Disorders - Anorexia Nervosa
Godart, N., Dorard, G., Duclos, J., Curt, F., Kaganski, I., Minier, L., Corcos, M., Falissard,
B., Eisler, I., Jeammet, P., Berthoz, S.
BACKGROUND: Randomized controlled trials showed the efficacy of family therapy for anorexia nervosa during adolescence, but studies
examining its long-term beneficial effect are still needed. This article presents the results of a 54-month post-randomization follow-up of a
previously reported randomized controlled trial that compared two post-hospitalization outpatient treatment programs: Treatment As Usual alone versus
Systemic Family Therapy added to Treatment As Usual.\rMETHODS: A consecutive series of 60 female adolescents with anorexia nervosa (DSM-IV) were
randomized (30 per group). During the first 18 months, in the Treatment As Usual group, subjects received a multidisciplinary treatment. In the other
group, Systemic Family Therapy sessions targeting intra-familial dynamics were added to Treatment As Usual. At 54 months, the primary outcome was
defined using the Morgan and Russell global Outcome Categories (Good or Intermediate versus Poor). Secondary outcomes were the Global Outcome
Assessment Schedule score, body mass index, amenorrhea, number of hospitalizations, eating disorder symptoms, psychopathological features, and family
functioning. Analyses were carried out using an Intention-To-Treat with the Last Observation Carried Forward procedure. Data of 59/60 subjects were
available.\rRESULTS: At 54 months, significant effects in favor of adding Systemic Family Therapy to Treatment As Usual were shown for the Global
Outcome Categories (60% of Good/Intermediate versus 31% in the control group, p = .026), mean body mass index (p = .048), resumption of menses (70.0%
vs. 40% p = .020), and mental state score (p = .010). Family cohesion scores were lower in the Systemic Family Therapy group (p = .040).
\rCONCLUSIONS: Adding Systemic Family Therapy focusing on intra-familial dynamics to a multidimensional outpatient treatment program appeared to lead
to a better long-term outcome in young women who suffered from severe anorexia nervosa during adolescence.
Journal of Child Psychology & Psychiatry & Allied Disciplines, 63(11) : 1368-
1380
- Year: 2022
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Giombini, L., Nesbitt, S., Kusosa, R., Fabian, C., Sharia, T., Easter, A., Tchanturia, K.
Objective: Randomised controlled
trial (RCT) in adults with anorexia nervosa (AN) showed that Cognitive Remediation Therapy (CRT) enhances cognitive flexibility, abstract thinking
and quality-of-life. Despite inconsistent findings, CRT has the potential as an adjunct treatment for young people (YP) with AN. A feasibility RCT
was conducted in an inpatient setting. The study will also consider the effect of CRT in YP with AN and autistic symptoms. Method(s): Participants
were randomly allocated to the Immediate or Delayed condition to receive individual CRT sessions, in addition to standard treatment. A repeated
measures design was conducted. Result(s): Eighty participants were recruited. The neuropsychological measures were feasible for evaluating individual
CRT in YP. Significant improvements in set-shifting and central coherence were found, with no main effect between immediate and delayed condition.
Significant interactions were found between the condition, and autism spectrum condition (ASC) and No-ASC subgroup, with significant positive impact
of CRT on set-shifting in the No-ASC subgroup. There was some evidence that for the No-ASC subgroup, CRT was more effective if delivered at the start
of the treatment; and for the ASC subgroup, that CRT was more effective if delivered at the later stage of treatment. Conclusion(s): These findings
suggest that the overall positive effect of CRT in set-shifting and central coherence alongside standard treatment. They also indicate the importance
of screening for the presence of ASC which could require tailored CRT. Copyright © 2021 Eating Disorders Association and John Wiley & Sons Ltd.
European Eating
Disorders Review, 30(1) : 50-60
- Year: 2022
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy
Curzio, O., Billeci, L., Belmonti, V., Colantonio, S., Cotrozzi, L., De-Pasquale, C. F., Morales, M. A., Nali, C., Pascali, M. A., Venturi, F., Tonacci, A., Zannoni, N., Maestro, S.
