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A Retrospective Analysis of Refeeding Outcomes Over 5-years in a Specialist Adolescent Eating Disorder Centre in the UK

Cliona Brennan*, Simon Chapman and Sarah Illingworth

Background: Refeeding syndrome (RS) is a serious clinical syndrome, its early identification is key to safe management of adolescent anorexia nervosa. The aim of this study was to evaluate existing practices in a highly specialist centre for eating disorders and compare refeeding management, nutritional, and clinical outcomes in cases admitted to a medical stabilisation unit with those managed in outpatient care. Methods: Retrospective analysis of electronic case records of 59 adolescent patients at high risk of developing refeeding syndrome and treated for anorexia nervosa by a specialist eating disorder centre in London over a 5-year period. Statistical analysis compared refeeding methods used in this population to establish if there were differences in refeeding methods used between the inpatient and outpatient groups. Results: The inpatient group (n=19) had significantly lower baseline energy intakes, prior to assessment (374 kcal/d ± 205 compared with 621 kcal/d ± 348, p=0.001) and higher rates of weight loss at leading up to assessment (0.86 kg/week ± 0.7 compared with 0.38 kg/week ± 0.7, p=0.003), than the outpatient group (n=40). Incidence of RS symptoms did not differ significantly between groups. Conclusions: These findings support recent evidence that advocates a less conservative refeeding approach for moderately malnourished adolescents with AN and a review of current national guidance.