Anorexia nervosa is a serious problem, primarily among adolescent girls in the U.S. It has been estimated that between 1 and 4 percent of teenage girls suffer to some extent from the body dysmorphic disorder, in which they starve themselves (sometimes to death) in the mistaken belief that they are too fat, even when they are at death s door. The severe form of the condition is extraordinarily difficult to treat, often requiring intensive care unit hospitalization and a variety of feeding techniques along with psychiatric intervention, yet fatalities are not uncommon.
In the first of its kind study to compare refeeding protocols for patients diagnosed with anorexia nervosa, researchers found more aggressive, high-calorie diets produced twice the rate of weight gain among adolescents. The findings by researchers at the University of California-San Francisco s Benioff Children s Hospital, challenge the current start low, and go slow approach to avoid refeeding syndrome a potentially fatal condition resulting from rapid electrolyte shifts in a starving patient.
In the study soon to be published in the November issue of the Journal of Adolescent Health researchers evaluated 56 patients, primarily female, who were placed on higher-calorie diets, starting at 1,800 calories per day and advancing by 120 calories each day. The patients received three meals and three snacks each day, and vital signs and electrolytes were monitored closely. The control group patients started on 1,100 calories per day and advanced at a slower rate of 100 calories per day. When comparing the two groups, researchers found the rate of weight gain was almost double on higher- versus lower-calorie diets. Patients who received more calories were also hospitalized for an average of seven fewer days, without an increased risk of refeeding syndrome.
Researchers say the findings are crucial to developing evidence-based guidelines for the treatment of young patients suffering from the severe malnutrition that is the hallmark of the eating disorder, anorexia nervosa, when it is poorly-controlled.