Studies in psychiatric populations have found a positive effect of
Horticultural therapy (HCT) on reductions in stress levels. The main objective of the present pilot study was to evaluate the impact of the addition
of HCT to conventional clinical treatment (Treatment as Usual, TaU) in a sample of six female adolescents with anorexia nervosa restricting type
(AN-R), as compared to six AN-R patients, matched for sex and age, under TaU only. This is a prospective, non-profit, pilot study on patients with a
previous diagnosis of AN-R and BMI < 16, recruited in 2020 in clinical settings. At enrolment (T0) and after treatment completion (TF), psychiatric
assessment was performed. At T0, all the patients underwent: baseline electrocardiogram acquisition with a wearable chest strap for recording heart
rate and its variability; skin conductance registration and thermal mapping of the individual's face. An olfactory identification test was
administered both to evaluate the olfactory sensoriality and to assess the induced stress. One-way analyses of variance (ANOVAs) were performed to
analyze modifications in clinical and physiological variables, considering time (T0, TF) as a within-subjects factor and group (experimental vs.
control) as between-subjects factors. When the ANOVA was significant, post hoc analysis was performed by Paired Sample T-tests. Only in the HCT
group, stress response levels, as measured by the biological parameters, improved over time. The body uneasiness level and the affective problem
measures displayed a significant improvement in the HCT subjects. HCT seems to have a positive influence on stress levels in AN-R. Copyright © 2022
by the authors.
Nutrients, 14(24) (no pagination) :
- Year: 2022
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Ansari, S., Asgari, P., Makvandi, B., Heidari, A., Khorrami, N. S.
Background: Anorexia nervosa is a
refusal to maintain the lowest normal body weight, a severe fear of weight gain, and a significant impairment in body image. Objective(s): The
purpose of this study was to evaluate the impact of cognitive behavior therapy on anorexic patients' psychological distress, body image, and eating
disorder beliefs in anorexic patients. Method(s): This was a semi-experimental study based on a pre-test, post-test, and follow-up design with a
control group. The statistical population of the study included patients with eating disorders who were referred to obesity treatment centers in
Tehran, from whom 30 patients were selected using a purposeful sampling method and were randomly assigned to two groups of experiment and control.
Before the intervention, the Eating Disorder Beliefs Questionnaire was used as a pre-test. After then, the experimental group received the
intervention (no intervention was carried out on the control group). The Body Image Concern Inventory, Psychological Distress Questionnaire, and
Eating Disorder Beliefs Questionnaire were used to gather the data. Multivariate covariance analysis was used to examine the data using the SPSS
program (Version 22). Result(s): According to the findings, cognitive behavior therapy helped anorexic patients with their psychological distress
(P<0.001), body image issues (P<0.001), and eating disorder beliefs (P<0.001), respectively. Conclusion(s): It is evident that cognitive behavior
therapy helps anorexic patients by lowering psychological discomfort, issues with their bodies, and ideas about eating disorders. Copyright © 2022,
Razavi International Journal of Medicine.
Razavi International Journal of
Medicine, 10(3) :
- Year: 2022
- Problem: Anorexia Nervosa
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Agne, A., Quesnel, D. A., Larumbe-Zabala, E., Olmedillas, H., Graell-Berna, M., Perez-Ruiz, M., Fernandez-Del-Valle,
M.
BACKGROUND: and purpose: Exercise has not typically been used as an adjunct in treatment of anorexia nervosa (AN). This study aimed to
examine the effects of progressive resistance exercise (PREx) on perceived quality of life (QoL) and body composition in adolescents with AN.
MATERIALS AND METHODS: Forty-four adolescents diagnosed with AN were randomly allocated to either PREx or control groups after hospitalization. The
PREx group completed twenty-four PREx sessions over two months including three sets of 8-10 repetitions of eight whole-body exercises at a moderate
intensity. QoL and body composition were evaluated at baseline and after two months using Health Questionnaire Short-Form 36 (SF-36) and
anthropometric measurements. RESULT(S): At completion, forty-one participants (n = 19 PREx, and n = 22 controls) with mean age of 12.78 +/- 0.88
years and mean body mass index of 18 +/- 2.2 kg/m2 were analyzed. Significant group x time effects were found on SF-36 role physical (RP) scores.
Significant improvements with large effect sizes (d > 0.72) were found in RP, and arm circumferences in the PREx group. Spearman association analyses
between percent change in anthropometric variables and change in QoL scores showed positive associations with moderate-to-large effect sizes in the
PREx group among the following variables: mid-thigh-circumference, physical functioning (PF) and general health (GH); calf-circumference relaxed and
body pain; biceps skinfold and GH scores; triceps-skinfold, and role physical (RP) and vitality (VT); supraspinale-skinfold and RP and VT; mid-
thigh-skinfold and calf-skinfold and VT. CONCLUSION(S): PREx after hospitalization enables modest positive changes in QoL associated to
anthropometric changes in adolescents with AN without adverse effects on weight recovery. Copyright © 2022 Elsevier Ltd. All rights reserved.
, 48 : 101576
- Year: 2022
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Zaja, O., Fiolic, M., Cuk, M. C., Tiljak, M. K.
