From over- to under-weight: treatment of post-surgical anorexia nervosa in morbid obesity

Obesity is a pandemic condition with medical, psychological and economic consequences that is getting more and more widespread and severe. The World Health Organization estimates that around 500 million adults are obese (i.e., BMI>30 kg/m2). The relationship between obesity and mental health is considered important since a special relationship between obesity major depression, bipolar disorder, panic disorder and eating disorders (EDs) has been reported. Bariatric surgery (BS) is the most effective therapy for morbid obesity and can result in improvement and complete resolution of comorbidities. Although preoperative psychopathology may decline post-operatively, some authors report that psychopathology, not secondary to the degree of obesity, may persist and previous cases of AN after BS have been reported. Although the emergence of an ED after BS has been previously reported, no data are available on long term follow-up of these patients.