We can all think of a time in our lives when we felt like we were not good enough. Sometimes we hold ourselves to unrealistic standards or we internalize the criticisms of others. But can you think of a time when you were not bad enough? The only examples that come to my mind are inconsequential, such as deciding that a skinned knee was not bad enough for a Band-Aid. However, for individuals with eating disorders, this kind of thinking is much more serious because it can have life-threatening consequences.
One population is particularly susceptible to the “not bad enough” thinking trap: individuals diagnosed with Other Specified Feeding and Eating Disorders (OSFED), formerly known as Eating Disorders Not Otherwise Specified (EDNOS). OSFED is described as “a feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder.”1 Because the criteria for anorexia nervosa, binge-eating disorder, and bulimia nervosa have frequency and duration “criteria”, many individuals with an extremely unhealthy and dangerous relationship to food and/or exercise fall under the OSFED category.
A diagnosis is simply a shared language and allows providers to communicate with each other efficiently. But the truth is that variations on the themes are more common than the prototypic pictures of anorexia nervosa, bulimia nervosa, and binge-eating disorder. If you are struggling with an eating disorder, no matter what the diagnostic details, you deserve understanding and treatment.
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