The treatment of eating disorders requires the expertise of a multidisciplinary team. This case presents the psychologic and physiologic challenges observed in managing these patients. Attention must be directed toward the use of techniques to obtain a commitment from patients to meet a therapeutic goal. Care must be taken to avoid overaggressive feeding of patients with eating disorders to avoid the refeeding syndrome.
Get full access to this article
View all access options for this article.
References
1.
Reiff Dan , Lampson K.Eating disorders: nutrition therapy in the recovery process. Rockville, MD: Aspen Publishers, 1992; 99-100.
2.
American Dietetic Association.Position of the American Dietetic Association: nutrition intervention in the treatment of anorexia nervosa and bulimia nervosa. J Am Diet Assoc1988;88:68-9.
3.
American Psychiatric Association.Practice guideline for eating disorders . Am J Psychiatry1993;150:212-28.
4.
Drewnowski A. , Stanley G.Concerning the use of weight tables to categorize patients with eating disorders. Int J Eating Disord1987;6:639-46.
5.
Krahn D., Rock C., Dechert R., et al. Changes in resting energy expenditure and body composition in anorexia nervosa patients during refeeding. J Am Diet Assoc1993;93:434-8.
6.
Solomon SM, Kirby DFThe refeeding syndrome: a review. JPEN1990 ;14:90-7.
7.
Havala T., Shronts E.Managing the complications associated with refeeding. NCP1990;5:23-9.
8.
Devlin M., Walsh B., Kral J., et al. Metabolic abnormalities in bulimia nervosa. Arch Gen Psychiatry1990;47:144-8.
9.
Gwirtsman H. , Kaye W., Obarzanck E., et al. Decreased caloric intake in normal-weight patients with bulimia: comparison with female volunteers . Am J Clin Nutr1989;49:86-92.
10.
Kaye W., Hansen D.Caloric utilization necessary for weight gain and weight maintenance in the eating disorders. National Anorexic Aid Society Newsletter1989;Jan-March:3-4.
11.
Kaye W., Gwirtsman H., George T., et al. Caloric consumption and activity levels after weight recovery in anorexia nervosa: a prolonged delay in normalization. Int J Eating Disord1986;5:489-502.
12.
Sedlet K., Ireton-Jones C.Energy expenditure and the abnormal eating pattern of a bulimic: a case report . J Am Diet Assoc1989;89:74-6.
13.
Altemus M., Hetherington M., Flood M., et al. Decrease in resting metabolic rate during a abstinence from bulimic behavior. Am J Psychiatry1991;148:1071-2.
14.
Oppenheimer R., Howells K., Palmer R., et al. Adverse sexual experience in childhood and clinical eating disorders: a preliminary description . J Psychiatry1985;19:357-61.
15.
Waller G.Sexual abuse as a factor in eating disorders. Br J Psychiatry1991;159:664-71.
16.
Winston D.Treatment of severe malnutrition in anorexia nervosa with enteral tube feedings . Nutr Supp Serv1987; (7)6:24-26.
