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Refeeding patients with moderate and severe eating disorders: A retrospective cohort study

By Jamie Manwaring

Rabito G., Blalock D. V., Beaty L., Harr B., Manwaring J., Rienecke R. D., Trees N., & Mehler P. (2021). Refeeding patients with moderate and severe eating disorders: A retrospective cohort study. International Journal of Nutritional Sciences 6 1050.

Introduction

The Eating Recovery Center Research Team, including Dan V. Blalock, Philip S. Mehler, n, Jamie Manwaring, and Renee D. Rienecke, examined the nutrition rehabilitation protocol of 395 adult patients diagnosed with AN and admitted to residential eating disorder treatment is implemented, how the protocol is sustained throughout a patient’s treatment stay to achieve desired weight gain, and how the patients’ biochemical and clinical progress proceeded between admission and discharge, including laboratory results and body mass index (BMI).. Learn more about our research team here.

Abstract

Background: Anorexia Nervosa (AN) is a life-threatening mental illness that can cause significant medical complications, including the potentially fatal refeeding syndrome. Registered dietitians (RDs) are a critical part of an eating disorder multidisciplinary team that focuses treatment on safe weight restoration and nutrition rehabilitation.

Method: This study is a description of how the nutrition rehabilitation protocol of 395 adult patients diagnosed with AN and admitted to residential eating disorder treatment is implemented, how the protocol is sustained throughout a patient’s treatment stay to achieve desired weight gain, and how the patients’ biochemical and clinical progress proceeded between admission and discharge, including laboratory results and body mass index (BMI).

Results: One hundred twenty-six patients required phosphorus supplementation for refeeding hypophosphatemia (RH); admission BMI was not significantly different between those with and without RH. The 15% of patients who required enteral nutrition at any point during their admission gained significantly less weight than patients who only received an oral meal plan. 34.4% of patients admitted with starvation induced hepatitis, 28.6% experienced refeeding hepatitis at some point, 21.0% of patients had elevated liver function tests 2 weeks into refeeding and 28.6% at discharge.

Conclusions: This study demonstrated overall effectiveness in achieving weight restoration goals with aggressive kcal increases without a single incidence of refeeding syndrome and infrequent RH. No significant biochemical changes were observed during refeeding. With close medical supervision and concurrent RD oversight, a refeeding approach with consistent calorie increases that is more aggressive than previously recommended appears to be safe.

Read the full study here: https://www.austinpublishinggroup.com/nutritional-sciences/fulltext/ijns-v6-id1050.php  

 

Written by

Jamie Manwaring

Dr. Manwaring earned her doctorate in psychology from Washington University in St. Louis, where she published peer-reviewed research in the field of eating and weight disorders. Since joi...
Written by

Renee D. Rienecke, PhD, FAED

Renee D. Rienecke, PhD, FAED, is a clinical psychologist and Director of Research for Eating Recovery Center/Pathlight Mood and Anxiety Centers and Adjunct Associate Professor in the Depa...
Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip Mehler, prior to joining Eating Recovery Center, served as the Medical Director of Denver Health and Hospital Authority a position he held up until his retirement in 2014. Dr. ...
Written by

Dan Blalock

Dan Blalock is a health services researcher in the Health Services Research & Development Center of Innovation at the Durham Veterans Affairs Medical Center, Assistant Consulting Professo...

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