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  • Title: Specialized refeeding treatment for anorexia nervosa patients suffering from extreme undernutrition.
    Author: Gentile MG, Pastorelli P, Ciceri R, Manna GM, Collimedaglia S.
    Journal: Clin Nutr; 2010 Oct; 29(5):627-32. PubMed ID: 20416994.
    Abstract:
    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.
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