Efficacy of voluntary nasogastric tube feeding in female inpatients with anorexia nervosa.
BACKGROUND
This investigation assesses the efficacy of a voluntary nasogastric tube feeding protocol on the weight gain of patients with anorexia nervosa, tube feeding's effect on recovery from the psychologic aspects of anorexia, patient satisfaction with treatment, and medical complications.


METHODS
The study included a nonrandomized retrospective review of 381 female inpatients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of anorexia nervosa, both subtypes. A total of 155 patients received tube feeding and oral refeeding; 226 received oral refeeding alone. Recovery from the psychologic aspects of anorexia was measured by the change in Eating Disorder Inventory-2 scores between admission and discharge. Patient satisfaction with treatment was measured with a patient satisfaction questionnaire completed at discharge. Repeated measures and multivariate analyses were performed.


RESULTS
When severity-of-illness and caloric intake differences between patients with and without tube feeding were controlled, patients who received tube feeding gained significantly more weight per treatment week than those who received oral kilocalories alone. Patients who received tube feeding for at least one-half their length of stay gained 1 kg/week versus 0.77 kg/week for patients receiving oral refeeding alone. Tube-fed patients evidenced no differences in recovery from anorexia's psychologic aspects, satisfaction with treatment, or medical complication frequency.


CONCLUSIONS
In residential psychiatric treatment settings in which intensive therapeutic interventions and appropriate medical monitoring can manage potential psychologic and medical risks, tube feeding's weight gain benefits may be a viable and safe option in treating anorexia.
Zuercher
Juliet N
JN
Nutrition Services Department, Remuda Ranch Center for Anorexia and Bulimia Inc., Wickenburg, Arizona 85390, USA.
Cumella
Edward J
EJ
Woods
Brenda K
BK
Eberly
Marian
M
Carr
Janet K
JK
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D007902:Length of Stay; D017060:Patient Satisfaction; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015430:Weight Gain