Abstract
BackgroundOther Specified Feeding and Eating Disorders (OSFED) are characterized by less frequent symptoms or symptoms that do not meet full criteria for another eating disorder. Despite its high prevalence, limited research has examined differences in severity and treatment outcome among patients with OSFED compared to threshold EDs [Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED)]. The purpose of the current study was to examine differences in clinical presentation and treatment outcome between a heterogenous group of patients with OSFED or threshold EDs.MethodPatients with threshold EDs (AN = 42, BN = 50, BED = 14) or OSFED (n = 66) presenting for eating disorder treatment completed self-report questionnaires at intake and discharge to assess eating disorder symptoms, depression symptoms, impairment, and self-esteem.ResultsAt intake, OSFED patients showed lower eating concerns compared to patients with BN, but similar levels compared to AN and BED. The OSFED group showed higher restraint symptoms compared to BED, and similar restraint to AN and BN. Global symptoms as well as shape and weight concerns were similar between OSFED and threshold ED groups. There were no differences between diagnostic groups in self-esteem, depression scores, or symptom change from intake to discharge.DiscussionOur findings suggest that individuals with OSFED showed largely similar ED psychopathology and similar decreases in symptoms across treatment as individuals diagnosed with threshold EDs. Taken together, findings challenge the idea that OSFED is less severe and more resistant to treatment than threshold EDs.
Highlights
There are three named eating disorders (EDs) in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED)
The purpose of the current study was to examine differences between patients diagnosed with OSFED vs. Threshold ED Comparison (OSFED) compared to threshold EDs on eating and other psychopathology and response to treatment
Our findings indicated that ED psychopathology among OSFED patients was largely similar to patients with threshold EDs, with a few exceptions
Summary
There are three named eating disorders (EDs) in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). OSFED has received much less research attention compared to threshold EDs (i.e., AN, BN, and BED) since its introduction in DSM-5. Only one study to date has examined outcomes among OSFED patients receiving outpatient enhanced CBT (CBT-E), finding low motivation to change as well as high rates of dropout in this group (Riesco et al, 2018). Despite its high prevalence, limited research has examined differences in severity and treatment outcome among patients with OSFED compared to threshold EDs [Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED)].
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