A Case of Cachexia Secondary to Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD), a relatively common psychiatric illness, is diagnosed using DSM-V criteria. Its severity isassessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Symptoms are broken down intofive categories ofobsessive-compulsive (O-C) manifestations: contamination/cleaning, symmetry/ordering, taboo thoughts, doubt aboutharm/checking, and worry about throwing away items that could prove useful or valuable/hoarding. CBT in the form ofexposure response therapy (ERP) and/or SSRI/clomipramine administration is the mainstay of treatment. We present a uniqueOCD case in the nature of obsessions and compulsions, cachexia presentation without anorexia, and history of multipleinpatient psychiatric admissions. Our patient’s obsessions focus on eating at specific times, prompting compulsive eatingpatterns that often result in starvation due to missing timeframes that the patient deems acceptable for eating. His resultingcachexia and eventual worsening of depression to the point of suicidality necessitated multiple inpatient stays and placement ata long-term mental health care facility