Feeding and Eating Disorders (OSFED) in Males

   Prevalence of OSFED in males is underrepresented and have less studies compared to females. Recent research has started to shed light on the prevalence of OSFED. The accurate prevalence rates are challenging to determine due to underdiagnosis, misdiagnosis, and stigma associated with eating disorders in males.

   Studies show that OSFED occurs in males, but the rates are lower as compared to females. ⁽³⁾ OSFED in males is lower as compared with females, but the males affected may require appropriate recognition, diagnosis, and treatment. More research and awareness are important for better understanding of the prevalence and unique aspect of OSFED in males.

2. Importance of Addressing Other Specified Feeding and Eating Disorders (OSFED) in Males

   Addressing OSFED in males is important due to several reasons.

   • Improvement in Health and Well-Being: A person with OSFED may be affected physically, emotionally, and psychologically. It can lead to weight fluctuations, nutritional deficiencies, cardiovascular problems, loss of bone density, gastrointestinal issues, and other health complications.

   • More Equity and Inclusivity: Recognizing and addressing OSFED in males promotes gender equality and inclusivity in healthcare. Raising awareness and providing appropriate support for males with OSFED can create more inclusivity and an equitable healthcare system.

   • Breaking Stigma and Stereotypes: Most people perceive eating disorders solely affect females. This prevents males from seeking help and receiving support. By acknowledging that males can experience ODFED, the barrier can be broken and stigma can be reduced. This can encourage individuals to seek help without fear and judgment.

   • Holistic Care: A comprehensive healthcare approach may be needed in addressing OSFED in males. It emphasizes the unique experiences, challenges, and needs of males with OSFED.

   Addressing OSFED in males is vital for the health, equity, inclusivity, and well-being of males. By providing appropriate support and resources, the outcome can be improved and the overall care of males can be enhanced.

3. Signs and Symptoms of Other Specified Feeding and Eating Disorders (OSFED) in Males

   OSFED may present in several ways. It has many potential symptoms, which include:

   • Having recurrent thoughts about body weight and body shape and being anxious about eating in front of others

   • Being preoccupied with calories, fat, or sugar

   • A feeling that weight loss, dieting, and food control must be the main priority

   • Thinking they look fat despite significant weight loss.

   • Experiencing mood swings, occurring mostly around the time of eating food.

   A male with OSFED may also experience behavior changes. This may lead to:

   • Skipping meals or restricting portion sizes

   • Disappearing into the bathroom after meals

   • Making drastic changes to the diet following fad diets or cutting out on large food groups

   • Using mouthwash, breath mints, or chewing gums frequently

   • Frequently checking themselves or their reflection for flaws in appearance

   • Stealing or hoarding food and keeping them in unusual places

   • Regularly buying or using laxatives, diuretics, or enemas

   • Hiding body with layers or loose clothing

   The physical symptoms of OSFED include:

   • Fluctuations in body weight

   • Sleep issues

   • Constipation

   • Pain in the abdomen

   • Thin, dry, and brittle hair

   • Dizziness or fainting

   • Swelling in cheeks or jaw area

   • Impaired immunity

   • Slow and poor wound healing

   • Cuts or calluses on the hands

   • Enamel erosion, cavities, or teeth sensitivity

   • Feeling cold frequently

   • A lack of menstrual periods, periods occurring only while taking hormonal birth control

   • Cold and mottled hands and feet

   • Tiredness and fatigue

4. Causes of Other Specified Feeding and Eating Disorders (OSFED) in Males

   There are multifactorial causes of OSFED in males. While the exact causes are not fully understood, potential factors contributing to OSFED in males may include:

   • Genetic Predisposition: Genetic components may increase the susceptibility to developing an eating disorder, including OSFED. ⁽⁵⁾ It can be related to an imbalance in genes and biological factors related to appetite regulation, metabolism,, and neurochemical imbalance.
   • Body Image Dissatisfaction: Having a negative body image and dissatisfaction with one’s appearance can be a significant contribution to OSFED.
   • Perfectionism: People with high levels of perfectionism may be more prone to OSFED (6). There may be unrealistic expectations, striving for control, and a strong desire to meet rigid standards. This can drive disordered eating behaviors.
   • Low Self-Esteem: Poor self-esteem, low self-worth, and negative self-image contribute to the development of OSFED.
   • Societal and cultural factors: Societal pressure, peer influence, and family dynamics contribute to OSFED. People may face pressure to achieve a muscular or lean physique that can lead to eating behavior. Also, family attitudes towards weight, body image, eating image, and eating habits can play a role in the development of OSFED.
   • Traumatic Experience: Having experienced childhood abuse, bullying, or significant life stressors may contribute to the development of OSFED.

5. Diagnosis and Treatment of Other Specified Feeding and Eating Disorders (OSFED) in Males

   OSFED can be diagnosed by taking a medical history of the person and enquiring about the frequency, duration, and cause of symptoms. The answers are then compared with the DSM-5-TR criteria for diagnosing OSFED.

   Diagnostic tests may be performed to look for anemia, low thyroid or hormone levels, nutritional deficiencies, and blood count.

   Treatment of OSFED is the same as that of other eating disorders. ⁽²⁾ The team needed for the treating it may include:

   • Primary care doctors

   • Dieticians

   • Personal and family therapist

   • Social workers

   The first priority should be to address urgent medical needs such as deficiencies. ⁽⁴⁾ A regular routine can be established for eating meals. Intensive therapies can be started for addressing underlying beliefs that are causing such behavior and other co-existing mental health conditions.

   The treatment may be given depending on how severe the symptoms are, they may receive treatment as an outpatient, resident, or as an inpatient in the hospital.

6. Conclusion

   Addressing OSFED in males is important for the well-being and overall health of an individual. It is less studied as well as underrepresented but it is crucial to recognize and address their unique needs.

   Continued research, awareness, and education are important to improve the recognition, diagnosis, and treatment of OSFED in males and promote better outcomes.

   The earlier the person has support, the sooner they can begin to recover.

Also Read:

• Can Yoga Help in Treating Eating Disorders?
• Warning Signs of Eating Disorders
• Can Body Image Cause Eating Disorders?
• Causes of Eating Disorders & the Types of Eating Disorders Along With Their Symptoms
• Understanding the Complex Link Between PCOS and Eating Disorders