Higher Calories Don’t Equal Higher Distress

A new study by researchers at UC San Francisco has shown that a higher-calorie re-nourishment plan doesn’t cause inpatient anorexia nervosa and atypical anorexia patients more distress compared with a lower-calorie diet.

The study supports the researchers’ earlier findings that showed that a higher-calorie regimen was safe and reduced the patients’ time in hospital. Many clinicians are still wary of giving their patients a high-calorie diet while in treatment for anorexia for fear of causing psychological harm, although this study does not back up their concerns.

There were 111 patients in the study aged 12 to 24, with each randomly given the higher or lower calorie nutrition plan. They were asked to rate their distress after meals. Both groups refused the same amount of food and both had similar levels of distress around mealtimes. The patients mostly thought they had been given the high-calorie diet.

First author on the study, Erin Accurso PhD, said: ‘This shows that patients with anorexia and atypical anorexia will be stressed out about eating during inpatient treatment, but they won’t be more stressed if they get a higher-calorie diet.’

In fact, she added that, ‘Mealtime anxiety was moderate — actually lower than we might have expected — and part of the treatment is helping patients learn to tolerate their anxiety so they can continue making progress after discharge.’

Accurso hopes that ‘these data will reassure the community that higher-calorie refeeding is acceptable and manageable for patients and clinicians, in addition to being superior to lower-calorie regimens in terms of clinical outcomes.’