Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment

Marzola, Enrica; Nasser, Jennifer A.; Hashim, Sami A.; Shih, Pei-an Betty; Kaye, Walter H.

doi:10.1186/1471-244x-13-290

Cited by 137 publications

(121 citation statements)

References 84 publications

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“…Providing such big amounts of food to the inpatient could cause an increase in the level of anxiety and, consequently, treatment resistance (11). Furthermore, abdominal discomfort and psychological distress may appear.…”

Section: Discussionmentioning

confidence: 99%

“…This syndrome is caused by a shift in fluid and electrolytes (particularly phosphate) from the extracellular to intracellular spaces upon refeeding, when insulin is released in response to an influx of nutrients (particularly carbohydrate). This results in electrolyte abnormalities, in particular hypophosphatemia, hypokalemia, and hypomagnesemia, glucose intolerance and thiamine deficiency, and can cause muscle weakness, delirium, coma, ataxia, arrhythmias and congestive heart failure or arrest (11). A review of the literature has revealed an average incidence rate of refeeding hypophosphatemia of 14% (8).…”

Section: Discussionmentioning

confidence: 99%

“…Regaining weight during hospitalization and the maintenance of this weight gain after discharge have been shown to be one of the major prognostic factors and predict favorable short and long-term outcomes, and these have been associated with an improvement in a number of psychological and medical complications (5,11). Restoring weight in young patients can also reverse growth retardation, developmental delay, and compromised bone density (6).…”

Section: Discussionmentioning

confidence: 99%

“…In addition to nutritional rehabilitation, cognitive-behavioral psychotherapy and family therapy have all shown to be effective in treating patients with anorexia nervosa (7,9). Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment for children and adolescents with AN, manifesting underweight or medically compromised, and it is an essential step for overall rehabilitation and recovery (5,10,11).…”

Section: Introductionmentioning

confidence: 99%

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Abordaje nutricional de pacientes ingresados con anorexia nerviosa

Miguelsanz¹,

Hinojal²,

Uribe

et al. 2016

Nutr Hosp

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ResumenLa anorexia nerviosa (AN) es el trastorno del comportamiento alimentario más prevalente en niños y adolescentes; su tratamiento es largo y complejo, e involucra a múltiples profesionales. La rehabilitación nutricional y la recuperación de un peso corporal normal es uno de los objetivos centrales en las fases iniciales del tratamiento del paciente ingresado. Sin embargo, las recomendaciones actuales sobre los requerimientos energéticos iniciales para estos pacientes son inconsistentes, con una clara ausencia de estudios controlados, evidencia científi ca disponible y consenso global sobre la forma de realimentación más efectiva y segura en adolescentes ingresados con anorexia nerviosa (AN). Clásicamente se han recomendado una realimentación conservadora para prevenir el síndrome de realimentación. No obstante, han aparecido recientemente varios trabajos recomendado una ingesta calórica inicial más elevada, sin observar más complicaciones ni síndrome de realimentación, y asociadas a estancias medias más cortas. Presentamos aquí nuestra experiencia en el tratamiento de la AN restrictiva con un tratamiento progresivo conservador. Hemos obtenido buenos resultados con este abordaje, bien tolerando por los pacientes, y sin observar complicaciones. Gracias a él, el equipo médico pudo establecer más fácilmente un acuerdo sobre los objetivos terapéuticos con el paciente. AbstractAnorexia nervosa (AN) is the most prevalent of eating disorders in children and adolescents, and its treatment is long and complex, involving a multidisciplinary team. Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment. However, current recommendations on initial energy requirements for these patients are inconsistent, with a clear lack of controlled studies, available scientifi c evidence and global consensus on the most effective and safe refeeding practices in hospitalized adolescents with anorexia nervosa (AN). Conservative refeeding recommendations have been classically established in order to prevent the refeeding syndrome. Nevertheless, various works have recently appeared advocating a higher initial caloric intake, without observing more complications or refeeding syndrome, and allowing a shorter average stay. We present our experience in the treatment of restricting AN with a conservative progressive treatment. We have obtained good results with this approach, which was well tolerated by patients, with no observing complications. As a consequence, the medical team could establish a pact about the therapeutic goals with the patients in an easier way.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Abordaje nutricional de pacientes ingresados con anorexia nerviosa

Miguelsanz¹,

Hinojal²,

Uribe

et al. 2016

Nutr Hosp

View full text Add to dashboard Cite

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“…Food variety is important when establishing meal plans as well as foods that are higher in energy density. However, Marzola, E. et al (2013), reported that people must consume adequate calories, starting slowly, and increasing at a measured pace.…”

Section: Methodsmentioning

confidence: 99%

Athletes Abstinence Knowledge from Eating Disorders like Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED), as Health Education Method in Decreasing Unhealthy Ageing with Reference to Physical and Mental Health

Joseph¹,

Augustine²,

Joe³

2017

jesp

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Aim: The objective of this study was to point out abstinence knowledge in decreasing unhealthy ageing with reference to physical and mental health, with justification to evaluate athlete's abstinence knowledge from eating disorders like Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) as health education method in decreasing unhealthy ageing with reference to physical and mental health among athletes at Njala Campus. Method: Behavioral Health Risk Modified Survey Questionnaire (BHRMSQ) was the research instrument for the survey. The variables of the findings were proved at level of significance p<0.05 through an inferential statistical instrument called Dependent t-test (t). The researchers interviewed mainly undergraduate athletes with an average number of one hundred and fifty (n=150), of which 37% (n=55) female and 63% (n=95) male, were selected using the stratified random sampling. Also stratified were 43.2% (n=65) from the School of Agriculture-to-Environmental Science; 57% (n=85) from the School of Education-to-Technology; 83 % (n=125) from level (100-to-200); 17% (n=25) from level (300-to-400); 60% (n=90) within the age circle of (18-to-25); 40% (n=60) within the age circle of (26-to-30+) in years. Results: Analysis shows negative skewedness in all three variables as placed in tabulated values (t-scores of 0.237, 0.452 and 0.318)of 5, 7 and 9 when proved at p < 0.05. Conclusion: The findings demonstrated that majority of athletes' lack abstinence knowledge from eating disorders like Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) regarding health education method in decreasing unhealthy ageing with reference to physical and mental health among athletes at Njala Campus.

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