Atypical Anorexia Nervosa Developed in a Patient with Severe Obesity and Type 2 Diabetes Following Sleeve Gastrectomy and Postoperative Treatment with Semaglutide and Tirzepatide.

We describe an unusual case of a 60-year-old Japanese woman who developed atypical anorexia nervosa (AN) after undergoing bariatric surgery and postoperative semaglutide and tirzepatide therapy. At 57 years of age, due to severe obesity with a body weight of 113 kg (BMI 47.0), she underwent laparoscopic sleeve gastrectomy, and semaglutide and tirzepatide were started one month after surgery. Three years post-surgery, her weight drastically decreased to 50.3 kg (BMI: 20.9). Her rapid weight reduction, intense fear of weight gain, obsession with her body image, and normal weight (BMI >18.5) led to the diagnosis of atypical AN according to the DSM-5.