Re-Feeding Syndrome: The Deadly Complication Associated with Anorexia Nervosa
The Dangers of Re-Feeding Syndrome
Re-feeding syndrome is one of the most dangerous and well-known complications from anorexia nervosa. Although the disorder itself does not result in increased mortality, the electrolyte disturbances that occur secondary to this disorder result in cardiac and renal failure potentially causing death. Re-feeding syndrome occurs when the severely malnourished individual begins to increase their caloric intake either voluntarily or through a feeding tube or intravenous line. In a starvation state the body usually breaks down fats and proteins into energy because carbohydrates are depleted first in starvation. Upon increasing caloric intake through re-feeding, a rise in insulin occurs due to an increase in carbohydrates resulting in a sudden shift from fat and protein metabolism to carbohydrate metabolism resulting in an extreme electrolyte imbalance. A severe decrease in phosphate, potassium and magnesium occur, formally known as hypophosphatemia, hypokalemia and hypomagnesemia. Re-feeding syndrome is a medical professional’s worst nightmare when treating an individual with anorexia nervosa as they must monitor fluids, electrolytes and organ function very closely and this syndrome does warrant a hospital admission and may even warrant an admission to the intensive care unit.
