Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2025; 13(24): 106941
Published online Aug 26, 2025. doi: 10.12998/wjcc.v13.i24.106941
Diagnostic dilemma of avoidant/restrictive food intake disorder after bariatric surgery: A case report and review of literature
Kamila Cass, Adam Leggett, Dennis Glen Gibson
Kamila Cass, Adam Leggett, Dennis Glen Gibson, ACUTE Center for Eating Disorders and Severe Malnutrition, Denver Health, Denver, CO 80204, United States
Kamila Cass, Dennis Glen Gibson, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, United States
Author contributions: All authors were involved in the writing of this manuscript, final revision, and approve of the final manuscript.
Informed consent statement: Documentation of informed consent submitted, with file attached.
Conflict-of-interest statement: No conflict of interest for any of the authors.
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Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dennis Glen Gibson, MD, Associate Professor, ACUTE Center for Eating Disorders and Severe Malnutrition, Denver Health, 723 Delaware St., Pav M, Denver, CO 80204, United States. dennis.gibson@dhha.org
Received: March 11, 2025
Revised: April 15, 2025
Accepted: May 13, 2025
Published online: August 26, 2025
Processing time: 97 Days and 9.7 Hours
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.

Keywords: Malnutrition; Avoidant/restrictive food intake disorder; Bariatric surgery; Eating disorders; Case report

Core Tip: Eating behaviors after bariatric surgery may lack specific nomenclature and/or not meet the diagnostic criteria for the currently recognized feeding and eating behaviors in the Diagnostic and Statistical Manual, 5th edition. Many individuals who have undergone bariatric surgery seemingly meet criteria for avoidant/restrictive food intake disorder but this diagnosis may not be considered due to the body dysmorphia that many individuals experience in relation to bariatric surgery. Improvements in the assessment and categorization of disordered eating habits following bariatric surgery are warranted to improve post-operative outcomes.