European eating disorders review : the journal of the Eating Disorders Association · 2025
High-Caloric Realimentation and Mental and Physical Well-Being in Patients With Extreme Anorexia Nervosa. A Prospective Study.
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Voderholzer Ulrich, Silbernagl Juliane, Haas Verena, Cuntz Ulrich, Naab Silke, Quadflieg Norbert
Аннотация
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: In 46 patients (mean age 27.57 years, 2 males, 44 females), the body mass index increased from 12.6 (SD 1.1) at baseline to 14.4 (SD 1.0) kg/m2 (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.
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: In 46 patients (mean age 27.57 years, 2 males, 44 females), the body mass index increased from 12.6 (SD 1.1) at baseline to 14.4 (SD 1.0) kg/m2 (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.