How To Avoid Refeeding Syndrome When Treating Anorexia Nervosa

Anorexia nervosa is a serious condition characterized by a person's fear of gaining weight. Once thought to be merely behavioral or a matter of willpower, researchers have discovered that this multifactorial condition is extremely complex. Issues may stem from genetics, brain chemistry, other conditions (such as Sensory Deprivation Disorder or Obsessive-Compulsive Disorder), environmental, emotional, and psychological problems. Treatment for anorexia nervosa should be multi-faceted and monitored closely by health care experts.

One big hurdle to get over when someone is recovering from anorexia is learning to eat normally again. This process is known as nutritional rehabilitation or refeeding. Unfortunately, it's not as easy as willing yourself to clear your plate. In fact, that could be dangerous.

Refeeding Syndrome

Refeeding syndrome is a complication that can arise when anorexia patients are beginning to eat again. The potential danger of refeeding syndrome should be taken seriously, as it can be fatal.

A healthy body breaks down food and converts it to fuel for all the body's cells, tissue, and organs. When your body is doing this, it's in an anabolic state.

When deprived of food, the body begins to shut down and store energy. When it has little energy left, it starts feeding on itself—it breaks down its own muscles to convert to energy. When the body is doing this, it's known as a catabolic state.

When the body is given food again, it shifts back into an anabolic state. This shift can cause a wave of metabolic changes. The body gets so excited that nutrients are coming in that it rushes to do some damage control. It begins shifting nutrients, salts, and fluids from the bloodstream to build cells and repair the tissue damage.

This shift results in the blood being robbed of essential nutrients and electrolytes (charged salts). The level of nutrients and electrolytes in the blood can go so low that it can have severe health risks: heart arrhythmia, heart failure, and respiratory failure. Any of these conditions can be fatal.

Avoiding Refeeding Syndrome

The best way to avoid refeeding syndrome is to remember that too much too soon is not a good alternative to starvation. The more underweight and malnourished a person is, the more carefully refeeding needs to be approached. Calories should be introduced in small quantities and gradually increased.

Health care professionals should closely monitor people at risk for refeeding syndrome. In the first few days, they should have their vital statistics, heart, and blood nutrient levels monitored every day. Over the next few weeks, if they're doing well, they should be monitored every other day.

Anorexia patients should not attempt self-care. Even if you feel ready to start on the road to recovery, get help from your health care provider.

Sources: Eating Disorder Hope, Very Well Mind

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