title: Bariatric surgery and multiple personality disorder: complexities and nuances of care.
abstract: BACKGROUND
  Multiple personality disorder (MPD) can occur in patients with morbid obesity in need of bariatric surgery, though few reports noting this association exist in the literature. Herein we address MPD in morbid obesity, in the context of a patient presenting to us seeking surgical treatment of her morbid obesity.
  
  
  METHODS
  A 31-year-old morbidly obese (BMI 49 kg/m2) Hispanic female presented in early 1994 requesting bariatric surgery. She had been a victim of violent sexual abuse as a young girl. Subsequently, she developed at least three personalities, including one male personality.
  
  
  RESULTS
  Although she has lost nearly 45 kg after gastroplasty, her care has been complicated by her named multiple personalities. While MPD are infrequent and unfamiliar to most care providers, successful outcomes can be promoted with a proper approach.
  
  
  CONCLUSIONS
  This patient's care illustrates that: (1) all personalities must agree to proposed operative intervention; (2) consent must be obtained from the 'true' patient; and (3) postoperative care and follow-up must address all personalities for an optimal outcome.
authors.affiliation: Department of Surgery, University of South Florida College of Medicine, Tampa, USA.
authors.forename: M
authors.initials: M
authors.lastname: Bloomston
authors.forename: E E
authors.initials: EE
authors.lastname: Zervos
authors.forename: P S
authors.initials: PS
authors.lastname: Powers
authors.forename: A S
authors.initials: AS
authors.lastname: Rosemurgy
mesh_terms: D000328:Adult; D009105:Dissociative Identity Disorder / Q000150:complications* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000523:psychology*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000523:psychology; D010349:Patient Compliance; D010551:Personality; D011182:Postoperative Care; D012742:Sex Offenses / Q000523:psychology; D016896:Treatment Outcome; D015431:Weight Loss