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Protocol to Treat Anorexia Is Faulted

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When a malnourished teenager with anorexia nervosa is admitted to the hospital, weight gain is a top priority — and food is medicine. But doctors mete out meals with caution, providing fewer calories than needed at first because the patients may be so frail that major swings in diet can be life-threatening.
The strategy, called “start low, advance slow,” often results in further weight or fluid loss during the first day or two of hospitalization. Now some researchers and health providers, both in the United States and abroad, are challenging the start-low approach, suggesting that many patients could be fed more aggressively as long as they are closely monitored for medical complications.Scientific evidence in support of the start-low method has been scarce. In a study published online in The Journal of Adolescent Health in August, researchers at the University of California, San Francisco, sought to evaluate it more closely, examining weight gain in hospitalized teenagers on a recommended refeeding protocol, in what they believe is the first study of its kind.

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EDRC