Newer approaches to acute nutritional rehabilitation for patients with anorexia nervosa

Refeeding in the hospital is recommended for patients with malnutrition and medical instability secondary to restrictive eating disorders. For decades, the standard approach to refeeding was lower calorie diets, aimed at minimizing risk for the refeeding syndrome. Emerging data indicate that this approach may be too conservative, and that higher calorie refeeding is feasible. This approach is being rapidly translated into practice with wide variability in routes of delivery and electrolyte correction. This article reviews the current research on refeeding, with particular attention to gaps in the evidence that must be filled before new refeeding recommendations can be developed.