Artificial nutrition in anorexia nervosa

In view of the paucity of studies and recognized difficulties in conducting randomized clinical trials in anorexia nervosa, evidence-based guidelines for enteral and parenteral nutrition in these patients are lacking, and current recommendations are based on experts’ opinions. After reviewing available studies on this topic, we’ll attempt to outline practice recommendations for artificial nutrition in anorexia nervosa. Although criteria for the use of artificial nutrition and its management vary among countries and among different centres for eating disorders, a consensus prevails that enteral nutrition should be resorted to when oral feeding fails especially in critical situations (as a life-saving intervention), while parenteral nutrition should be considered only for patients with impaired intestinal function. Both available studies and clinical experience support the effectiveness of enteral nutrition on weight restoration. When enteral nutrition is integrated in a multimodal approach (nutritional and psychotherapeutic), and managed by an expert team, patients’ acceptance and compliance to nasogastric feeding are satisfactory, and major complications, such as the refeeding syndrome, may be avoided. However, it is essential that every team involved in treatment of eating disorders develop standard criteria and procedures for its use.