Solène Chatelet1, Jen Wang2, Mathea Gjoertz1, Françoise Lier2,3, Carole Monney Chaubert4, Anne-Emmanuelle Ambresin5,6. 1. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. 2. Interdisciplinary Division for Adolescent Health (DISA), Lausanne University Hospital (CHUV), Hôpital Nestlé 04-312, Avenue de la Sallaz 2, 1011, Lausanne, Switzerland. 3. Vaudois Centre for Anorexia and Bulimia (abC), Lausanne University Hospital (CHUV), Lausanne, Switzerland. 4. Etablissements Hospitaliers du Nord-Vaudois (eHnv): St. Loup Hospital, Pompaples, Switzerland. 5. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. anne-emmanuelle.ambresin@chuv.ch. 6. Interdisciplinary Division for Adolescent Health (DISA), Lausanne University Hospital (CHUV), Hôpital Nestlé 04-312, Avenue de la Sallaz 2, 1011, Lausanne, Switzerland. anne-emmanuelle.ambresin@chuv.ch.
Abstract
OBJECTIVE: Nutrition restoration in inpatients with anorexia nervosa (AN) is a core element in treatment, enabling recovery of cognitive functions essential for psychological care. This study aims to identify factors associated with inpatient weight gain. METHODS: Medical records from 107 inpatients aged 13-55 years with AN, hospitalized for more than 7 days at a specialized unit, were examined in a retrospective study. Weight evolution graphs were created for each patient and graded independently as optimal, moderate, and inadequate weight gain after 2 weeks and increasing, flat or decreasing weight in the first 2 weeks by expert clinicians. Driven by explicit hypotheses, bivariable analyses were carried out to detect relevant factors associated with weight gain during and after the first 2 weeks of admission. RESULTS: Initial weight gain in the first 2 weeks of hospitalization and the introduction of a protocol harmonizing treatment procedures around rapid refeeding were strong factors associated with optimal weight gain after 2 weeks of hospitalization, whereas prior hospitalization in a psychiatric unit, diagnosis with binge-eating/purging subtype and age over 18 years were significantly associated with inadequate weight gain (p < 0.001-0.05). CONCLUSION: To promote weight gain during hospitalization, clinicians should consider the following therapeutic measures: rapid refeeding strategies, renutrition protocols, and controlling purging behaviors. LEVEL OF EVIDENCE: Level III, retrospective cohort study.
OBJECTIVE: Nutrition restoration in inpatients with anorexia nervosa (AN) is a core element in treatment, enabling recovery of cognitive functions essential for psychological care. This study aims to identify factors associated with inpatient weight gain. METHODS: Medical records from 107 inpatients aged 13-55 years with AN, hospitalized for more than 7 days at a specialized unit, were examined in a retrospective study. Weight evolution graphs were created for each patient and graded independently as optimal, moderate, and inadequate weight gain after 2 weeks and increasing, flat or decreasing weight in the first 2 weeks by expert clinicians. Driven by explicit hypotheses, bivariable analyses were carried out to detect relevant factors associated with weight gain during and after the first 2 weeks of admission. RESULTS: Initial weight gain in the first 2 weeks of hospitalization and the introduction of a protocol harmonizing treatment procedures around rapid refeeding were strong factors associated with optimal weight gain after 2 weeks of hospitalization, whereas prior hospitalization in a psychiatric unit, diagnosis with binge-eating/purging subtype and age over 18 years were significantly associated with inadequate weight gain (p < 0.001-0.05). CONCLUSION: To promote weight gain during hospitalization, clinicians should consider the following therapeutic measures: rapid refeeding strategies, renutrition protocols, and controlling purging behaviors. LEVEL OF EVIDENCE: Level III, retrospective cohort study.
Entities:
Keywords:
Anorexia nervosa; Inpatients; Renutrition protocol; Risk factors; Weight gain