REFEEDING, METABOLIC-RATE, AND WEIGHT-GAIN IN ANOREXIA-NERVOSA - A REVIEW

Patients with anorexia nervosa require refeeding to restore normal bod y weight. A variety of studies have examined the role of metabolic rat e in the refeeding of anorectic patients. Several measurement techniqu es have been used to divide metabolic rate into its components: basal metabolic rate, resting energy expenditure, activity-induced thermogen esis, and dietary-induced thermogenesis. In anorexia nervosa patients several consistent findings are present. First, the number of kilocalo ries required for weight gain or weight maintenance increases as weigh t increases. Second, over 50% of the body mass gained in anorectic ind ividuals represents fat tissue. Finally, both a history of bulimic sym ptoms and a higher premorbid body weight may lead to lower calorie req uirements. These findings suggest the need for gradual increase in cal ories provided throughout treatment; resting energy expenditures may a id the determination of caloric requirements. (C) 1995 by John Wiley a nd Sons, Inc.