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Physicians should know the signs of male anorexia
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LAS VEGAS — Physicians must be able to recognize the endocrinopathies of anorexia in male patients, not just females, to prevent extreme and unnecessary measures, a presenter said at the AACE 23rd Annual Scientific & Clinical Congress.
“No one really thinks of men with anorexia. These patients were going to go for invasive procedures that they didn’t need. It really needs to be on the differential diagnosis at least for anyone coming in with any of these endocrinopathies who you may suspect had weight loss or is malnourished. To really treat them appropriately is to get them the nutrition they need, nutritional support, mental health services, and to get them on board with all of that,” Aren Skolnick, DO, from the division of endocrinology and metabolism, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, said during a press briefing.
Aren Skolnick
Skolnick reported a series of four cases in which anorexia was almost missed completely in males. All of the patients reported with bradycardia and various levels of hypothyroidism, along with other endocrinopathies ranging from hypercortisolemia to hypogonadal symptoms. Upon further interviewing, Skolnick said all four patients reported an average weight loss of 113 lb during a few months, along with increased exercise, lack of eating, depression and, in one case, even a weight-loss pill.
Still, two of the patients nearly underwent a cardiac pacemaker procedure and another nearly underwent a gastric pacemaker procedure, he said.
“They were on the stretcher, on their way to go, and we stopped them and said, ‘No, this is not how you treat the bradycardia. We need to feed them.’ So, we stopped them from having invasive procedures,” Skolnick said.
These four patients were treated with various feeding tubes or IV nutrition, and one was considered for electroconvulsive therapy before he consented to eat.
Although these short-term treatments were the beginning of therapy, Skolnick reiterated the need for long-term follow-up since the endocrinopathies present have a much broader effect and these men should be followed for short stature, osteoporosis and hypogonadism.
For more information:
Skolnick A. Abstract #822. Presented at: AACE 23rd Annual Scientific & Clinical Congress; May 13-18, 2014; Las Vegas.
Disclosure: Endocrine Today could not confirm disclosures at the time of press.