Medical management and differential diagnosis of restrictive eating disorders in men: a case study report with co-produced recommendations
Abstract
Males with eating disorders (EDs) are an underrepresented population whose symptomatology and treatment needs are poorly understood, having been overlooked in clinical research to date. The role of gastrointestinal disorders, such as gastroparesis, in the context of restrictive EDs is similarly under-explored. Making use of emerging evidence regarding conditions that co-occur with severe EDs to consider potential differential diagnoses in cases of complex and uncertain symptomatology can assist in providing more individualised and empathetic care, preventing avoidable outcomes, including death. The case of a male patient with a longstanding history of restrictive eating and diagnosis of anorexia nervosa is presented. After hospital admission, they developed severe complications, including aspiration pneumonia. Despite medical interventions, the patient’s complex presentation and the lack of individualised treatment options contributed to the tragic outcome of death. A postmortem diagnosis revealed gastroparesis, a condition that had gone undetected during his life. Prior to his death, the patient had presented with symptoms overlapping with Avoidant Restrictive Food Intake Disorder (ARFID) and neurodivergence, which are worth considering for how they may have played a role in complicating the clinical picture and making diagnosis and treatment more challenging. The case illustrates the value of exploring differential diagnoses when providing individualised and comprehensive…
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