Living With Food: The Science Supporting Eating Disorder Treatment

The Academy for Eating Disorders (AED) has developed an important new brochure that describes the early recognition and medical risk management of eating disorders. This effort represents the most developed resource for professionals, therapists, patients, and families. The brochure from the AED website should be reviewed by everyone in the eating disorder field. Over the next few weeks we would like to review some of the high points of this new document. We are pleased that CCED was able to participate with the AED in the creation of this brochure. Some of the language below is taken directly from the AED brochure. Our thanks to them.

 

One of the most deadly aspects of eating disorders is refeeding syndrome. Refeeding syndrome describes an imbalance of electrolytes and fluid shifts that can occur when a malnourished individual begins to eat normally. This is a serious consequence and can result in multiple physical issues related to fluid shifts and electrolyte imbalance. In some cases it can cause death. The risk factors for refeeding syndrome include vary rapid weight loss or profound weight loss. It is not necessary to be at a low weight to be at risk for refeeding syndrome. For instance, people who have had significant weight loss from surgical procedures that have resulted in a month or more of inability to eat may be at risk for refeeding syndrome, regardless of weight. An abnormal cardiac presentation and low phosphorus levels represent increased risk for refeeding syndrome. This is one reason why all patients in eating disorder programs must have cardiograms, and their phosphorus and magnesium levels checked. In order to avoid refeeding syndrome we begin the refeeding process at a low level of energy replacement. We attempt to refeed slowly, adjusting for the age, nutritional status, and developmental stage of the patient. We also need to closely monitor electrolytes, cardiac status, and mental status during the refeeding process. For those at home, things to look for are: swelling of the legs or feet, difficulty breathing, and/or altered mental status. If you are refeeding and notice any of these issues, immediately contact your health care provider.

 

At CCED we monitor all of these issues very closely. For anyone who is being refed we require visits to primary care or specialty physicians, ongoing lab workups, and, if necessary, monitoring at CCED for refeeding syndrome on a daily basis. For more information on refeeding please visit the AED website.

 

 

Should you have any questions or comments regarding this post please email blog@eatingdisorderscleveland.org.