Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient

Weight restoration is crucial for successful treatment of anorexia nervosa. Without it, patients may face serious or even fatal medical complications of severe starvation. However, the process of nutritional rehabilitation can also be risky to the patient. The refeeding syndrome, a problem of electr...

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Main Authors: Philip S. Mehler, Amy B. Winkelman, Debbie M. Andersen, Jennifer L. Gaudiani
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:Journal of Nutrition and Metabolism
Online Access:http://dx.doi.org/10.1155/2010/625782
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author Philip S. Mehler
Amy B. Winkelman
Debbie M. Andersen
Jennifer L. Gaudiani
author_facet Philip S. Mehler
Amy B. Winkelman
Debbie M. Andersen
Jennifer L. Gaudiani
author_sort Philip S. Mehler
collection DOAJ
description Weight restoration is crucial for successful treatment of anorexia nervosa. Without it, patients may face serious or even fatal medical complications of severe starvation. However, the process of nutritional rehabilitation can also be risky to the patient. The refeeding syndrome, a problem of electrolyte and fluid shifts, can cause permanent disability or even death. It is essential to identify at-risk patients, to monitor them carefully, and to initiate a nutritional rehabilitation program that aims to avoid the refeeding syndrome. A judicious, slow initiation of caloric intake, requires daily management to respond to entities such as liver inflammation and hypoglycemia that can complicate the body's conversion from a catabolic to an anabolic state. In addition, nutritional rehabilitation should take into account clinical characteristics unique to these patients, such as gastroparesis and slowed colonic transit, so that measures can be taken to ameliorate the physical discomforts of weight restoration. Adjunct methods of refeeding such as the use of enteral or parenteral nutrition may play a small but important role in a select patient group who cannot tolerate oral nutritional rehabilitation alone.
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spelling doaj-art-4f53dceea7ce4c4385beeb034d0f06d22025-08-20T02:05:38ZengWileyJournal of Nutrition and Metabolism2090-07242090-07322010-01-01201010.1155/2010/625782625782Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic PatientPhilip S. Mehler0Amy B. Winkelman1Debbie M. Andersen2Jennifer L. Gaudiani3Department of Internal Medicine, Denver Health Medical Center, Denver, CO 80204, USAFood and Nutrition Services Department, Denver Health Medical Center, Denver, CO 80204, USAFood and Nutrition Services Department, Denver Health Medical Center, Denver, CO 80204, USADepartment of Internal Medicine, Denver Health Medical Center, Denver, CO 80204, USAWeight restoration is crucial for successful treatment of anorexia nervosa. Without it, patients may face serious or even fatal medical complications of severe starvation. However, the process of nutritional rehabilitation can also be risky to the patient. The refeeding syndrome, a problem of electrolyte and fluid shifts, can cause permanent disability or even death. It is essential to identify at-risk patients, to monitor them carefully, and to initiate a nutritional rehabilitation program that aims to avoid the refeeding syndrome. A judicious, slow initiation of caloric intake, requires daily management to respond to entities such as liver inflammation and hypoglycemia that can complicate the body's conversion from a catabolic to an anabolic state. In addition, nutritional rehabilitation should take into account clinical characteristics unique to these patients, such as gastroparesis and slowed colonic transit, so that measures can be taken to ameliorate the physical discomforts of weight restoration. Adjunct methods of refeeding such as the use of enteral or parenteral nutrition may play a small but important role in a select patient group who cannot tolerate oral nutritional rehabilitation alone.http://dx.doi.org/10.1155/2010/625782
spellingShingle Philip S. Mehler
Amy B. Winkelman
Debbie M. Andersen
Jennifer L. Gaudiani
Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient
Journal of Nutrition and Metabolism
title Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient
title_full Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient
title_fullStr Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient
title_full_unstemmed Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient
title_short Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient
title_sort nutritional rehabilitation practical guidelines for refeeding the anorectic patient
url http://dx.doi.org/10.1155/2010/625782
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AT jenniferlgaudiani nutritionalrehabilitationpracticalguidelinesforrefeedingtheanorecticpatient