Background: Anorexia nervosa (AN) carries the risk of potentially irreversible medical
complications, especially in children and adolescents. Constipation is frequent and difficult to manage. Due to the symptoms it causes, constipation
can further compromise nutritional rehabilitation. Objective(s): To investigate the role of probiotics (Lactobacillus reuteri DSM 17938) in children
and adolescent with AN. Design, setting and participants: Randomized, double blind, placebo controlled study in 31 female pediatric AN patients with
constipation, referred to nutritional therapy in Pediatric Gastroenterology Department, Sestre milosrdnice University Hospital Centre in Zagreb.
Method(s): At hospitalization, patients were randomly assigned into two groups; one taking L. reuteri, and other placebo for 3 months, along with the
conventional nutritional rehabilitation. Patients were followed 3 months after stopping the treatment. The primary outcome was relief of
constipation, assessed after 3 months, while secondary outcomes were normalization of body weight, stool frequency and consistency, relief of
dyspepsia, weight gain and recovery of malnutrition regarding bone density and vitamin D3 levels. Result(s): The study showed statistically
significant difference between the two groups considering the stool frequency (6.4 vs. 4.2 stools/week; p < 0.05) and normalization of body weight
(93 vs. 63%; p = 0.04) after 6 months, but no significant effect on the rate of relief of constipation (87 vs. 64%; p = 0.22) at 3 months. In the L.
reuteri group, the normalization of BMD was achieved in 8/15, whereas in the placebo group, in 3/16 patients. However, there was no statistically
significant difference compared to the placebo group regarding the BMD recovery as well as the normalization of D3 levels (p = 0.056). Conclusion(s):
Probiotics may serve as simple and safe adjuvant therapy of constipation in childhood AN and contribute to faster nutritional recovery. Although a
statistically significant difference between the two group in relief of constipation could not be shown after 3 months, a benefit from probiotics
could be in increasing stool frequency and nutritional recovery in childhood AN after six months. Registered under ClinicalTrials.gov Identifier no.
NCT02004288. Copyright © 2021 European Society for Clinical Nutrition and Metabolism
Clinical Nutrition ESPEN, 46 : 47-
53
- Year: 2021
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Wang, C., Xiao,
R.
Objective: To investigate the efficacy
and feasibility of music and art therapy combined with cognitive behavioral therapy (CBT) in the treatment of adolescent patients with anorexia.
Method(s): A total of 77 patients admitted to our hospital from August 2018 to October 2019 were recruited as the study cohort, but 11 patients who
dropped out of the study were excluded. The data from the 66 patients were collected for a statistical analysis. There were 31 patients in the
control group and 35 patients in the treatment group. After the intervention, the body weight, cognitive and behavioral ability, emotional reaction,
and treatment satisfaction changes were compared and analyzed in the two groups. Result(s): The treatment group had a significantly lower dropout
rate and higher overall treatment satisfaction than the control group. After the intervention, the body weights, body mass indexes (BMI), and
abdominal subcutaneous fat thicknesses were increased in the two groups, and the increase in the treatment group was significantly higher than it was
in the control group (P < 0.05). After the intervention, the Eating Disorder Examination Questionnaire 6.0 (EDE-Q-6.0), the Beck Anxiety Inventory
(BAI), and the Beck Depression Inventory (BDI) scores were significantly lower than they were before the intervention, and the scores in the
treatment group were significantly lower than they were in the control group (P < 0.05). Conclusion(s): Music and art therapy combined with CBT can
effectively improve patients' recognition and acceptance of the treatment, the therapeutic effects, and the adverse emotional reactions (e.g.,
depression and anxiety), and help patients establish the correct cognition regarding food, body shape, and weight. Copyright © 2021 E-Century
Publishing Corporation. All rights reserved.
American Journal of Translational Research, 13(6) : 6534-6542
- Year: 2021
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Creative expression: music, dance, drama, art
Solmi, M., Wade, T.
D., Byrne, S., Del-Giovane, C., Fairburn, C. G., Ostinelli, E. G., De-Crescenzo, F., Johnson, C., Schmidt, U., Treasure, J., Favaro,
A., Zipfel, S., Cipriani, A.
