Anorexia nervosa is a complex disorder. The etiology is diverse. We expose a case report of a 19 year old patient, with an atipical anorexia nervosa in a woman admitted as inpatient in traumatology. The consultation was made because extreme thinnness. The patient and her mother, were averse to any intervention (to be weighed, measured…) This was only possible after menacing with judicial intervention. The BMI was 11.5 (weight 25 Kg and heitht 1.47 m).
Eating problems first appeared when she was 10 years old after being sexually abuse. Depressive mood and anorexia were the main symptoms. Coincident with this her mother lost her job and started dedicating herself intensively to her daughter.
In spite of the precarious physical state with extreme thinness and amenorrhea, they do not make any consultation or treatment. The mother justifies the low weigh as constitutional and related to stress.
At admission the patient collaborates with nutrition, no body scheme misperception is detected, and there is no anxiety with the rapidly weigh gainance. The behavior of the mother remembers the relation of a mother with a baby, demanding even her admission in Pediatry.
The acceptance and collaboration of the mother with symptoms reminds a factitious disorder by proxy. In this case the objective of the mother will not be to obtain hospital treatment but to mantain her daughter in a permanent childhood.
The possibility that this atipic anorexia case could be a factitious disorder by proxy is discussed.