When you think of eating disorders and how they affect pregnancy, you usually think of anorexia, bulimia, and binge eating. But 40 to 60 percent of women with an eating disorder may have another eating disorder diagnosis called OSFED or EDNOS. OSFED is an acronym for Other Specified Feeding or Eating Disorder. OSFED is the newer name for EDNOS, which stands for Eating Disorder Not Otherwise Specified. Whether you call it OSFED or EDNOS, having an eating disorder during pregnancy carries some special risks and requires extra care.
What Is OSFED/EDNOS?
Let’s use the newer designation OSFED. Like the other more recognized eating disorders, OSFED is a serious, sometimes life threatening, but treatable mental health disorder. Eating disorders cause extreme and harmful emotions, attitudes, and behaviors centered around food and weight.
OSFED disorders may fit most but not all of the diagnostic criteria for the diagnosis of anorexia, bulimia, or binge-eating. There are 5 types of OSFED:
- Atypical anorexia nervosa: Women with this type have all the signs and symptoms of anorexia nervosa but have a normal weight. Weight may even be above normal. Symptoms will include restricting certain foods, intense fear of gaining weight, and a distorted view of their own body weight.
- Binge eating disorder of low frequency or duration: Women with this type binge on large amounts of food but may do it less than once a week or for less than 3 months.
- Bulimia of low frequency or duration: Women with this type binge and purge afterwards. After binging they feel shame and regret. They purge by inducing vomiting, over exercising, or taking laxatives. This occurs less than once a week or for less than 3 months.
- Purging disorder: Women with this type purge with vomiting, laxatives, or over exercising, but purging is not proceeded by binging.
- Night eating disorder: Women with this type binge at night or after dinner. They may wake up to eat. They get about one-fourth of their calories at night. This behavior happens at least twice a week.
OSFED and Pregnancy
OSFED can be as severe as any of the other eating disorders and can interfere with your ability to get pregnant as well as your ability to have a healthy pregnancy. These are the possible effects:
- Poor nutrition can lead to fatigue, weakness, and a higher risk for infections. Any of these can make pregnancy more difficult.
- Loss of weight can lead to not having periods which can make it hard to get pregnant.
- Not enough weight gain during pregnancy can increase your risk for premature birth, a low birth-weight baby, or a miscarriage.
- Too much weight gain during pregnancy can increase your risk for pregnancy diabetes, high blood pressure, a high-birthweight baby, and C section.
- The emotional and physical stress of pregnancy can cause OSFED to come back or make it worse.
- The combination of pregnancy and OSFED can increase your risk of depression during or after pregnancy.
What to Do?
If you have been diagnosed with OSFED or if you think you may have OSFED, talk to your doctor before you try to get pregnant. Even if you had it in the past, let your doctor know. The emotional stress of pregnancy may be a trigger for OSFED. Working with your health care provider, a mental health counsellor with experience treating eating disorders, and a nutritionist before pregnancy can help you be prepared.
If you are already pregnant, talk to your doctor about treating OSFED during pregnancy. Add a mental health counselor and a nutritionist to your pregnancy care team. An experience mental health counsellor can help you deal with the thoughts, emotions, and behaviors that lead to OSFED. A nutritionist will help you diet to maintain a healthy pregnancy weight.
The good news is that OSFED is treatable. Most women with eating disorders can and do have successful pregnancies. Remember that treatment should continue after pregnancy as well. Breastfeeding and child rearing can also be harder with an active eating disorder. These disorders can be a life-long struggle. Long-term effects of untreated eating disorders can be dangerous or even deadly. Don’t be afraid or ashamed to ask for help.