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From malnutrition to refeeding during anorexia nervosa.

Abstract

Anorexia nervosa is one of the most common forms of malnutrition observed in Western society in individuals without physical diseases, with an average risk of mortality of 20% in a younger population aged between 15 and 25 years. It is characterised by an initial dramatic decrease in food intake that leads to profound depletion in muscle and fat mass. During the course of the disease, the resting energy expenditure decreases proportionally to the loss of lean body mass with a decrease in thyroid hormone secretion. The metabolic adaptation during anorexia nervosa is similar to that observed during starvation with a relative sparing of protein stores. After an initial weight loss, the total energy expenditure is similar to that in normal individuals, with a decrease in resting energy expenditure and an increased energy-related physical activity. At the end stage of wasting, however, physical activity dramatically decreases as well as energy intake. This metabolic adaptation of semi-starvation is impaired during refeeding with an increase in the thermic effect of food and a high risk of refeeding syndrome with severe hypophosphatemia.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Nutrition Clinique, Hôpital Raymond Poincaré, Garches, France. jean-claude.melchior@rpc.ap-hop-paris.fr

    Source

    MeSH

    Anorexia Nervosa
    Body Composition
    Diet Therapy
    Energy Metabolism
    Humans
    Nutrition Disorders

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    10565398

    Citation

    Melchior, J C.. "From Malnutrition to Refeeding During Anorexia Nervosa." Current Opinion in Clinical Nutrition and Metabolic Care, vol. 1, no. 6, 1998, pp. 481-5.
    Melchior JC. From malnutrition to refeeding during anorexia nervosa. Curr Opin Clin Nutr Metab Care. 1998;1(6):481-5.
    Melchior, J. C. (1998). From malnutrition to refeeding during anorexia nervosa. Current Opinion in Clinical Nutrition and Metabolic Care, 1(6), pp. 481-5.
    Melchior JC. From Malnutrition to Refeeding During Anorexia Nervosa. Curr Opin Clin Nutr Metab Care. 1998;1(6):481-5. PubMed PMID: 10565398.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - From malnutrition to refeeding during anorexia nervosa. A1 - Melchior,J C, PY - 1999/11/24/pubmed PY - 1999/11/24/medline PY - 1999/11/24/entrez SP - 481 EP - 5 JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care VL - 1 IS - 6 N2 - Anorexia nervosa is one of the most common forms of malnutrition observed in Western society in individuals without physical diseases, with an average risk of mortality of 20% in a younger population aged between 15 and 25 years. It is characterised by an initial dramatic decrease in food intake that leads to profound depletion in muscle and fat mass. During the course of the disease, the resting energy expenditure decreases proportionally to the loss of lean body mass with a decrease in thyroid hormone secretion. The metabolic adaptation during anorexia nervosa is similar to that observed during starvation with a relative sparing of protein stores. After an initial weight loss, the total energy expenditure is similar to that in normal individuals, with a decrease in resting energy expenditure and an increased energy-related physical activity. At the end stage of wasting, however, physical activity dramatically decreases as well as energy intake. This metabolic adaptation of semi-starvation is impaired during refeeding with an increase in the thermic effect of food and a high risk of refeeding syndrome with severe hypophosphatemia. SN - 1363-1950 UR - https://www.unboundmedicine.com/medline/citation/10565398/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=10565398 DB - PRIME DP - Unbound Medicine ER -