2024 Volume 4 Issue 1 Pages 37-44
A 30-year-old male with a history of rumination of food which began in junior high school, due to the pleasure and reassurance he feels when food passes through his throat. Upon entering high school, he joined the track and field club and began to restrict his diet in an attempt to achieve better results as a long-distance runner, which led him to engage in binge eating and vomiting. Suspected of having an eating disorder, he received treatment from a nearby psychiatrist, which led to weight recovery and cessation of binge eating and vomiting, but without improving the rumination. Once he entered university, stress from interpersonal relationships triggered a relapse of binge eating and vomiting, which worsened due to job-related stress once he began working. His weight loss and leukopenia were noted during a routine check-up at his company, which resulted in him visiting an internal medicine specialist who suspected an eating disorder and referred him to a psychiatrist within the same hospital. This psychiatrist then further referred him to our hospital due to our specialization in eating disorders. With a diagnosis of anorexia nervosa binge-purge type, we initiated nutritional therapy, which reduced the binge eating and vomiting, but not the rumination. We did not actively treat the rumination, instead recommending social adjustments including those relating to his eating environment. Given the rare nature of male cases where rumination disorder precedes anorexia nervosa, we report this case with a literature review.
