Specialized refeeding treatment for anorexia nervosa patients suffering from extreme undernutrition.
OBJECTIVE
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.
Gentile
Maria Gabriella
MG
Eating Disorders Unit, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20126 Milan, Italy. centrodca@ospedaleniguarda.it
Pastorelli
Paola
P
Ciceri
Raffaella
R
Manna
Giulia Maria
GM
Collimedaglia
Simona
S
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000178:diet therapy*; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002153:Calorimetry, Indirect; D015331:Cohort Studies; D002149:Energy Intake; D005260:Female; D006801:Humans; D018529:Nutritional Support; D055677:Refeeding Syndrome / Q000517:prevention & control*; D012189:Retrospective Studies; D055815:Young Adult