Anorexia nervosa following gastroplasty in the male: two cases

The first stage in the development of anorexia nervosa involves voluntary restriction of food intake, that is, diet. Marked weight loss, impairment in body image, and deterioration of health ensue. Anorexia nervosa is much more prevalent among women than men. Its etiology and presentation are mostly similar for both sexes. Certain features, such as greater premorbid obesity and sexual identity concerns, are thought to be more prevalent in male patients. We present 2 male patients who had undergone gastroplasty for morbid obesity and subsequently developed anorexia nervosa. Both evinced signs of identity confusion. Neither one of the patients underwent psychiatric evaluation before surgery. The cases described illustrate that anorexia nervosa may succeed acute and marked weight loss following gastroplasty. This emphasizes the need for a psychiatric assessment before bariatric surgery, and should alert clinicians to search for elements that may predispose vulnerable individuals to a risk of developing anorexia nervosa.