Anorexia nervosa in adults and adolescents: The refeeding syndrome
- Philip Mehler, MD
Philip Mehler, MD
- Executive Medical Director, ACUTE, Denver Health
- Chief Medical Officer, Eating Recovery Center
- Professor of Medicine, University of Colorado
Weight gain is the cornerstone of treatment for patients with anorexia nervosa . However, restoring weight by refeeding patients can lead to the refeeding syndrome, which is potentially fatal. A retrospective study of adolescents hospitalized for anorexia nervosa (n = 69) found that moderately severe cases of the refeeding syndrome occurred in 6 percent, and mild cases in 22 percent .
In addition, patients other than those with anorexia nervosa are at risk for the refeeding syndrome . These include oncology patients undergoing chemotherapy, malnourished elderly patients, certain postoperative patients, and homeless or alcoholic patients who have not eaten for many days.
The refeeding syndrome in anorexia nervosa and its management are reviewed here. The evaluation for medical complications and criteria for hospitalizing patients with anorexia nervosa; medical complications of anorexia nervosa and their management; epidemiology, pathogenesis, clinical features, treatment, and outcome of anorexia nervosa; and the medical complications of bulimia nervosa and binge eating disorder are discussed separately.
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