Treatment for eating disorders is typically protracted and is often characterized by a waxing and waning course with one or more periods of relapse.
There are potential complications of treatment that make careful monitoring essential.
- Strober M., Freeman R., and Morrell W. The Long-Term, Course of Severe Anorexia Nervosa in Adolescents: Survival Analysis of Recovery, Relapse, and Outcome Predictors Over 10-15 Years in a Prospective Study. International Journal of Eating Disorders. 1997; 22:339-60.
- "The course of anorexia nervosa is protracted" 76% of their sample, followed for 10-15 years after initial admission, eventually met criteria for full recovery, but time to recovery ranged from 57-74 months. An additional 10% met criteria for partial recovery.
- "The course of anorexia nervosa is protracted" 76% of their sample, followed for 10-15 years after initial admission, eventually met criteria for full recovery, but time to recovery ranged from 57-74 months. An additional 10% met criteria for partial recovery.
- Garfinkel, PE Eating Disorders. In H.I. Kapper, F. (2000). The Changing epidemiology of hospitalized eating disorder patients. Paper presented at Academy of Eating Disorders, NY, May 4-7, 2000.
- Treatment is effective! Of those with anorexia nervosa followed 5-10 years, 50% of the sample had recovered, 25% improved with some residual symptoms, and 25% remain ill or die.
- Treatment is effective! Of those with anorexia nervosa followed 5-10 years, 50% of the sample had recovered, 25% improved with some residual symptoms, and 25% remain ill or die.
- Society for Adolescent Medicine. Eating Disorders in Adolescents: Position
Paper of the Society for Adolescent Medicine. J Adolescent Health. 1995; 16:476-480.
- "Lack of care or insufficient treatment can result in chronicity, social or psychiatric morbidity, and even death."
- "Lack of care or insufficient treatment can result in chronicity, social or psychiatric morbidity, and even death."
- Fichter, M.M and Quadflieg, N. Six-Year Course of Bulimia Nervosa. International Journal of Eating Disorders. 1997; 22:361-84.
- The course of recovery is uneven, with a decline during the 2 years after intensive inpatient treatment, then later improvement and stabilization.
- The course of recovery is uneven, with a decline during the 2 years after intensive inpatient treatment, then later improvement and stabilization.
- Ornstein RM, Golden NH, Jacobson MS. et al. Hypophosphatemia during Nutritional Rehabilitation in Anorexia Nervosa: Implications for Re-feeding and Monitoring. J Adolescent Health. 2003; 32:83-88.
- "The re-feeding syndrome involves a host of fluid and electrolyte derangements and leads to a constellation of cardiac, neurologic, and hematologic complications, including sudden, unexpected death, that occur in the weeks after the initiation of nutritional rehabilitation... many case reports describe morbidity, as well as mortality, with too vigorous initial re-feeding The findings of this retrospective study show that over one-quarter of adolescents with AN hospitalized for malnutrition experience mild to moderate hypophosphatemia. Those patients most severely malnourished are at the greatest risk for developing moderate hypophosphatemia. With close monitoring and supplementation of phosphorus when needed, it is possible to avoid the complications of the re-feeding syndrome."
- "The re-feeding syndrome involves a host of fluid and electrolyte derangements and leads to a constellation of cardiac, neurologic, and hematologic complications, including sudden, unexpected death, that occur in the weeks after the initiation of nutritional rehabilitation... many case reports describe morbidity, as well as mortality, with too vigorous initial re-feeding The findings of this retrospective study show that over one-quarter of adolescents with AN hospitalized for malnutrition experience mild to moderate hypophosphatemia. Those patients most severely malnourished are at the greatest risk for developing moderate hypophosphatemia. With close monitoring and supplementation of phosphorus when needed, it is possible to avoid the complications of the re-feeding syndrome."
- American Psychiatric Association. Treatment Recommendations for Patients with Eating Disorders. Am J Psychiatry. 2006; 163(7 suppl):1-54.
- "Excessively rapid re-feeding and nasogastric or parenteral feeding may be particularly dangerous because of their potential for inducing severe fluid retention, cardiac arrhythmias, cardiac failure, respiratory insufficiency, delirium, seizures, rhabdomyolysis, red cell dysfunction, and even sudden death, especially in the lowest weight patients."
- "Patients’ serum levels of phosphorus, magnesium, potassium, and calcium should be determined daily for the first 5 days of re-feeding and every other day for several weeks thereafter, and electrocardiograms should be performed as indicated.
- "Excessively rapid re-feeding and nasogastric or parenteral feeding may be particularly dangerous because of their potential for inducing severe fluid retention, cardiac arrhythmias, cardiac failure, respiratory insufficiency, delirium, seizures, rhabdomyolysis, red cell dysfunction, and even sudden death, especially in the lowest weight patients."
- American Dietetic Association. Position of the American Dietetic Association: Nutritional Intervention in the Treatment of Anorexia Nervosa, Bulimia Nervosa, and Other Eating Disorders. Journal of the Am Dietetic Association. 2006; 106:2073-2082[s3]
- Nutritional treatment goals, typically referred to as nutritional rehabilitation, relate to restoration of healthful weight and normalization of eating patterns.... Individuals with acute medical needs may have shorter hospitalizations because of economic restraints with health insurance limitations and consequently may leave the hospital without progress toward medical nutrition therapy goals."
- Nutritional treatment goals, typically referred to as nutritional rehabilitation, relate to restoration of healthful weight and normalization of eating patterns.... Individuals with acute medical needs may have shorter hospitalizations because of economic restraints with health insurance limitations and consequently may leave the hospital without progress toward medical nutrition therapy goals."