A case report: Treatment of severe anorexia nervosa with home total parenteral hyperalimentation

Clinical Efficacy and Safety of Parenteral Nutrition in Adolescent Girls with Anorexia Nervosa

“…In patients with oral rehabilitation alone, final caloric intake is achieved during 1 week. The intake of dietary proteins, fats, and carbohydrates is calculated according to DRI recommendations [18]: 15-20% proteins of the daily energy intake consisting of 30% fats and 50 -55% carbohydrates. The aim of our nutritional rehabilitation is to maintain a weight gain of approximately 400 -800 g/week during hospitalization and not to exceed 1 kg/week, according to previous recommendations [2,3,13].…”

“…Therefore it is preferred by some psychiatrists, as in our center. Although it may represent an alternative to EN in selected AN cases, it is infrequently used, and only a few case series [5,14 -16] or anecdotic ones are reported in literature [17][18][19].…”

Weight changes during inpatient refeeding of underweight eating disorder patients

“…The American Psychiatric Association (APA) guidelines recommend 0.9-1.4 kg/ week with 'expected rates of controlled weight gain' (Yager et al, 2006), however there are only a few descriptions of actual weight gain in inpatient treatment. The literature is comprised of descriptions of practice based on clinical treatment in particular facilities (Okamoto et al, 2002;Zuercher, Cumella, Woods, Eberly, & Carr, 2003); case studies (Latzer, Eysen-Eylat, & Tabenkin, 2000;Mehler & Weiner, 2007;Neiderman, Zarody, Tattersall, & Lask, 2000) or studies with small sample sizes (Arii, Yamashita, Kinoshita, Shimizu, Nakamura, & Nakajima, 1996;Silber, Robb, Orrell-Valente, Ellis, Valadez-Meltzer, & Dadson, 2004) and there are only a few descriptions of patterns of weight change in Anorexia Nervosa (AN) subjects with a sample size greater than 100 (Beumont, Al-Alami, & Touyz, 1988;Diamanti et al, 2008;Zuercher et al, 2003). Evidence of how achievable described weight targets are in clinical settings is unclear as there is frequently limited detail to aid in translation of treatment practices into other settings (Davies & Jaffa, 2005).…”

Treatment of intestinal failure: home parenteral nutrition

“…Less-common indications include hyperemesis gravidarum, 13 cystic fibrosis, 14,15 and anorexia nervosa. 16 Generally, enteral feeding should be pursued as the sole (or at least as a supplemental) source of nutrition, unless the bowel is unusable.…”