Orthorexia, ARFID, and OSFED
When people think about eating disorders, a set of illnesses that affect tens of millions of Americans, it is likely that what comes to mind are ones such as anorexia nervosa, bulimia nervosa, as well as binge eating disorder. However, there are several other types of eating disorders out there, each with their own particular set of health consequences and risk factors, though many may overlap. It is important to remember that, despite any myths largely held by our society about eating disorders, anyone can develop one.
What is Orthorexia?
People who become obsessed with healthy or “proper” eating may be suffering from orthorexia, an illness that has yet to be formally recognized by the DSM 5. The term “orthorexia” was first coined in 1998, and specialists are becoming increasingly aware of the disorder. While it is not necessarily a bad thing to be concerned with the nutritional quality of what you’re eating, people who have orthorexia become so consumed by the notion of “healthy eating” that it can actually be detrimental to their health.
What is ARFID?
ARFID stands for Avoidant Restrictive Food Intake Disorder, and is a new diagnosis found in the DSM 5 that was once called “Selective Eating Disorder.” In some ways, ARFID is similar to anorexia nervosa because someone who suffers from it also limits how much food and what types of it they consume; however, people who have ARFID are not afraid about being “fat” or feel distress about their body size or shape. In adults, ARFID manifests as an inability to eat enough to maintain basic bodily functions, while children with ARFID do not eat enough food to properly develop or grow. ARFID can lead to issues at work or school, weight loss in adults, and slowed vertical growth and weight gain in children.
What is OSFED?
OSFED is an acronym for Other Specified Feeding or Eating Disorders. This category was developed by the DSM 5 to include people who are struggling with severe eating disorders but do not meet the strict diagnostic criteria for issues such as bulimia nervosa or anorexia nervosa. In previous editions of the DSM 5, OSFED was called “Eating Disorder Not Otherwise Specified,” (EDNOS) and most people who have been diagnosed with an eating disorder were actually diagnosed with OSFED/EDNOS. Research into this disorder has shown that people struggling with OSFED are in as much danger as people struggling with other eating disorders.
Warning Signs of an Eating Disorder
There are many potential warning signs you could look out for that may suggest someone you love is struggling with an eating disorder. Some physical signs might include:
- Impaired immunity
- Difficulties concentrating
- Noticeable fluctuations (both up and down) of weight
- The discoloration of teeth as well as the development of cavities, which may result from vomiting
- Stomach cramps and other non-specific gastrointestinal issues such as constipation and acid reflux
- Abnormal laboratory results such as low hormone levels, anemia, low white and red blood cell counts, and low potassium
- Yellow skin (could be in the context of eating large amounts of carrots)
- Issues with one’s sleep
- Constantly feeling cold
- Dry hair and skin
- Fine hair on one’s body
- Poor wound healing
- Cold, mottled hands
- Brittle nails
- Dizziness, particularly when one stands up
- Menstrual irregularities, such as missed periods or only experiencing a period when on hormonal contraceptives
- Muscle weakness
- The Swelling of one’s feet
- Swelling around the salivary glands
- Cuts and/or calluses across the top of finger joints, which could suggest inducing vomiting