Research conducted at Curtin University has identified that an inpatient treatment methodology can substantially aid adults with eating disorders, not only in enhancing their physical health but also their psychological well-being. This method, known as ‘High-energy refeeding,’ which is typically employed to rehabilitate malnourished adolescents with anorexia nervosa, involves a rapid escalation of caloric intake over a short period to bolster nutritional health quickly. There was initial scepticism regarding applying this approach to adults with the same condition, but the recent findings suggest that such concerns may be unwarranted.
In a study spearheaded by the School of Population Health at Curtin, 97 voluntary hospital inpatients, split between 55 adults and 42 adolescents, all suffering from eating disorders, predominantly anorexia nervosa, underwent treatment using the high-energy refeeding protocol. The outcome was encouraging, showing that adults and adolescents exhibited similar positive responses, marked by notable weight gain and improved psychological health assessments. Fiona Salter, a Master’s student and lead researcher, had highlighted concerns that adult patients might be more susceptible to refeeding syndrome — a potentially fatal condition arising from a sudden reintroduction of nutrition to severely malnourished individuals, causing drastic shifts in body fluids and electrolytes.
Despite worries about the greater frequency of mental health issues in adults potentially complicating their medical care, the study recorded just one adult unable to tolerate the high-energy regimen due to oedema, where excess fluid accumulates in body tissues. Dr Emily Jeffery, a co-author of the study, elaborated that these findings affirm that high-energy refeeding can be safely administered to adults who are mild to moderately malnourished, delivering substantial nutritional and psychological benefits. However, she cautioned that the approach might need to be adjusted for severely malnourished adults to prevent complications.
The psychological improvements noted in adult patients were particularly significant, underscoring the critical role of psychological well-being in the treatment regime. Salter pointed out that while the physical restoration of nutritional health can be achieved relatively quickly, the psychological recovery from an eating disorder is a more extended process, often taking months or years. She emphasized the importance of maintaining these gains after discharge to support long-term psychological recovery.
Looking forward, Salter indicated that subsequent research would focus on the effectiveness of high-energy refeeding in less structured environments, such as intensive treatment day programs. The aim is to determine whether similar positive outcomes can be maintained when patient meals are only partially supervised, testing the adaptability of the high-energy protocol outside the strictly controlled hospital setting. This exploration will help in understanding how to extend best the benefits of this treatment approach to broader and potentially less controlled real-world settings.
More information: Fiona Salter et al, A prospective observational study examining weight and psychosocial change in adolescent and adult eating disorder inpatients admitted for nutritional rehabilitation using a high-energy re-feeding protocol, Journal of Eating Disorders. DOI: 10.1186/s40337-024-01015-x
Journal information: Journal of Eating Disorders Provided by Curtin University
