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Anorexia Nervosa Treatment – Unique Nutritional Needs
Anorexia Nervosa is one of the most prolific eating disorder diagnoses, characterized by restriction of food intake, overwhelming fear of gaining weight, and having a distorted view one oneself. Individuals with this disorder have unique nutritional needs that must be considered in their treatment. A starved body results in a starved brain that can impact every area of one’s life, making the refeeding process a key aspect in healing from this disorder.
The Treatment Process
When an individual is hospitalized for eating disorder treatment, they will undergo a “period of supervised refeeding to increase their weight and stabilize their vital signs and organ function [1].” The refeeding process needs to be approached cautiously, as the reintroduction of food can result in an illness known as Refeeding Syndrome.
Refeeding syndrome occurs when “from a catabolic state (a state of breaking down tissues for nutrients) to an anabolic state (a state of rebuilding tissues/growth) [2].” During this process, salt is often moved from the blood to growing cells in an effort to support rebuilding and healing them.
This can lead to low potassium, phosphorous, and magnesium levels in the blood and result in complications such as heart or respiratory failure, arrhythmia, muscle breakdown, and even death [2].
The Refeeding Debate
Due to the precariousness of refeeding, professionals are cautious about how they address this process. There is debate in the eating disorder treatment field as to exactly how to approach refeeding most safely.
Traditionally, treatment centers would begin patients on a lower calorie diet and slowly titrate up from there. Recently, some treatment centers have begun refeeding with higher calorie counts. The safety of this approach is still unclear. Therefore, researchers from the University of California in San Francisco conducted a study comparing both methods.
The study compared how long it took participants to reach medical stability, including improvements in heart rate, blood pressure, and body temperature, and reaching at least 75% of the average body max index (BMI) for their age and sex [1].”
Ultimately, the study determined that an equal proportion of individuals reached medical stability while hospitalized but that those in the “higher-calorie group stabilized an average of 3 days earlier than those receiving fewer calories [1].”
These individuals heart rates also normalized faster, and they gained more weight overall during their stay. This is important in considering future refeeding procedures, as the higher-calorie group was able to discharge from the hospital an average of 4-days sooner [1].
This not only indicates that higher calorie refeeding is safe but that it may reduce hospitalization times.
Resources:
[1] Reynolds, S. (2020). Higher calorie treatment for people hospitalized with anorexia nervosa. National Institute of Health. Retrieved from https://www.nih.gov/news-events/nih-research-matters/higher-calorie-treatment-people-hospitalized-anorexia. [2] Mascolo, M. Refeeding patients with anorexia nervosa: what does research show? Eating Disorder Hope. Retrieved from https://www.eatingdisorderhope.com/information/anorexia/refeeding-patients-with-anorexia-nervosa-what-does-research-showAbout the Author:
Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published January 29, 2021, on EatingDisorderHope.com
Reviewed & Approved on January 29, 2021, by Jacquelyn Ekern MS, LPC
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
