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减肥手术后回避/限制型食物摄入障碍的诊断困境:一例病例报告及文献综述

Diagnostic dilemma of avoidant/restrictive food intake disorder after bariatric surgery: A case report and review of literature.

作者信息

Cass Kamila, Leggett Adam, Gibson Dennis Glen

机构信息

ACUTE Center for Eating Disorders and Severe Malnutrition, Denver Health, Denver, CO 80204, United States.

Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, United States.

出版信息

World J Clin Cases. 2025 Aug 26;13(24):106941. doi: 10.12998/wjcc.v13.i24.106941.

Abstract

BACKGROUND

Bariatric surgery is an effective treatment for severe obesity but is associated with an increased risk for development of eating disorders. Indeed, numerous maladaptive eating behaviors and eating disorders have been described following bariatric surgery. However, the differentiation of pathologic eating patterns from expected dietary changes following bariatric surgery can sometimes be difficult to discern.

CASE SUMMARY

A female in her early 40s presented for medical stabilization of severe protein calorie malnutrition after losing 52.3 kg over the last six months after Roux-en-Y gastric bypass, with subsequent development of cyclic nausea and vomiting. Fear of these aversive physical symptoms led to further restriction of nutritional intake and weight loss. The patient was diagnosed with avoidant/restrictive food intake disorder, which has not been previously reported after bariatric surgery.

CONCLUSION

Improvement in the diagnostic nomenclature for feeding and eating disorders is warranted for patients who have undergone bariatric surgery.

摘要

背景

减肥手术是治疗重度肥胖的有效方法,但与饮食失调风险增加有关。事实上,减肥手术后出现了许多适应不良的饮食行为和饮食失调情况。然而,有时很难区分减肥手术后病理性饮食模式与预期饮食变化。

病例摘要

一名40岁出头的女性在接受Roux-en-Y胃旁路手术后的六个月内体重减轻了52.3千克,随后出现周期性恶心和呕吐,前来就医以稳定严重蛋白质热量营养不良的状况。对这些厌恶身体症状的恐惧导致营养摄入进一步受限和体重减轻。该患者被诊断为回避/限制性食物摄入障碍,此前减肥手术后尚未有过相关报道。

结论

对于接受过减肥手术的患者,有必要改进进食和饮食障碍的诊断命名。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9644/12207561/191e640b7158/wjcc-13-24-106941-g001.jpg

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