Abstract
It is known that patients with anorexia nervosa have a decreased resting energy expenditure (REE). A 26-year-old female diagnosed as anorexia nervosa presented to our hospital with severe emaciation. After admission, enteral feeding was started at a low dose (600 kcal/day). It was gradually increased to 866 kcal/day on day 2 after admission. Subsequently, unstable circulatory dynamics, hyperglycemia, hypophosphatemia and hypokalemia developed, and refeeding syndrome was suspected. Therefore, enteral feeding was reduced to 630 kcal/day 4 days after admission. Her REE was measured based on indirect calorimetry. Feeding was then performed based on the measured REE. Her condition soon thereafter stabilized. Overfeeding often induces refeeding syndrome, however, inadequate feeding leads to a further deterioration of the patient's condition. Anorexia nervosa requires optimal feeding. Therefore, feeding based on the measured REE can help to prevent complications, such as refeeding syndrome.
