PURPOSE: Nutritional rehabilitation is an essential part of inpatient treatment for adolescents with restrictive eating disorders (ED). The purpose of this study was to examine weight gain, prevalence of refeeding syndrome, and nutritional composition of the diet in hospitalized adolescents with anorexia nervosa (AN) and eating disorder not otherwise specified (EDNOS), restrictive type, on a structured nutrition rehabilitation protocol (NRP). METHODS: An evidence-based NRP was implemented on the inpatient eating disorders unit at the Hospital for Sick Children in June 2011. Adolescents 12-18 years of age with AN or EDNOS, an ideal body weight (IBW) of 70% or greater, no clinical or metabolic signs of refeeding syndrome, and on their first admission were assigned to the NRP. A retrospective chart review between June 2011 and June 2012 was completed. A repeated measures analysis was used to determine the mean rate of weight gain. Mean cumulative % change in body mass index (BMI) was plotted against days to assess daily weight trajectory. RESULTS: Twenty-nine patients, mean age of 14.7 (SD ± 1.5) years, were included in the study. A total of 3.5% developed hypophosphatemia on day 1. Mean weight gain was .24 kg/day (p < .0001) and 1.7 kg/week. An increase in mean cumulative % change in BMI was observed from days 2-14. Actual caloric intake was 98%-113% of the prescribed intake. Macronutrient distribution was within acceptable limits based on dietary reference intakes. CONCLUSIONS: The NRP is considered effective, efficient, and safe. Further research is needed to explore the effectiveness and safety of NRPs in other populations.
PURPOSE: Nutritional rehabilitation is an essential part of inpatient treatment for adolescents with restrictive eating disorders (ED). The purpose of this study was to examine weight gain, prevalence of refeeding syndrome, and nutritional composition of the diet in hospitalized adolescents with anorexia nervosa (AN) and eating disorder not otherwise specified (EDNOS), restrictive type, on a structured nutrition rehabilitation protocol (NRP). METHODS: An evidence-based NRP was implemented on the inpatient eating disorders unit at the Hospital for Sick Children in June 2011. Adolescents 12-18 years of age with AN or EDNOS, an ideal body weight (IBW) of 70% or greater, no clinical or metabolic signs of refeeding syndrome, and on their first admission were assigned to the NRP. A retrospective chart review between June 2011 and June 2012 was completed. A repeated measures analysis was used to determine the mean rate of weight gain. Mean cumulative % change in body mass index (BMI) was plotted against days to assess daily weight trajectory. RESULTS: Twenty-nine patients, mean age of 14.7 (SD ± 1.5) years, were included in the study. A total of 3.5% developed hypophosphatemia on day 1. Mean weight gain was .24 kg/day (p < .0001) and 1.7 kg/week. An increase in mean cumulative % change in BMI was observed from days 2-14. Actual caloric intake was 98%-113% of the prescribed intake. Macronutrient distribution was within acceptable limits based on dietary reference intakes. CONCLUSIONS: The NRP is considered effective, efficient, and safe. Further research is needed to explore the effectiveness and safety of NRPs in other populations.
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: Kristin A Shadman; Ryan J Coller; Windy Smith; Michelle M Kelly; Paula Cody; William Taft; Laura Bodine; Daniel J Sklansky Journal: J Hosp Med Date: 2019-04-08 Impact factor: 2.960
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: Jochen Seitz; Katharina Bühren; Ronald Biemann; Nina Timmesfeld; Astrid Dempfle; Sibylle Maria Winter; Karin Egberts; Christian Fleischhaker; Christoph Wewetzer; Beate Herpertz-Dahlmann; Johannes Hebebrand; Manuel Föcker Journal: Eur Child Adolesc Psychiatry Date: 2016-02-05 Impact factor: 4.785
Authors: Kathryn Smith; Julie Lesser; Beth Brandenburg; Andrew Lesser; Jessica Cici; Robert Juenneman; Amy Beadle; Sarah Eckhardt; Elin Lantz; James Lock; Daniel Le Grange Journal: J Eat Disord Date: 2016-12-19
Authors: Elizabeth K Parker; Sahrish S Faruquie; Gail Anderson; Linette Gomes; Andrew Kennedy; Christine M Wearne; Michael R Kohn; Simon D Clarke Journal: J Nutr Metab Date: 2016-05-12