Bonne O B, Bashi R, Berry E M
Department of Psychiatry, Hadassah University Hospital, Jerusalem, Israel.
Int J Eat Disord. 1996 Jan;19(1):105-8. doi: 10.1002/(SICI)1098-108X(199601)19:1<105::AID-EAT13>3.0.CO;2-V.
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.
神经性厌食症发展的第一阶段涉及对食物摄入量的自主限制，即节食。随之而来的是明显的体重减轻、身体形象受损和健康状况恶化。神经性厌食症在女性中比男性更为普遍。其病因和表现对于两性来说大多相似。某些特征，如病前肥胖程度较高和对性身份的关注，被认为在男性患者中更为普遍。我们报告了2例因病态肥胖接受胃成形术并随后发展为神经性厌食症的男性患者。两人都表现出身份认同混乱的迹象。两名患者在手术前均未接受精神科评估。所描述的病例表明，胃成形术后急性且显著的体重减轻可能会引发神经性厌食症。这强调了在减肥手术前进行精神科评估的必要性，并应提醒临床医生寻找可能使易感个体有患神经性厌食症风险的因素。
