title: A review of feeding methods used in the treatment of anorexia nervosa.
abstract: BACKGROUND
  Clear evidence based guidelines on the best and safest method of achieving and maintaining normal body weight during inpatient treatment of Anorexia Nervosa (AN) are currently not available. Oral feeding with food alone, high-energy liquid supplements, nasogastric feeding and parenteral nutrition all have the potential to achieve weight gain in the treatment of AN but the advantages and disadvantages of each method have not been comprehensively evaluated. A literature search was undertaken to identify papers describing feeding methods used during inpatient treatment of AN. The selection criteria searched for papers that described the feeding method; and reported weight change variables such as admission and discharge weight in kilograms, or Body Mass Index; or weight change over the course of inpatient treatment.
  
  
  RESULTS
  Twenty-six papers were identified, describing a total of 37 samples with a mean sample size of 58.9 participants, and a range from 6 to 318. The majority (84.6%) of papers were observational cohorts and retrospective chart reviews. The most common feeding method described was nasogastric feeding and food, then high-energy liquid supplements and food.
  
  
  CONCLUSIONS
  There is limited evidence on the efficacy of feeding methods used in the refeeding and nutritional rehabilitation of AN, therefore no conclusion can be made about the most effective method of achieving weight gain during inpatient treatment. While there are a number of papers exploring this issue there is no consistency in the way the information is reported to enable comparisons between the different methods. There is an urgent need for research in this area to guide decision-making in the inpatient management, refeeding and nutritional rehabilitation of AN.
authors.affiliation: Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia ; Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Camperdown, NSW 2006, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Hart
authors.affiliation: School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Franklin
authors.affiliation: Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia ; Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Camperdown, NSW 2006, Australia ; Northside Clinic Eating Disorder Program, Greenwich, NSW 2065, Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: Russell
authors.affiliation: Northside Clinic Eating Disorder Program, Greenwich, NSW 2065, Australia ; Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards 2065, NSW, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Abraham
keywords: Anorexia nervosa; Enteral; Feeding; Nasogastric; Parenteral; Refeeding