Anorexia Nervosa

Gastrointestinal Complications of Refeeding in Anorexia Nervosa

Journal of Nutritional Biology
By Philip S. Mehler, MD, FACP, FAED, CEDS Ann Koutsavlis, MPH, RD, CEDRD


Anorexia nervosa (AN) is a complicated and life-threatening mental illness. Restoration of weight and nutrition rehabilitation are key elements for the treatment of AN. However, gastrointestinal (GI) complications often develop due to eating disorder behaviors, concomitant malnutrition, and during the refeeding process. These problems may give rise to significant medical complications and contribute to increased difficulties with refeeding and weight restoration. This review aims to describe common GI complications in AN including delayed gastric emptying, gastric dilatation, superior mesenteric artery (SMA) syndrome, refeeding hepatitis, and refeeding syndrome. Recommendations for clinicians refeeding a patient with AN are provided. Knowledge of these GI manifestations is required for correct management and successful nutritional rehabilitation of patients with AN.

Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…
Written by

Ann Koutsavlis, MPH, RD, CEDRD

Ann Koutsavlis obtained her master’s degree in Public Health/Nutrition at University of Massachusetts Amherst. She earned her bachelor’s degree in Human Nutrition and Foods at West Virginia…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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