BACKGROUND: No consistent first-option psychological interventions for adult outpatients with anorexia nervosa emerges from
guidelines. We aimed to compare stand-alone psychological interventions for adult outpatients with anorexia nervosa with a specific focus on body-
mass index, eating disorder symptoms, and all-cause dropout rate.\rMETHODS: In this systematic review and network meta-analysis, we assessed
randomised controlled trials about stand-alone pharmacological or non-pharmacological treatments of adult outpatients with anorexia nervosa, defined
according to standardised criteria, with data for at least two timepoints relating to either body-mass index or global eating disorder
psychopathology. We searched Cochrane CENTRAL, CINAHL, MEDLINE, and PsychINFO for published and unpublished literature from inception until March 20,
2020. The primary outcomes were the change in body mass index and clinical symptoms, and the secondary outcome was all-cause dropout rate, which were
all assessed for treatment as usual, cognitive behavioural therapy (CBT), Maudsley anorexia treatment for adults, family-based treatment,
psychodynamic-oriented psychotherapies, a form of CBT targeting compulsive exercise, and cognitive remediation therapy followed by CBT. Global and
local inconsistencies for the network meta-analysis were measured, and CINeMA was used to assess the confidence in evidence for primary outcomes. The
protocol is registered in PROSPERO (CRD42017064429).\rFINDINGS: Of 14 003 studies assessed for their title and abstract, 16 (0.1%) randomised
controlled trials for psychological treatments were included in the systematic review, of which 13 (0.1%) contributed to the network meta-analysis,
with 1047 patients in total (of whom 1020 [97.4%] were female). None of the interventions outperformed treatment as usual in our primary outcomes,
but the all-cause dropout rate was lower for CBT than for psychodynamic-oriented psychotherapies (OR 0.54, 95% CI 0.31-0.93). Heterogeneity or
inconsistency emerged only for a few comparisons. Confidence in the evidence was low to very low.\rINTERPRETATION: Compared with treatment as usual,
specific psychological treatments for adult outpatients with anorexia nervosa can be associated with modest improvements in terms of clinical course
and quality of life, but no reliable evidence supports clear superiority or inferiority of the specific treatments that are recommended by clinical
guidelines internationally. Our analysis is based on the best data from existing clinical studies, but these findings should not be seen as
definitive or universally applicable. There is an urgent need to fund new research to develop and improve therapies for adults with anorexia nervosa.
Meanwhile, to better understand the effects of available treatments, participant-level data should be made freely accessible to researchers to
eventually identify whether specific subgroups of patients are more likely to respond to specific treatments.\rFUNDING: Flinders University, National
Institute for Health Research Oxford Health Biomedical Research Centre.
The Lancet. Psychiatry, 8(3) : 215-
224
- Year: 2021
- Problem: Anorexia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Singhal, V., Bose, A., Slattery, M., Haines, M. S., Goldstein, M. A., Gupta, N., Brigham, K. S., Ebrahimi, S., Javaras, K. N., Bouxsein, M. L., Eddy, K.
T., Miller,
K. K., Schoenfeld, D., Klibanski, A., Misra, M.
CONTEXT: Anorexia nervosa (AN) is prevalent in adolescent girls and is
associated with bone impairment driven by hormonal alterations in nutritional deficiency. OBJECTIVE(S): To assess the impact of estrogen replacement
with and without recombinant human insulin-like growth factor-1 (rhIGF-1) administration on bone outcomes. DESIGN: Double-blind, randomized,
placebo-controlled 12-month longitudinal study. PARTICIPANTS: Seventy-five adolescent and young adult women with AN age 14 to 22 years. Thirty-three
participants completed the study. INTERVENTION: Transdermal 17-beta estradiol 0.1 mg/day with (i) 30 mcg/kg/dose of rhIGF-1 administered
subcutaneously twice daily (AN-IGF-1+) or (ii) placebo (AN-IGF-1-). The dose of rhIGF-1 was adjusted to maintain levels in the upper half of the
normal pubertal range. MAIN OUTCOME MEASURES: Bone turnover markers and bone density, geometry, microarchitecture, and strength estimates. RESULT(S):
Over 12 months, lumbar areal bone mineral density increased in AN-IGF-1- compared to AN-IGF-1+ (P = 0.004). AN-IGF-1+ demonstrated no improvement in
areal BMD in the setting of variable compliance to estrogen treatment. Groups did not differ for 12-month changes in bone geometry,
microarchitecture, volumetric bone mineral density (vBMD), or strength (and results did not change after controlling for weight changes over 12
months). Both groups had increases in radial cortical area and vBMD, and tibia cortical vBMD over 12 months. Levels of a bone resorption marker
decreased in AN-IGF-1- (P = 0.042), while parathyroid hormone increased in AN-IGF-1+ (P = 0.019). AN-IGF-1- experienced irregular menses more
frequently than did AN-IGF-1+, but incidence of all other adverse events did not differ between groups. CONCLUSION(S): We found no additive benefit
of rhIGF-1 administration for 12 months over transdermal estrogen replacement alone in this cohort of young women with AN. Copyright © The Author(s)
2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail:
[email protected].
