Study of Refeeding to Optimize iNpatient Gains

Multi-center Randomized Controlled Trial of Refeeding in Anorexia Nervosa

The purpose of this study is to compare the efficacy, safety, and cost-effectiveness of lower calorie refeeding versus higher calorie refeeding in hospitalized adolescents with anorexia nervosa.

Inclusion Criteria:

• diagnosis of AN
• atypical AN
• no hospital admissions for the previous six months
• meet hospitalization criteria: daytime heart rate (HR) < 50 bpm or night time HR < 45 bpm, blood pressure (BP) <90/45 mmHg, temperature < 35.6° C, or symptomatic orthostasis defined by increase in HR > 35 bpm or decrease in systolic BP > 20 mmHg or decrease in diastolic BP > 10 mmHg from lying to standing

Exclusion Criteria:

• diagnosis of bulimia nervosa [DSM-5]
• currently in remission (as defined by weight and EDE-Q score)
• admission for food refusal without malnutrition
• current pregnancy
• chronic disease (e.g. immune/endocrine disorders, pulmonary, cardiac, or renal disease)
• current suicidality or psychosis
• < 60% mBMI