Vol 16, No 3 (2019)
Review paper
Published online: 2019-07-09
Weight rehabilitation program in anorexia
Psychiatria 2019;16(3):132-138.
Abstract
Anorexia nervosa occurs in 0.3-2.2% of people. It is estimated that mortality in anorexia is around 5-20%. Suicides cause about half of deaths in anorexia, other deaths are a consequence of complications (mainly those of a cardiological nature). Weight rehabilitation is aimed primarily at rebuilding the reserves of the body and motivational work, which in turn will lead to a decision on further therapeutic treatment. Incorrect implementation of nutritional rehabilitation in patients with anorexia may result in re-feeding syndrome (RFS). In this syndrome, in malnourished patients in whom high energy nutrition is included, there are severe electrolyte disturbances, mainly low levels of phosphorus, magnesium and potassium in serum, and metabolic disorders.The Society for the Clinical Nutrition and Metabolism (ESPEN) recommends in the first phase of nutritional rehabilitation covering the period up to the seventh day from the beginning, supply of 5-10 kcal / kg of the patient's body weight per day. The diet should correspond to the assumptions of the easily digestible diet, in addition to the diet should be supplemented with B vitamins with special regard to thiamine (vitamin B1).
Keywords: anorexiaweight rehabilitationrefeeding syndrome
References
- Międzynarodowa Statystyczna Klasyfikacja Chorób i Problemów Zdrowotnych. Rewizja dziesiąta. Rozdział V: Zaburzenia psychiczne zachowania. Uniwersyteckie Wydawnictwo Medyczne „Vesalius, Kraków 1994.
- Kryteria diagnostyczne zaburzeń psychicznych DSM-5. Wydawnictwo EDRA URBAN & PARTNER 2017.
- Kucharska K, Wilkos E. Zaburzenia odżywiania. In: Jarema M, Wilkos E. ed. Psychiatria. Podręcznik dla studentów medycyny. PZWL, Warszawa 2016: 417.
- Ciborowska A, Rudnicka A. Żywienie zdrowego i chorego człowieka. Wydawnictwo PZWL, Warszawa 2014.
- Westmoreland P, Krantz MJ, Mehler PS. Medical Complications of Anorexia Nervosa and Bulimia. Am J Med. 2016; 129(1): 30–37.
- Katzman DK. Medical complications in adolescents with anorexia nervosa: a review of the literature. Int J Eat Disord. 2005; 37 Suppl: S52–9; discussion S87.
- Shamim T, Golden NH, Arden M, et al. Resolution of vital sign instability: an objective measure of medical stability in anorexia nervosa. J Adolesc Health. 2003; 32(1): 73–77.
- Schocken D, Holloway D, Powers P. Weight loss and the heart. Archives of Internal Medicine. 1989; 149(4): 877.
- Callum A, Lewis L. Diabulimia among adolescents and young adults with Type 1 diabetes. Clinical Nursing Studies. 2014; 2(4): 12 –16.
- Larrañaga A, Docet MF, García-Mayor RV. Disordered eating behaviors in type 1 diabetic patients. World J Diabetes. 2011; 2(11): 189–195.
- ORNSTEIN R, GOLDEN N, JACOBSON M, et al. Hypophosphatemia during nutritional rehabilitation in anorexia nervosa: implications for refeeding and monitoring. Journal of Adolescent Health. 2003; 32(1): 83–88.
- Khan LUR, Ahmed J, Khan S, et al. Refeeding syndrome: a literature review. Gastroenterol Res Pract. 2011; 2011.
- Agarwal R, Knochel JP. Hypophosphatemia and hyperphosphatemia. In: Brenner bM, Knochel JP. ed. The kidney. WB Saunders, Philadelphia 2000: 1107–1071.
- Brooks MJ, Melnik G. The refeeding syndrome: an approach to understanding its complications and preventing its occurrence. Pharmacotherapy. 1995; 15(6): 713–726.
- Weinsier RL, Krumdieck CL. Death resulting from overzealous total parenteral nutrition: the refeeding syndrome revisited. Am J Clin Nutr. 1981; 34(3): 393–399.
- Drozdz L, Veisman N. Zaburzenie odżywiania - jadłowstręt i żarłoczność psychiczna. In: Veisman N. ed. Podstawy żywienia klinicznego. Scientifica, Warszawa 2013: 711–717.
- Crook MA. Refeeding syndrome: problems with definition and management. Nutrition. 2014; 30(11-12): 1448–1455.
- Heymsfield SB, Bethel RA, Ansley JD, et al. Cardiac abnormalities in cachectic patients before and during nutritional repletion. Am Heart J. 1978; 95(5): 584–594.
- Schocken DD, Holloway JD, Powers PS, et al. Heart failure during treatment of anorexia nervosa. Am J Psychiatry. 1982; 139(9): 1167–1170.
- Palla B, Litt IF. Medical complications of eating disorders in adolescents. Pediatrics. 1988; 81(5): 613–623.
- Solomon SM, Kirby DF. The refeeding syndrome: a review. JPEN J Parenter Enteral Nutr. 1990; 14(1): 90–97.
- Rohrer S, Dietrich JW. [Refeeding syndrome: a review of the literature]. Z Gastroenterol. 2014; 52(6): 593–600.
- Ibrahim IB, Hussain AA, Sjögren JM. [The refeeding syndrome in anorexia nervosa]. Ugeskr Laeger. 2018; 180(18).
- Alvin P, Zogheib J, Rey C, et al. Complications graves et mortalité au cours des dysorexies mentales a l’adolescence (a partir de 99 patients hospitalises) . Arch Fr Pediatr. 1993; 50: 755–762.
- Fisher M, Simpser E, Schneider M. Hypophosphatemia secondary to oral refeeding in anorexia nervosa. Int J Eat Disord. 2000; 28(2): 181–187.
- Birmingham CL, Alothman AF, Goldner EM. Anorexia nervosa: refeeding and hypophosphatemia. Int J Eat Disord. 1996; 20(2): 211–213.
- Dudkiewicz A, Grzelak T. Dietoterapia doustna u pacjentów z anoreksją. Psychiatr Psychol Klin. 2016; 16(2): 104–109.
- Jaworski M, Klimkowska K, Różańska K, et al. Rehabilitacja żywieniowa w jadłowstręcie psychicznym: rola i zakres pracy dietetyka w zespole terapeutycznym. Medycyna Ogólna i Nauki o Zdrowiu. 2017 ; 23(2).
- Lewitt A, Brzęczek K, Krupienicz K. Interwencje żywieniowe w leczeniu anoreksji – wskazówki dietetyczne. Endokr. Otyłość Zaburzenia przemiany materii. 2008; 4(3): 128–136.
- Hart S, Abraham S, Luscombe G, et al. Eating disorder management in hospital patients: Current practice among dietitians in Australia. Nutrition & Dietetics. 2008; 65(1): 16–22.
- Rollnick S, Miller WR, Butler CC. Wywiad motywujący w opiece zdrowotnej. Academica Wydawnictwo SWPS, Warszawa 2010.
- Dulmen AMv. Different perspectives of doctor and patient in communication. International Congress Series. 2002; 1241: 243–248.
- Macdonald P, Hibbs R, Corfield F, et al. The use of motivational interviewing in eating disorders: a systematic review. Psychiatry Res. 2012; 200(1): 1–11.
- Pużyński S. Depresje i zaburzenia afektywne. PZWL, Warszawa 2002.
