BACKGROUND & AIMS: Refeeding severely malnourished patients with Anorexia nervosa requires specialized in-patient treatment to reduce medical risks, to avoid refeeding syndrome and other life-threatening situations. METHODS: The authors present a retrospective cohort nutritional rehabilitation study of 33 very severe Anorexia nervosa in-patients, aged 22.8 ± 7.6 years (mean ± SD) and with an initial body mass index ≤ 12 kg/m(2), treated in a specialized Eating Disorders Unit. RESULTS: Thirty-three female patients were included and treated. Mean BMI increased from 11.3 ± 0.7 Kg/m(2), to 13.5 ± 1 Kg/m(2), and mean body weight from 29.1 ± 3.2 Kg to 34.5 ± 3.3 Kg, after 60 days of intensive in-patient treatments (p < 0.0001). Feeding was carefully instituted; caloric intake levels were established after measuring REE by indirect calorimetry. Nutritional support was initiated with temporary nasogastric feeding in 30 patients, and with oral supplementation in 3 patients. Vitamins, potassium and phosphate supplements were administered during refeeding. All patients achieved a significant increase in body weight, none developed refeeding syndrome as far as laboratory and clinical investigations were concerned. CONCLUSIONS: Our findings show that, even in cases of extreme undernutrition, if feeding is performed cautiously and in a specialized unit, it is possible to avoid the refeeding syndrome.
BACKGROUND & AIMS: Refeeding severely malnourished patients with Anorexia nervosa requires specialized in-patient treatment to reduce medical risks, to avoid refeeding syndrome and other life-threatening situations. METHODS: The authors present a retrospective cohort nutritional rehabilitation study of 33 very severe Anorexia nervosa in-patients, aged 22.8 ± 7.6 years (mean ± SD) and with an initial body mass index ≤ 12 kg/m(2), treated in a specialized Eating Disorders Unit. RESULTS: Thirty-three female patients were included and treated. Mean BMI increased from 11.3 ± 0.7 Kg/m(2), to 13.5 ± 1 Kg/m(2), and mean body weight from 29.1 ± 3.2 Kg to 34.5 ± 3.3 Kg, after 60 days of intensive in-patient treatments (p < 0.0001). Feeding was carefully instituted; caloric intake levels were established after measuring REE by indirect calorimetry. Nutritional support was initiated with temporary nasogastric feeding in 30 patients, and with oral supplementation in 3 patients. Vitamins, potassium and phosphate supplements were administered during refeeding. All patients achieved a significant increase in body weight, none developed refeeding syndrome as far as laboratory and clinical investigations were concerned. CONCLUSIONS: Our findings show that, even in cases of extreme undernutrition, if feeding is performed cautiously and in a specialized unit, it is possible to avoid the refeeding syndrome.
Authors: Andrea K Garber; Jing Cheng; Erin C Accurso; Sally H Adams; Sara M Buckelew; Cynthia J Kapphahn; Anna Kreiter; Daniel Le Grange; Vanessa I Machen; Anna-Barbara Moscicki; Allyson Sy; Leslie Wilson; Neville H Golden Journal: JAMA Pediatr Date: 2021-01-01 Impact factor: 16.193
Authors: Andrea K Garber; Kasuen Mauldin; Nobuaki Michihata; Sara M Buckelew; Mary-Ann Shafer; Anna-Barbara Moscicki Journal: J Adolesc Health Date: 2013-09-17 Impact factor: 5.012
Authors: Andrea K Garber; Susan M Sawyer; Neville H Golden; Angela S Guarda; Debra K Katzman; Michael R Kohn; Daniel Le Grange; Sloane Madden; Melissa Whitelaw; Graham W Redgrave Journal: Int J Eat Disord Date: 2015-12-12 Impact factor: 4.861
Authors: Christoph Born; Larissa de la Fontaine; Bettina Winter; Norbert Müller; Annette Schaub; Clemens Früstück; Cornelius Schüle; Ulrich Voderholzer; Ulrich Cuntz; Peter Falkai; Eva Meisenzahl Journal: BMC Psychiatry Date: 2015-03-24 Impact factor: 3.630