Other Specified Feeding or Eating Disorder

What are the signs and symptoms of OSFED?  

The symptoms of OSFED can be difficult to identify. Signs may include noticeable fluctuations in weight while the child remains in a healthy BMI range. The child may also experience stomach cramps, fainting or feel cold. As with other eating disorders, OSFED may cause loss of menstruation in females and body image distortion. 

Young people often go to great lengths to deny and conceal their struggles with food and weight. Here are some signs that may help you recognize OSFED in someone you know: 

• Unusual eating habits. These may include taking tiny bites to stretch out eating time or compulsively arranging food on the plate. 
• Avoiding family meals. The child might make excuses that they are too busy or eating elsewhere. 
• Secretive behavior around eating and bathroom use. A teenager who habitually runs water, plays music or flushes the toilet repeatedly while using the bathroom may be masking the sounds of vomiting. 
• Use of laxatives or diet pills. Taking any medication outside of recommended use can be dangerous to overall health. 
• Excessive, and often obsessive, exercise. The child may attempt to burn calories consumed. 
• Physical signs of malnutrition. These can include dull or thinning hair, hair loss, splitting or softening nails, extreme sensitivity to cold, dental cavities and gum disease. 
• Absence of menstrual periods. This is related to loss of body fat. 
• Appearance of fine body hair on arms and legs. This is a result of the body’s attempt to keep warm. 
• Low self-esteem and/or mood changes. These may include irritability, depression, or talk of suicide. 
• Distorted body image. No matter how thin the child becomes, they believe they are overweight. 
• Weight loss. An eating disorder can be diagnosed when someone is significantly underweight, whether because of weight loss or failure to gain weight as they grow. 

How is OSFED treated?  

Our approach to treatment gives families the support and education they need to manage OSFED and help their child work toward recovery, while minimizing time out of school and away from home. Learn more about treatment for OSFED.  

For patients with significant medical concerns, an inpatient medical stabilization stay may be necessary before the family-based treatments below can safely begin.   

The Eating Disorders Program provides support to hundreds of children and teens, ages 6 to 18, each year. We offer customized treatment plans to meet each patient’s unique needs.   

We offer two program options:  

• Day Treatment Program: Also known as Partial Hospitalization Program, this is designed for children and teens who need intensive support through eating disorder recovery but do not require 24-hour care. This typically is between 5 and 7 days, with some or all meals eaten in program. A specialized care team guides families and children in developing healthy coping skills and supporting nutrition needs in their recovery process. Learn more about the Day Treatment Program.  
• Outpatient Clinic: Includes individual, family and group therapy, as well as psychiatric medication management, as needed. If you’re not sure if outpatient services are right for your child, call us at 720-777-6200 to speak with our team. Learn more about the Outpatient Clinic. 

The role of parents in meal planning and meal support 

Our treatment approach emphasizes family-based treatment (FBT), an evidence-based model that helps parents identify and interrupt their child’s eating disorder behaviors and redirect them toward health-promoting habits. Our team equips parents with the skills they need to successfully support their children by managing meals, routines and emotions, all of which actively support their child’s recovery.  

Parents learn how to plan balanced, nutrient-rich meals that support weight goals for their child. Mealtime becomes a focal point for working through challenges as parents develop strategies for addressing resistance, difficult emotions and disordered behaviors. By the time families transition out of the program and into outpatient support, parents will feel confident in continuing progress at home. By prioritizing family involvement, our program creates a sustainable and supportive path toward recovery together.  

Remember that there is no single cause for a child to develop an eating disorder. Early identification and treatment are among the best indicators of recovery, so discuss your concerns openly with your child and seek professional help as soon as you identify concerning behaviors. Most families start by contacting their pediatrician or primary care provider.  

For more information about the Children's Hospital Colorado Eating Disorders Treatment Program, call 720-777-6200. 

Family Health Library 

Children's Hospital Colorado's Anschutz Medical Campus location offers a Family Health Library with information on parenting, child development, medical diagnosis in children, and more. Families are welcome to visit and use this resource at any time. 

Recommended books 

• "What Causes Eating Disorders - And What Do They Cause?" by Guido Frank, MD (2016) 
• "Off the C.U.F.F. (Calm, Unwavering, Firm and Funny)" by Nancy Zucker, Ph.D., a parent skills manual that provides the curriculum taught to parents in group programs. Duke University Eating Disorders Program. (2008) 
• "Unlocking the Mysteries of Eating Disorders" by David B. Herzog, M.D., Debra L. Franko, PH.D., and Pat Cable, RN (2007) 
• "Skills-Based Learning for Caring for a Loved One with an Eating Disorder. The New Maudsley Method" by Janet Treasure, Grainne Smith and Anna Crane. Routledge Taylor and Francis Group, London and New York (2007) 
• "Help your Teenager Beat an Eating Disorder" by Jim Lock, MD, PhD, and Daniel LeGrange, PhD.  The Guilford Press, New York and London (2005) 
• “Survive FBT: Skills Manual for Parents Undertaking Family Based Treatment (FBT) for Child and Adolescent Anorexia Nervosa” by Maria Ganci. LMD Publishing (2016) 

Organizations and recommended websites 

• National Association of Anorexia Nervosa & Associated Disorders 
• National Eating Disorders Association (NEDA) 
• The Academy of Eating Disorders