ANOREXIA-NERVOSA FOLLOWING GASTROPLASTY IN THE MALE - 2 CASES

The first stage in the development of anorexia nervosa involves volunt ary restriction of food intake, that is, diet. Marked weight loss, imp airment in body image, and deterioration of health ensue. Anorexia ner vosa is much more prevalent among women than men. Its etiology and pre sentation are mostly similar for both sexes. Certain features, such as greater premorbid obesity and sexual identity concerns, are thought t o be more prevalent in male patients. We present 2 male patients who h ad undergone gastroplasty for morbid obesity and subsequently develope d anorexia nervosa. Both evinced signs of identity confusion. Neither one of the patients underwent psychiatric evaluation before surgery. T he cases described illustrate that anorexia nervosa may succeed acute and marked weight loss following gastroplasty. This emphasizes the nee d for a psychiatric assessment before bariatric surgery, and should al ert clinicians to search for elements that may predispose vulnerable i ndividuals to a risk of developing anorexia nervosa. (C) 1996 by John Wiley & Sons, Inc.