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Higher-Calorie Refeeding Beneficial in Anorexia Nervosa

TUESDAY, Oct. 20, 2020 -- For adolescents and young adults with anorexia nervosa or atypical anorexia nervosa, higher-calorie refeeding restores medical stability significantly earlier than lower-calorie refeeding, with no increase in electrolyte abnormalities or adverse events, according to a study published online Oct. 19 in JAMA Pediatrics.

Andrea K. Garber, Ph.D., from the University of California in San Francisco, and colleagues compared the short-term efficacy, safety, and cost of lower- versus higher-calorie refeeding for 120 adolescents and young adults aged 12 to 24 years hospitalized with anorexia nervosa or atypical anorexia nervosa. A total of 111 participants were included in the modified intention-to-treat analyses. Higher-calorie refeeding started at 2,000 kcal/day and increased by 200 kcal every day, while lower-calorie refeeding started at 1,400 kcal/day and increased by 200 kcal every other day.

The researchers found that compared with lower-calorie refeeding, higher-calorie refeeding restored medical stability significantly earlier (hazard ratio, 1.67). There was no difference noted between the groups in electrolyte abnormalities and other adverse events. Among the group receiving higher-calorie refeeding, hospital stay was 4.0 days shorter, which led to a savings of $19,056 in hospital charges per participant.

"Our inpatient programs are operating at maximum capacity; the isolation, uncertainty, and anxiety of COVID-19 is amplified for our patients," Garber said in a statement. "We believe that this faster and more efficacious approach will reduce the upheaval of hospitalization during an already stressful time."

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Posted: October 2020

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