Eating disorders after bariatric surgery: a case series.

OBJECTIVE: A significant number of post-bariatric surgery (BS) patients present with eating disorders (EDs) symptoms that require specialized treatment. These cases are thought to be underreported due to their frequent sub-syndromal presentation. This article describes ED syndromes that develop subsequent to BS. METHOD: The clinical charts of 12 individuals who were hospitalized on a specialized inpatient EDs unit were reviewed. RESULTS: Based on the new DSM-5 proposed criteria, six patients would meet criteria for an anorexia nervosa (AN) diagnosis: three with binge eating/purge AN subtype and three with restrictive AN subtype. An additional four met criteria for atypical AN, since they were at a normal weight, and two patients met criteria for bulimia nervosa. DISCUSSION: Several similarities to the classical EDs were found. The findings that most distinguished these patients from those with classical EDs were their ages, and the age of onset of the ED for some patients.

Minimizing and treating chronicity in the eating disorders: a clinical overview.

OBJECTIVE: The purpose of this article is to review the available literature regarding treatment and management of eating disorder patients who fail to change over protracted periods of time. METHOD: Literature was reviewed pertaining to approaches to promoting change in treatment-resistant cases and the treatment of chronic eating disordered individuals. RESULTS: Although there are a number of clinical perspectives on the treatment of chronic eating disorder patients, fundamental studies defining the concept of "chronicity" and standardized treatment approaches do not exist. Empirical studies of chronic cases are needed, given the absence of investigation of maintenance factors in chronic eating disorders and evidence-based approaches for treatment. An integrative and practical clinical protocol is provided. DISCUSSION: The results of this review suggest that a significant number of eating disorder patients display a chronic course, which is poorly understood. Treatments for these individuals are not based on evidence-based findings.