Enteral nutrition in hospitalized patients with severe anorexia nervosa: short- and medium-term outcomes

Objective: To evaluate short- and medium-term outcomes of enteral nutrition in patients with anorexia nervosa (AN) hospitalized for medical complications. Design: Observational study. Patients/methods: Subjects were 61 AN patients, consecutively hospitalized for medical complications. Staged oral refeeding was the first choice of treatment, and enteral nutrition was resorted to when oral nutrition failed. Clinical and biochemical parameters were evaluated on admission, at discharge, and 6 months after discharge. Results: Forty-two patients received staged oral refeeding, while 19 patients required nasogastric feed- ing. Tube-fed patients had a mean duration of illness of 101.4 ± 84.9 months. Their body mass index (BMI) was 12.8 ± 1.7 on admission, 14.2 ± 1.4 at discharge, 16.6 ± 1.9 at 6 months after discharge. Mean duration of enteral nutrition was 19.3 ± 13.1 days. No major complications attributable to naso- gastric feeding were noticed and patients' compliance was satisfactory. Multivariate analysis revealed that BMI on admission and duration of illness, but not the type of treatment (oral/enteral), were predic- tors of weight gain at 6-month follow-up. Conclusion: When oral nutrition fails, enteral nutrition represents a safe and effective intervention in AN patients with life-threatening medical complications. (Nutritional Therapy & Metabolism 2008; 26: 129-36)