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Unformatted text preview: The Annual Meeting of the Nutrition Society and BAPEN was held at Harrogate International Centre, Harrogate on 4–5 November 2008 Conference on ‘Malnutrition matters’ Symposium 8: Feeding size 0: the challenges of anorexia nervosa Managing anorexia from a dietitian’s perspective Annette Cockfield 1 * and Ursula Philpot 2,3 1 The Retreat, York, UK 2 Yorkshire Centre for Eating Disorders, Seacroft Hospital, Leeds, UK 3 Leeds Metropolitan University, Leeds, UK Anorexia nervosa has the highest mortality rate of any psychiatric condition and its manage- ment is complex and multi-faceted, requiring a multidisciplinary team approach. Dietitians are an important part of the multidisciplinary team, offering objective nutritional advice with the aim of helping the patient to develop an improved relationship with food. Refeeding patients with a low body weight requires careful management; nonetheless, refeeding the low-weight patient with anorexia presents many additional complications, largely of a psychological nature. Treatment plans need to consider psychological, physical, behavioural and psycho- social factors relating to anorexia nervosa. Currently, there is no consistent approach and a paucity of evidence to support best practice for weight restoration in this group of patients. Tube feeding is utilised at varying BMI in anorexia nervosa, mainly in an inpatient setting. However, its use should be seen as a last resort and limited to a life-saving intervention. Weight restoration is best managed by an experienced dietitian within a spet eating disorders team, using normal foods. This approach is ideal for nutrition rehabilitation, promoting skills for eating and normal behaviour and providing a longer-term solution by challenging unhelpful coping strategies from the onset. Dietitians have a unique mix of skills and knowledge in numerous areas including nutrition, physiology, psychology, sociology and behaviour change, which can be applied to support patients with thoughts and behaviours around food, weight and appetite. Further research is required into the effectiveness of dietetic interventions in eating disorders in order to establish an evidence base for best practice. Anorexia nervosa: Tube feeding: Nutrition Anorexia nervosa is a psychiatric condition that varies in severity, from mild to severe and chronic cases, resulting in extreme dieting and starvation (1) . With a mortality rate amongst the highest of all psychiatric illnesses (2) , anorexia nervosa is a life-threatening disorder. Not only does severe weight loss increase the risk of medical complications, but other associated behaviours, such as bingeing, purging, over-exercising and deliberate self-harm, pose a substantial risk to both physical and psychological health and well- being....
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- Nutrition, weight gain, weight restoration