{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:25:59Z","timestamp":1788175559160,"version":"build-2803163510"},"reference-count":54,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the impact of our new rapid refeeding protocol on patients with anorexia nervosa (AN) in our Eating Disorders Program. We hypothesize that the new protocol would lead to a more rapid weight gain and a shorter length of stay, with no effect on medical complications or program completion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This cohort design included consecutive inpatients and day hospital patients admitted to the program with a BMI &lt;18\u2009kg\/m<jats:sup>2<\/jats:sup> and a diagnosis of AN between 2007 and 2020; <jats:italic>N<\/jats:italic>\u00a0=\u00a0326 patients. Main outcomes measured were rate of weight gain and length of stay. Safety indicators included electrolyte disturbances and supplementation required, complications including refeeding syndrome and completion of the program. A <jats:italic>p<\/jats:italic> value &lt;.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Total length of stay was 21\u2009days shorter for patients on the rapid refeeding protocol compared to the traditional refeeding protocol. Patients on the new protocol gained 0.21 more kg\/week compared to patients on the old protocol. There was no difference in completion rates between programs. Electrolyte imbalances were mild to moderate and easily treated with oral electrolyte supplementation. There were no deaths or cases of refeeding syndrome with either protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This is the first Canadian study to assess the effectiveness and safety of rapid refeeding in an adult population. Rapid refeeding protocols can be safely administered and are cost effective. Shorter hospital admissions are desirable to minimize possible regression and dependency on inpatient services and positively impacts patients' quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>This study advances the idea that rapid refeeding in patients with anorexia nervosa can be administered safely and effectively with close medical monitoring. In addition, rapid refeeding leads to shorter hospital stays, with a cost\u2010savings to the health system. Shorter admissions are desirable to minimize possible regression and dependency on inpatient services and also positively impacts patients' quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23698","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T09:18:50Z","timestamp":1648199930000},"page":"653-663","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Rapid refeeding in anorexia nervosa: A dialectic balance"],"prefix":"10.1002","volume":"55","author":[{"given":"Randolf","family":"Staab","sequence":"first","affiliation":[{"name":"Trillium Health Partners  Mississauga Ontario Canada"},{"name":"Department of Psychiatry University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Campagna","sequence":"additional","affiliation":[{"name":"Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ma","sequence":"additional","affiliation":[{"name":"Institute for Better Health, Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5918-6968","authenticated-orcid":false,"given":"Anjana","family":"Sengar","sequence":"additional","affiliation":[{"name":"Trillium Health Partners  Mississauga Ontario Canada"},{"name":"Institute for Better Health, Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.06.005"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890423363"},{"key":"e_1_2_8_4_1","volume-title":"Clinical practice guidelines anorexia nervosa: Management","author":"Association Fran\u00e7aise pour le D\u00e9veloppement des Approches Sp\u00e9cialis\u00e9es des Troubles du Comportement Alimentaire","year":"2010"},{"key":"e_1_2_8_5_1","volume-title":"Joint German guideline \u201cdiagnosis and treatment of eating disorders\u201d","author":"Association of the Scientific Medical Societies in Germany","year":"2018"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1991.tb93887.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20367"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20009"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-019-00709-5"},{"key":"e_1_2_8_10_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2019"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(200009)28:2<181::AID-EAT7>3.0.CO;2-K"},{"issue":"1","key":"e_1_2_8_12_1","first-page":"19","article-title":"Short\u2010term outcomes of the study of refeeding to optimize inpatient gains for patients with anorexia nervosa","volume":"175","author":"Garber A. 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