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Unspecified Feeding or Eating Disorders (UFED)

Prof. Yael Letzer, The Faculty of Social Welfare and Health Sciences at the University of Haifa; the Eating Disorders Center at Rambam Health Care Campus.
14 July 2025

This article is written using feminine terms because most people affected by the disorder are girls and young women. However, the information also applies to boys, young men, and people of all genders and ages.

There are several conditions in this diagnostic group that do not fully meet the criteria for an eating disorder, but they still show significant issues with eating behaviors.

Problematic Eating Behaviors

This group includes eating behaviors that do not meet the specific criteria for any recognized eating disorder. In other words, the symptoms are not severe enough to qualify as an eating disorder. Still, these behaviors indicate a serious disturbance in eating patterns and could lead to a full-blown eating disorder. That’s why it’s important to recognize and treat them as seriously as any eating disorder. Common examples of problematic eating behaviors include:

  • Chewing food and spitting it out without swallowing, while keeping a normal weight and regular menstrual cycle.

  • Eating only one type of food—like fruit—based on a strict belief that this behavior is healthy, even though it can lead to significant weight loss and nutritional deficiencies.

  • An obsessive focus on healthy eating that results in very restrictive eating and weight loss. For example, avoiding foods that are not properly washed, that were sprayed with chemicals, or that were exposed to air pollution.

  • Compulsive behaviors centered on physical activity, body shaping, and extreme diets. People with this pattern often spend a lot of time worrying about how their body looks and may hold false or distorted beliefs, such as thinking their body is too small or not muscular enough.

Feeding disorders

The new diagnostic manual, DSM-5, added a new group of disorders called "feeding disorders" that includes 3 separate diagnoses: Pica, rumination disorder, and avoidant/restrictive food intake disorder. These disorders do not show any evidence of distortion in body image or weight, and are most often observed in boys and girls aged 5-12. This is an eating disorder that usually develops in childhood but can persist into adolescence and adulthood.

An eating disorder characterized by eating non-edible materials, such as paper, stones, sand, cotton wool, paper clips, etc. This eating disorder is unrelated to the developmental stage in which infants tend to put any object they come across in their mouths. It is also unrelated to cultural customs in which it is customary to eat non-edible materials as part of traditional rituals. The disorder is also unrelated to an actual lack of food, which may lead to these behaviors. During the diagnosis, the treating party will check that there is no other mental or physical disorder that can lead to these eating behaviors.

This disorder mainly begins in childhood, and sometimes continues into adulthood. If it appears in adulthood, it requires a re-diagnosis. Rumination disorder is characterized by chewing, swallowing, regurgitating the food, chewing again and swallowing again. When the disorder lasts for at least a month, it is important to check and diagnose it. During the examination, the treating party will check that this eating behavior is not related to stomach problems, esophageal dysfunction, intestinal problems, or any other medical condition. In addition, it is important to check that this eating behavior is not related to anorexia or bulimia nervosa or any mental, developmental, or intellectual problem.

The disorder is characterized by 3 groups of states of reduction and avoidance of eating, which is called selective eating, or selective eating after preschool age:

  • Lack of interest in eating.
  • Sensory characteristics related to the texture, color, or shape of food.
  • Concern about the negative consequences of eating, including fear of vomiting, pain, etc.

Implications of feeding disorders

In these 3 situations, the reduction or avoidance of eating is manifested in the inability to consistently meet nutritional and energy needs, and causes at least one of the following conditions: 

  • Significant weight loss or growth delay.
  • Significant nutritional deficiency.
  • Dependence on tube feeding or nutritional supplements.
  • Significant impairment in psychosocial functioning.

When it comes to diagnosis, it is important to note that the professionals who diagnose the disorder check that it does not occur when there is already a diagnosis of anorexia nervosa or bulimia nervosa or if there is a diagnosed medical or mental problem.

It is also important to note that children with this disorder usually do not report a distortion in the perception of weight or body shape. In addition, it is necessary to check that it is not related to cultural beliefs or perceptions and that the family or community has no influence on their formation. The two prominent signs that repeat themselves in this disorder are eating a very small variety of foods, up to 10 items only, and a persistent and stubborn refusal to try new foods.

NOTE

NOTE

Picky eating is a normal phase for children between the ages of 2 and 6, and it usually gets better as they grow older.

Prevalence of feeding disorders

The prevalence of these disorders is approximately 5% of all children and adolescents in the general population. Although they are most common in young children, they are also diagnosed in adolescents and adults. Those diagnosed also have a high prevalence of comorbid mental disorders, including anxiety, ADHD, ASD (autistic spectrum disorders), and a history of abdominal pain. Treatment for this disorder is based on gradual exposure to anxiety-provoking foods, combined with parental guidance.   

Refusal to eat in infancy or early childhood and picky eating under the age of 6 are not an eating disorder, or suggestive of the development of any eating disorder, but rather typical and age-appropriate behavior. Overweight and obesity at these ages are also not defined as a medical condition that requires any treatment.