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History revealed severe disordered eating behaviours and led to a diagnosis of atypical anorexia nervosa. Rapid weight loss likely caused her acute biliary presentation, cardiac compromise and a high risk of refeeding syndrome that needed to be addressed before she could safely undergo surgery. This case highlights the severity of medical complications of malnutrition and eating disorders in youth presenting with normal or high weight, and the importance of early recognition for good prognosis.<\/jats:p>","DOI":"10.1136\/bcr-2025-269199","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:05:34Z","timestamp":1766117134000},"page":"e269199","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Choledocholithiasis leading to diagnoses of severe malnutrition and atypical anorexia nervosa in an adolescent"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2168-7597","authenticated-orcid":false,"given":"Melissa","family":"Campbell","sequence":"first","affiliation":[{"name":"Pediatrics, University of California San Diego, San Diego, California, USA"},{"name":"Rady Children\u2019s Hospital-San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane","family":"Lenzen","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital-San Diego, San Diego, California, USA"},{"name":"Pediatric Hospital Medicine, University of California San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Maginot","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego, San Diego, California, USA"},{"name":"Department of Psychiatry, Rady Children\u2019s Hospital-San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya M","family":"Kumar","sequence":"additional","affiliation":[{"name":"Pediatrics, University of California San Diego, San Diego, California, USA"},{"name":"Adolescent and Young Adult Medicine, Rady Children\u2019s Hospital-San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"2025121820052614000_18.12.e269199.1","unstructured":"Chamorro C , Arteaga P , Paredes C , et al . 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