Feeding Tubes for Eating Disorders: When Are They Needed?
Most patients with eating disorders recover without the use of feeding tubes. However, patients who have a difficult time with refeeding due to gastrointestinal issues or severe psychological distress may choose to use a feeding tube to achieve their nutrition goals.
Refeeding for Eating Disorders & Malnutrition
Nutrition therapy is a vital component of medical stabilization, and its importance cannot be understated. Most of the medical complications associated with severe eating disorders and malnutrition resolve with refeeding and weight restoration.
Feeding tubes can be used, but are rarely necessary for a variety of different conditions, such as:
Types of Refeeding
Refeeding is initiated through a variety of nutrition therapies, including:
- Progressive oral (PO) refeeding
- Nasogastric (NG) feeding tube
- Nasojejunal (NJ) feeding tube
- Percutaneous endoscopic gastrostomy (PEG) tube
- Percutaneous endoscopic jejunostomy (PEJ) tube
- Total parenteral nutrition (TPN)
- Peripheral parenteral nutrition (PPN)
Nasogastric tube feeding
Feeding tubes, typically nasogastric (NG) tube feeding, are a temporary means to supplement oral refeeding for specific individuals who meet criteria for use, including:
- Being medically unstable
- Body weight continuing to decline despite refeeding efforts
- Needing additional nutritional support to complete the necessary nutrition
NG tubes are inserted through the nostril, down the esophagus and into the stomach, where nutrition is delivered directly.
When are Feeding Tubes Appropriate?
Tube feeding should only be used when medically necessary under the supervision of specialized medical providers. The use of NG tubes involves thoughtful initiation of caloric intake reflecting the patient’s unique metabolic needs and medical complications.
Early in recovery, supplemental caloric intake via NG tube feeding supports medical stabilization and weight restoration in patients suffering from severe eating disorders or malnutrition. NG tube feeding can be a valuable tool facilitating both physical and mental eating disorder recovery when delivered by providers with experience in refeeding severely malnourished patients.
Who Can Benefit from NG Tube Feeding?
Gastrointestinal medical complications like gastroparesis and superior mesenteric artery (SMA) syndrome can cause physical discomfort associated with oral refeeding. Some patients also experience extreme psychological distress from increasing caloric intake. Circumstances like these may necessitate the use of feeding tubes for the treatment of patients with severe eating disorders or malnutrition. While not necessary for most patients, these adjunct methods of refeeding can be valuable interventions for patients with specific needs.
Refeeding for severe eating disorders
Many medical settings, including residential eating disorder treatment programs, are unlikely to have specific expertise in treating medical complications that occur when refeeding underweight patients. Providers at ACUTE have robust training in navigating the risks associated with refeeding.
Nutritional rehabilitation
Nutritional rehabilitation is essential to restore energy balance and correct nutrient deficiencies caused by eating disorders. It supports the recovery of normal physiological function and overall health. The registered dietitians at ACUTE meet with patients to assess the safest and most effective refeeding methods tailored to their individual needs.
Medical monitoring
Medical monitoring is essential to identify and manage complications of eating disorders early. It ensures patient safety and supports the restoration of the body's normal functions. ACUTE’s physicians and nurses carefully initiate refeeding, monitoring concurrent vital signs and blood chemistry while considering each patient’s unique risk factors.
Behavioral support
Behavioral support is essential for addressing the psychological factors underlying eating disorders. It promotes healthy coping strategies and fosters long-term behavioral and emotional recovery. Therapeutic support is also provided during the nutritional rehabilitation process to help patients emotionally stabilize as they physically recover.
Learn more about refeeding at ACUTE here.
Find Help for Severe Malnutrition
Severe malnutrition can be life-threatening and often requires intensive nutritional support, including tube feeding when oral intake isn’t sufficient. With careful medical monitoring and a coordinated care team, the body can safely regain nutrients and strength, making recovery possible.
