Treatment levels for OSFED

young woman in thought

Contributor: Leigh Bell, BA, writer for Eating Disorder Hope

Although people with OSFED (other specified feeding or eating disorders) may not fit directly into the diagnosis for a specific eating disorder, like anorexia or bulimia, they should be treated as if they do. [1]

For example, someone restricting food but not presenting a low body weight may be treated with the same effective methods as someone with anorexia. Obviously everyone and every eating disorder are different, and individualized treatment is always necessary.

The eating disorder profession accepts general treatment approaches, but unfortunately, none is a panacea.

OSFED and Cognitive Behavioral Therapy

Professionals normally treat eating disorders, regardless of type, with cognitive-behavioral therapy (CBT) in various settings, and sometimes, medication is included in the treatment program.

CBT, which aims to change behavior by altering thoughts, is recognized as the “most effective treatment” for bulimia, surpassing in successful outcomes the use of other psychotherapies and antidepressant medication, according to a large study of outcomes. [2]

Unfortunately, even with CBT, only about half of those with bulimia actually recover, researchers found.

People with anorexia also positively respond to CBT. One study compared two groups of adults with anorexia, one had CBT and the other had only nutritional counseling. [3] Those with nutritional counseling dropped out at a far greater rate (73%) than those with CBT (22%). Still, the researchers make a good point: “We know of no empirical support for any intervention for adult anorexia nervosa.”

OSFED and Medication Management

medicationMedication is often used in the treatment of eating disorders, however, the Federal Drug Administration has only approved Prozac (fluoxetine) for bulimia nervosa and, just last year, Vyvanse for binge-eating disorder (BED). Prozac and other antidepressants, along with anti-anxiety medications, are also commonly used in treatment.

Still research shows people with anorexia experience little to no benefit from Prozac and other antidepressants. This puzzles researchers because anorexia often presents symptoms similar to depression and obsessive-compulsive disorder, both of which respond to antidepressants. [4]

Even though eating disorders are serious mental illnesses, they also involve food, and recovery must include some type of nutritional therapy. It’s important, too, that a nutritional professional understand the complexities of eating disorders.

Other treatment types include family-based therapies, as well as body movement, and various creative therapies. Paramount when addressing an eating disorder is to realize everyone will have different needs but recovery is real and possible.

Community Discussion – Share your thoughts here!

What types of treatment have assisted in your OSFED recovery?

Leigh BellAbout the Author: Leigh Bell holds a Bachelor of Arts in English with minors in Creative Writing and French from Loyola Marymount University in Los Angeles. She is a published author, journalist with 15 years of experience, and a recipient of the Rosalynn Carter Fellowship for Mental Health Journalism. Leigh is recovered from a near-fatal, decade-long battle with anorexia and the mother of three young, rambunctious children.


[1]: Eating Disorders Explained – OSFED. (n.d.). Retrieved from on January 14, 2016.
[2]: Agras, W. S., Crow, S., Halmi, K., Mitchell, J., Wilson, G.T., Karemer, Helena. (2000). Outcome predictors for behavior treatment of bulimia nervosa: Data from
[3]: Pike, K., Walsh, B.T., Vitousek, K., Wilson, G.T., Bauer, J. (2003). Cognitive behavior therapy in posthospitalization treatment of anorexia nervosa. The American Journal of Psychiatry, 160(11), 2046-2049.
[4]: Attia, E., Haiman, C., Walsh, B.T., Flater, S., (1998). Does fluoxetine augment the inpatient treatment of anorexia nervosa? The American Journal of Psychiatry, 155(4), 548-551.

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 March 8, 2016
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