{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:53:59Z","timestamp":1769504039831,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD082166"],"award-info":[{"award-number":["R01HD082166"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K23MH120347"],"award-info":[{"award-number":["K23MH120347"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The StRONG study demonstrated that higher calorie refeeding (HCR) restored medical stability faster in patients hospitalized with anorexia nervosa (AN) and atypical AN (AAN), with no increased safety events compared with standard\u2010of\u2010care lower calorie refeeding (LCR). However, some clinicians have expressed concern about potential unintended consequences of HCR (e.g., greater mealtime distress). The purpose of this study was to examine patient treatment preference and compare mealtime distress, food refusal, and affective states between treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Participants (<jats:italic>N<\/jats:italic>\u00a0=\u00a0111) in this multisite randomized clinical trial were ages 12\u201324\u2009years, with AN or AAN, admitted to hospital with medical instability who received assigned study treatment (HCR or LCR). Treatment preference was assessed prior to randomization in the full sample. In a subset of participants (<jats:italic>n<\/jats:italic>\u00a0=\u00a045), linear mixed effect models were used to analyze momentary ratings of mealtime distress (pre, during, and post\u2010meals) and daily affective state during the hospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About half (55%) of participants reported a preference for LCR. Treatment assignment was not associated with food refusal, mealtime distress, or affective states in the subsample. Food refusal increased significantly over the course of refeeding (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.018). Individuals with greater depression experienced more negative affect (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.033), with worsening negative affect over time for individuals with higher eating disorder psychopathology (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Despite understandable concerns about potential unintended consequences of HCR, we found no evidence that treatment acceptability for HCR differed from LCR for adolescents and young adults with AN and AAN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>The efficacy and safety of higher calorie refeeding in hospitalized patients with anorexia nervosa has been demonstrated. However, it is not known whether higher calorie refeeding (HCR) increases meal\u2010time distress. This study demonstrated that HCR was not associated with increased mealtime distress, food refusal, or affective states, as compared with lower calorie refeeding. These data support HCR treatment acceptability for adolescents\/young adults with anorexia nervosa and atypical anorexia nervosa.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23931","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T07:00:30Z","timestamp":1678863630000},"page":"1219-1227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Hospital\u2010based higher calorie refeeding and mealtime distress in adolescents and young adults with anorexia nervosa or atypical anorexia nervosa"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5521-6381","authenticated-orcid":false,"given":"Erin C.","family":"Accurso","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Preventive &amp; Restorative Dental Sciences University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa I.","family":"Machen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Adolescent and Young Adult Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Buckelew","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Adolescent and Young Adult Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Kreiter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Adolescent Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Adolescent and Young Adult Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7293-9496","authenticated-orcid":false,"given":"Daniel","family":"Le Grange","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California  San Francisco California USA"},{"name":"Department of Psychiatry and Behavioral Neuroscience The University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2262-6955","authenticated-orcid":false,"given":"Neville H.","family":"Golden","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Adolescent Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea K.","family":"Garber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Adolescent and Young Adult Medicine University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23449"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000073"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2021.1939920"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JADA.2006.09.007"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20606"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0023246"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ERV.2639"},{"key":"e_1_2_9_9_1","volume-title":"CDC growth charts for the United States: Development and methods","author":"Centers for Disease Control and Prevention","year":"2002"},{"key":"e_1_2_9_10_1","first-page":"1","volume-title":"Dissemination and implementation research in health: translating science to practice","author":"Colditz G. A.","year":"2017"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/APPI.AJP.23180001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/S10862-011-9273-2"},{"key":"e_1_2_9_13_1","first-page":"309","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. C.","year":"2008"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-2339"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.3359"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-037135"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23386"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(01)00333-0"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.CBPRA.2020.09.011"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0B013E3283487591"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.11.3.326"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.03.006"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22536"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-016-0132-0"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/5168978"},{"key":"e_1_2_9_26_1","unstructured":"Rabin R. C.(2012).Hospital treatment for anorexia is questioned.The New York Times.https:\/\/www.nytimes.com\/2012\/01\/03\/health\/research\/anorexic-patients-can-be-fed-more-aggressively-study-says.html"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11031-005-7955-3"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-016-0124-0"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2019.1688008"},{"key":"e_1_2_9_30_1","volume-title":"The patient health questionnaire for adolescents: Validation of an instrument for the assessment of mental disorders among adolescent primary care patients","author":"Spitzer R. L.","year":"1995"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.PSYCHRES.2018.12.004"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.23931","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/eat.23931","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.23931","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T12:03:07Z","timestamp":1692446587000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.23931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,15]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/eat.23931"],"URL":"https:\/\/doi.org\/10.1002\/eat.23931","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,15]]},"assertion":[{"value":"2022-10-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}