The Journal of clinical endocrinology and metabolism, 106(7) : 2021-
2035
- Year: 2021
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Porras-Garcia, B., Ferrer-Garcia, M., Serrano-Troncoso, E., Carulla-Roig, M., Soto-Usera, P., Miquel-Nabau, H., Olivares, L. F. D. C., Marnet-Fiol, R., Santos-Carrasco, I. L. M., Borszewski, B., Diaz-Marsa, M., Sanchez-Diaz,
I., Fernandez-Aranda, F., Gutierrez-Maldonado,
J.
In vivo body exposure therapy is considered an effective
and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have
notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest
developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront
their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure
therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW,
BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received
treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the
intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group.
Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group
showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of
exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront
their core fears (i.e., food-or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image. Copyright
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Journal of Clinical Medicine, 10(4) : 1-
23
- Year: 2021
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Technology, interventions delivered using technology (e.g. online, SMS)
Philipp, J., Franta, C., Zeiler, M., Truttmann, S., Wittek,
T., Imgart, H., Zanko, A., Auer-Welsbach, E., Mairhofer, D., Mitterer,
M., Laczkovics, C., Schofbeck, G., Jilka, E., Egermann, W. B., Treasure, J., Karwautz, A. F. K., Wagner, G.
Skills trainings for
caregivers of patients with anorexia nervosa (AN) have been proven to be effective in improving caregiver skills and reducing caregivers'
psychopathology. The effects on patients, especially adolescents, are largely unknown. The aim of this study was to evaluate the effectiveness of a
caregivers' skills training program (Supporting Carers of Children and Adolescents with Eating Disorders in Austria, SUCCEAT, workshop or online
version) on adolescents with AN delivered as workshops (WS) or online (ONL). Outcomes are Body-Mass-Index (BMI) percentile, eating psychopathology
(Eating Disorder Examination, EDE), attitudinal and behavioural dimensions of eating disorders (Eating Disorder Inventory-2), motivation to change
(AN Stages of Change Questionnaire), emotional and behavioural problems (Youth Self-Report) and quality of life (KINDL). All outcome variables
significantly improved across both SUCCEAT groups (WS and ONL) and were sustained at 12-month follow-up. The online and workshop delivery of SUCCEAT
were equally effective. Most effect sizes were in the medium-to-high range. Full or partial remission was observed in 72% (WS) and 87% (ONL) of
patients. Caregiver skills trainings, either delivered as workshops or online modules, are highly recommended to complement treatment as usual.
International Journal of Environmental Research & Public Health [Electronic
Resource], 18(9) : 27
- Year: 2021
- Problem: Anorexia Nervosa
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Skills training, Other Psychological Interventions, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Parker, Elizabeth Kumiko, Flood, Victoria, Halaki, Mark, Wearne, Christine, Anderson, Gail, Gomes, Linette, Clarke,
Simon, Wilson, Frances, Russell, Janice, Frig, Elizabeth, Kohn, Michael
Background: The nutritional
rehabilitation of malnourished patients hospitalised with anorexia nervosa is essential. The provision of adequate nutrition must occur, while
simultaneously, minimising the risk of refeeding complications, such as electrolyte, metabolic, and organ dysfunction. The aim of this study was to
compare the efficacy and safety of an iso-caloric lower carbohydrate/high fat enteral formula (28% carbohydrate, 56% fat) against a standard enteral
formula (54% carbohydrate, 29% fat). Impact Statement Patients hospitalised with anorexia nervosa require nutrition support as part of their
treatment, whilst refeeding complications are prevented. Of particular concern, is the reintroduction of carbohydrate to malnourished patients, which
has been proposed to cause a surge in insulin levels and disturbance in electrolytes, particularly a decrease in blood phosphate levels. This
double-blinded randomised controlled trial measured the occurrence of low phosphate blood levels and other refeeding complications, in adolescent and
young adult patients hospitalised with anorexia nervosa. These patients were provided either a lower carbohydrate/high fat feed (28% carbohydrate,
56% fat) or a standard enteral feed (54% carbohydrate, 29% fat). Fewer patients in the lower carbohydrate/high fat feed group (5/14) than standard
feed group (9/10) developed a low phosphate level. There was no significant difference in weight gain, number of days to reach medical stability,
occurrence of hypoglycaemia, or hospital length of stay. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Journal of Eating Disorders Vol 9
2021, ArtID 160, 9 :
- Year: 2021
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Dietary advice, dietary change