To encompass all dysfunctional eating habits, experts have created a separate category for Unspecified Feeding or Eating Disorders (UFED). As defined by DSM-5 criteria, this category describes behavior that causes severe distress or a crisis due to eating disorders but does not meet the criteria for anorexia, bulimia, binge eating disorder, or avoidant/restrictive food intake disorder.
An individual may be diagnosed with UFED if their symptoms do not match those of another eating disorder, or if there is not enough information to make a more specific diagnosis. It may be used in situations where clinicians lack sufficient information to make a more specific diagnosis (e.g. in emergency room settings). As more information is gathered, or as symptoms change over time, the diagnosis of UFED may change.
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Signs & Symptoms of UFED
- Feeling self-conscious or unwilling to eat in front of others
- A tendency to disappear after meals in order to purge
- Low confidence and self-esteem
- Poor body image
- Socially withdrawn
- Introverted to an excessive degree
- Having overwhelming guilt, shame, and anxiety
- Wearing excessively loose clothing
- Overly preoccupied with counting calories
- Strict dieting
- Signs of dramatic weight loss
- Denies feeling hungry
- Obsessive food rituals (such as chewing food a certain number of times)
- Exercise that leads to injury and stress fractures
- Swelling of the cheeks (edema caused by frequent vomiting)
- Discolored or stained teeth
- Hand and knuckle calluses caused by self-induced vomiting
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Types of UFED
The following are examples of eating disorders that would receive a diagnosis of UFED:
According to DSM-5 criteria, pica is defined as eating non-food substances regularly and persistently for more than one month, such as chalk, soap, or paper. Additionally, it includes any edible item that has no nutritional value, such as ice.
- When diagnosing pica, it is important to consider whether the eating behavior is culturally supported or socially normative, as well as whether it warrants independent clinical attention if it occurs in conjunction with another mental disorder (e.g. autism spectrum disorder), or during a medical condition (e.g. pregnancy).
- A person’s developmental level is also taken into account. Often, babies and toddlers put non-food items in their mouths out of curiosity. As a result, pica is typically diagnosed in children over two years of age. The condition is most common in children, and some scientists have linked it to the nervous system and understood it to be a learned behavior or coping mechanism.
- As pica patients normally do not avoid regular food and don’t have a desire to lose weight or alter their appearance, it can be hard to diagnose them. Pica is often diagnosed after other medical problems, such as cracked teeth, toxicity, or infection, have occurred due to the foods they have been eating.
DSM-5 criteria describe someone with rumination disorder as repeatedly regurgitating their food without pain or effort for more than a month. A regurgitated meal can be re-chewed, re-swallowed, or spat out and it is not the result of an underlying medical condition.
- Unlike bulimia, rumination disorder is characterized by a lack of effort to bring up food, so it may occur spontaneously or without intent.
- Rumination disorder can also occur in people with anorexia nervosa, bulimia nervosa, binge eating disorder, or avoidant/restrictive eating disorder.
- If left untreated, rumination disorder can cause malnutrition, weight loss, tooth decay, and electrolyte imbalances.
Chewing and Spitting
Chewing and spitting (CHSP) is a disordered eating behavior where someone chews food but spits it out instead of consuming it.
- It is often high in salt, sugar, or fat, or considered ‘bad’ or ‘junk’ food by the person.
- Spitting out the food after chewing it is considered a way to enjoy the taste without gaining weight.
- A CHSP can be a symptom of a diagnosed eating disorder, or it can exist on its own as a condition that requires treatment.
- There is little awareness of or research on CHSP, and people who engage in this behavior may feel shame or guilt about seeking help.
Other Reasons for UFED Diagnosis
- Although someone may meet most criteria for anorexia nervosa, such as missing menstrual cycles and having a fear of gaining weight, their body weight might not be low enough to meet the current definition.
- Similarly, someone may meet most of the criteria for bulimia nervosa, but binging episodes occur infrequently over several months or years. In order to be diagnosed with BN, they must purge at least once a week for at least three months.
- In the event that food gets stuck in the esophagus during a binge episode, the doctor may diagnose the person with USFED.
- When someone purges, they take laxatives, enemas, and diuretics to lose weight, but they do not binge eat. Stress, for example, may trigger these symptoms sporadically. They may go for years symptom-free.
- In the event of severe dehydration caused by excessive laxative use, someone may be diagnosed with UFED in the ER.
UFED and OSFED:
A disordered eating behavior is not always anorexia nervosa, bulimia nervosa, or binge eating disorder. As a result, there are a variety of diagnoses classified under other specified feeding and eating disorders (OSFED).
UFED is a member of the spectrum of other specified feeding or eating disorders (OSFED). Among eating disorders, OSFED encompasses eating behaviors that don’t fit into any of the general categories. However, UFED also covers eating habits that do not fall under OSFED.
UFED, along with OSFED, accounts for the largest percentage of eating disorders – as high as 60% in some studies. People with UFED can have similar symptoms and behaviors to those with anorexia and bulimia, and can face the same risks associated with those disorders, so the diagnosis is just as serious and detrimental.
UFED Treatment in Dallas, Texas
It is common for people diagnosed with USFED to have untreated symptoms for years before they receive a diagnosis. There are many reasons why people do not realize they have an eating disorder, including denial, shame, or not wanting to seek help. Individuals like this are more likely to “slip through the cracks” of the medical system, unfortunately, and quietly endure until their health begins to deteriorate.
Eating disorders are not a choice but are serious mental illnesses. They can have significant impacts on all aspects of a person’s life – physical, emotional and social. Identifying an eating disorder early, and receiving treatment, increases the chances of recovery or improved quality of life for a person.
Each individual is evaluated thoroughly and a treatment plan is developed accordingly. Depending on each client’s needs, we create individualized treatment plans that incorporate the following therapies:
- Acceptance and Commitment Therapy (ACT)
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Family Therapy
- Group Therapy
- Nutrition Therapy
- Psychodynamic Therapy
We can address the physical and emotional needs of each client by focusing on individualized goals in both residential and outpatient treatment programs. By doing so, you can:
- Discover a Healthier Relationship with Food: Being aware of bodily hunger signals, eating regularly, and eating mindfully are all part of this process.
- Cope with Emotional Eating: Participants will discover healthier ways to cope with unwanted emotions and will begin to recognize triggers.
- Develop a Healthy Lifestyle: Our focus is on long-term recovery and developing healthy habits. Making time for social connection, lowering stress, getting enough sleep, and exercising regularly can all help.
Regardless of what type of disordered eating behavior you’re struggling with, it’s important to reach out for help and support. For more information on UFED treatment, call 855-808-4213.