INTRODUCTION AND DEFINITION
Weight gain is the cornerstone of treatment for patients with anorexia nervosa . However, serious and potentially fatal complications can arise when refeeding patients with anorexia nervosa. The refeeding syndrome is defined as the clinical complications that occur as a result of fluid and electrolyte shifts during nutritional rehabilitation of malnourished patients . Patients who weigh less than 70 percent of ideal body weight or lose weight rapidly are at greatest risk for the syndrome. One case series reported an incidence of six percent in adolescents hospitalized for treatment of anorexia nervosa .
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.
●(See "Anorexia nervosa in adults: Evaluation for medical complications and criteria for hospitalization to manage these complications".)
●(See "Anorexia nervosa in adults and adolescents: Medical complications and their management".)