{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:52:57Z","timestamp":1790153577795,"version":"4.0.1"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Evidence accumulates that, with close medical monitoring and phosphate supplementation, higher-caloric re-alimentation protocols beginning at 2000 kcal\/day (HCR) are not associated with an increased incidence of electrolyte abnormalities in patients with anorexia nervosa (AN) but rather result in faster weight gain. These studies are still scant and have largely been performed in adults or moderately malnourished adolescents. Methods: A retrospective chart review of patients with AN aged 12\u201320 years and with a body mass index (BMI) &lt; 15 kg\/m2 alimented according to a standardized treatment protocol in a German clinic specialized in AN was conducted. All patients received 2000 kcal\/day from day one. The effect of HCR was examined with respect to laboratory changes and weight development over 4 weeks. Results: In 120 youth (119 (99.2%) females and 1 (0.8%) male, the mean BMI was 13.1 \u00b1 1.1 (range = 10.2\u201315.0), %mBMI was 62.1 \u00b1 6.0% and weight gain was 0.76 \u00b1 0.22 kg per week, with the highest rate of weight gain during week 1 (1.25 \u00b1 1.28 kg\/week). Over 4 weeks, the total weight gain was 3.00 \u00b1 1.92 kg. Nine patients (7.5%) developed mild hypophosphatemia, and none developed refeeding syndrome. Conclusions: Starting re-alimentation with 2000 kcal\/d under close medical surveillance, severely malnourished youth with AN met the recommended weight gain targets between 0.5 and 1 kg\/week according to current treatment guidelines, without anyone developing refeeding syndrome.<\/jats:p>","DOI":"10.3390\/jcm11092585","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T13:10:26Z","timestamp":1651756226000},"page":"2585","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Outcomes of a Standardized, High-Caloric, Inpatient Re-Alimentation Treatment Protocol in 120 Severely Malnourished Adolescents with Anorexia Nervosa"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0492-1205","authenticated-orcid":false,"given":"Sophia","family":"Dalenbrook","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Augustenburger Platz 3, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Naab","sequence":"additional","affiliation":[{"name":"Schoen Clinic Roseneck, Prien am Chiemsee, 83209 Prien am Chiemsee, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7563-0651","authenticated-orcid":false,"given":"Andrea","family":"Garber","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Correll","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Augustenburger Platz 3, 13353 Berlin, Germany"},{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead, NY 11549, USA"},{"name":"Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0261-3145","authenticated-orcid":false,"given":"Ulrich","family":"Voderholzer","sequence":"additional","affiliation":[{"name":"Schoen Clinic Roseneck, Prien am Chiemsee, 83209 Prien am Chiemsee, Germany"},{"name":"Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximillians Universit\u00e4t M\u00fcnchen, 80539 Munich, Germany"},{"name":"Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Augustenburger Platz 3, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/1098-108X(200009)28:2<181::AID-EAT7>3.0.CO;2-K","article-title":"Hypophosphatemia secondary to oral refeeding in anorexia nervosa","volume":"28","author":"Fisher","year":"2000","journal-title":"Int. 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