Lutfi Lubna, Hussein Basma S, Mukhtar Mazin A
Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE.
Psychiatry, Maudsley Health, Dubai, ARE.
Cureus. 2025 Aug 11;17(8):e89776. doi: 10.7759/cureus.89776. eCollection 2025 Aug.
This case report discusses a 29-year-old male with severe obsessive-compulsive disorder (OCD) who presented with food-related obsessions and compulsions, leading to extreme malnutrition, reflected in a dangerously low body mass index of 13.7 kg/m². His obsessions revolved around keeping his digestive tract completely empty to avoid illness. To achieve this, he restricted his food intake, spent long hours in the toilet, and engaged in excessive washing. These behaviors resulted in significant physical deterioration that eventually required emergency medical intervention. Unfortunately, the initiation of treatment led to refeeding syndrome, which further complicated the case. Due to his unique symptoms and acute presentation, this case highlights the diagnostic and therapeutic challenges posed by atypical presentations of OCD. It reinforces the importance of a multidisciplinary team involving medical, psychiatric, and nutritional departments working collaboratively. Close monitoring for complications, such as refeeding syndrome, is essential. Psychoeducation for both patients and families remains crucial to support adherence to the treatment plan and improve outcomes.
本病例报告讨论了一名29岁患有严重强迫症（OCD）的男性，他出现了与食物相关的强迫观念和强迫行为，导致极度营养不良，其身体质量指数低至危险的13.7kg/m²。他的强迫观念围绕着保持消化道完全排空以避免生病。为了做到这一点，他限制食物摄入，长时间待在厕所，并过度清洗。这些行为导致身体严重恶化，最终需要紧急医疗干预。不幸的是，治疗的开始引发了再喂养综合征，使病情进一步复杂化。由于他独特的症状和急性表现，该病例突出了强迫症非典型表现所带来的诊断和治疗挑战。它强化了一个由医学、精神科和营养科组成的多学科团队协同工作的重要性。密切监测并发症，如再喂养综合征，至关重要。对患者及其家属进行心理教育对于支持他们坚持治疗计划并改善治疗效果仍然至关重要。
