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Outcomes of an inpatient refeeding protocol in youth with Anorexia Nervosa and atypical Anorexia Nervosa at Children's Hospitals and Clinics of Minnesota
Journal article   Open access   Peer reviewed

Outcomes of an inpatient refeeding protocol in youth with Anorexia Nervosa and atypical Anorexia Nervosa at Children's Hospitals and Clinics of Minnesota

Kathryn Smith, Julie Lesser, Beth Brandenburg, Andrew Lesser, Jessica Cici, Robert Juenneman, Amy Beadle, Sarah Eckhardt, Elin Lantz, James Lock, …
Journal of eating disorders, v 4(1), pp 35-35
19 Dec 2016
DOI: https://doi.org/10.1186/s40337-016-0124-0
PMID: 28018595
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1186/s40337-016-0124-0View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

Life Sciences & Biomedicine Nutrition & Dietetics Psychiatry Psychology Psychology, Clinical Science & Technology Social Sciences
Background: Historically, inpatient protocols have adopted relatively conservative approaches to refeeding in Anorexia Nervosa (AN) in order to reduce the risk of refeeding syndrome, a potentially fatal constellation of symptoms. However, increasing evidence suggests that patients with AN can tolerate higher caloric prescriptions during treatment, which may result in prevention of initial weight loss, shorter hospital stays, and less exposure to the effects of severe malnutrition. Therefore the present study sought to examine the effectiveness of a more accelerated refeeding protocol in an inpatient AN and atypical AN sample. Methods: Participants were youth (ages 10-22) with AN (n = 113) and atypical AN (n = 16) who were hospitalized for medical stabilization. A retrospective chart review was conducted to assess changes in calories, weight status (percentage of median BMI, % mBMI), and indicators of refeeding syndrome, specifically hypophosphatemia, during hospitalization. Weight was assessed again approximately 4 weeks after discharge. Results: No cases of refeeding syndrome were observed, though 47.3 % of participants evidenced hypophosphatemia during treatment. Phosphorous levels were monitored in all participants, and 77.5 % were prescribed supplemental phosphorous at the time of discharge. Higher rates of caloric changes were predictive of greater changes in % mBMI during hospitalization. Rates of caloric and weight change were not related to an increased likelihood of re-admission. Conclusions: Results suggest that a more accelerated approach to inpatient refeeding in youth with AN and atypical AN can be safely implemented and is not associated with refeeding syndrome, provided there is close monitoring and correction of electrolytes. These findings suggest that this approach has the potential to decrease length of stay and burden associated with inpatient hospitalization, while supporting continued progress after hospitalization.

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29 citations in Web of Science
29 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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Collaboration types
Domestic collaboration
Web of Science research areas
Nutrition & Dietetics
Psychiatry
Psychology, Clinical
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