Artificial nutrition in anorexia nervosa

In view of the paucity of studies and recognized difficulties in conducting randomized clinical trials in anorexia nervosa, evidence-based guidelines for enteral and parenteral nutrition in these patients are lacking, and current recommendations are based on the opinions of experts. After reviewing the available studies on this topic, we shall attempt to outline practice recommen- dations for artificial nutrition in anorexia nervosa. Although criteria for the use of artificial nutri- tion and its management vary among countries and among different centers for eating disorders, a consensus prevails that enteral nutrition should be resorted to when oral feeding fails, especially in critical situations (as a life-saving intervention), while parenteral nutrition should be considered only for patients with impaired intestinal function. Available studies and clinical experience sup- port the effectiveness of enteral nutrition in weight restoration. When enteral nutrition is integrated in a multimodal approach (nutritional and psychotherapeutic), and managed by an expert team, patients' acceptance of and compliance with nasogastric feeding are satisfactory and major com- plications such as the refeeding syndrome may be avoided. However, it is essential that every team involved in the treatment of eating disorders develop standard criteria and procedures for its use. (Nutritional Therapy & Metabolism 2007; 25: 183-8)