Avoidant Restrictive Food Intake Disorder

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

World Journal of Clinical Cases
By Kamila Cass, PhD, CEDS-C Adam Leggett, MA Dennis Gibson, MD, FACP, CEDS

Research Asset

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.

Written by

Kamila Cass, PhD, CEDS-C

Kamila Cass, PhD, CEDS-C, is a Licensed Clinical Psychologist at the ACUTE Center for Eating Disorders and Severe Malnutrition, where she has worked with patients with eating disorders since 2021. She…
Written by

Adam Leggett, MA

Adam has spent the last 13 years of his career working in the field of eating disorders in various capacities. As someone in recovery, and a trained clinician with many years working in eating…
Written by

Dennis Gibson, MD, FACP, CEDS

Dennis Gibson, MD, FACP, CEDS serves as a consulting physician for ACUTE. Dr. Gibson joined ACUTE in 2017 and has since dedicated his clinical efforts to the life-saving medical care of patients with…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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