Work

High‐Caloric Realimentation and Mental and Physical Well‐Being in Patients With Extreme Anorexia Nervosa. A Prospective Study

Year: 2025

Type: article

Abstract: OBJECTIVE: While high caloric realimentation (HCR) is increasingly recommended for quick weight restoration of patients with anorexia nervosa (AN), the development of AN-specific psychopathology and somatic symptoms during HCR have so far insufficiently been studied. METHOD: Patients hospitalised for the treatment of AN received oral realimentation starting with 2000 kcal under close medical monitoring and a substitution regimen. Weekly over the initial 6 weeks of treatment, assessments included body weight, drive for thinnesss, body dissatisfaction, depression, and somatic symptoms. RESULTS: (p < 0.001) at week 6 (d = 2.57). Drive for thinnesss did not change (28.9 [SD 10.2] to 27.7 [SD 10.8]; p = 0.102), while body dissatisfaction increased slightly from 37.3 (SD 7.8) to 39.1 (SD 9.2; p = 0.019; d = 0.41). Depression and somatic symptoms decreased significantly (p < 0.001) with large effect sizes (d = 1.09, d = 0.90, respectively). No case of refeeding syndrome was encountered. DISCUSSION: HCR was medically safe and associated with a decrease in depressive and somatic symptoms at only slight increase in body dissatisfaction. Fast realimentation brings patients with extreme AN quickly out of a weight range dangerous to their health.

Source: European Eating Disorders Review

DOI: 10.1002/erv.70074

Authors: Ulrich Voderholzer, Juliane Silbernagl, Verena Haas, Ulrich Cuntz, Silke Naab, Norbert Quadflieg