Doctors’ strategy to tackle anorexia challenged
By Rachel O’Rourke
Researchers and health providers in the US have challenged the food “start low” strategy for people with anorexia, 
believing that a more aggressive approach could be more effective.
According to the New York Times, the protocol strategy commonly called “start low, advance slow” for weaning those suffering with anorexia nervosa back on to food could be used more aggressively at the start of treatment, as long as they are closely monitored by health professionals.
Research by The Journal of Adolescent Health found that out of the 35 people studied, 83% on the “start low” regime (which offers fewer calories than needed at first in order to protect patients’ frail appetites) actually lost weight. Overall, patients did not regain the newly lost weight until the sixth day of being hospitalised.
Dr. David Rosen,a professor of paediatrics, internal medicine and psychiatry at the University of Michigan Medical School, told the American newspaper: “There is a body of evidence that our older, more cautious feeding strategies are older and more cautious than they need to be.”
“We’ve proven that with the regular approach, we don’t make as much progress as we’d like,” he said. “But do we know that feeding people more aggressively is a safe thing to do? The answer is, not really.”
Doctors have urged for caution to be taken before medical professionals make any radical changes in treatment, saying that more research needs to be done.
Sufferers of anorexia often suffer from refeeding syndrome, including digestive disorder, which, in severe cases, can lead to complications and death, when trying to return to a normal diet too quickly.
The study also highlighted psychological concerns and called for sufferers of anorexia to receive counselling during the refeeding stage.
Current guidelines from the American Academy of Paediatrics maintains that slow refeeding of malnourished people, particularly children and teenagers, and a “gradual increase of calorie intake” is needed to prevent complications.
Statistics published by the South Carolina Department of Health show that an estimated eight million Americans have an eating disorder (seven million women and one million women). Anorexia and eating disorders currently hold the highest mortality rate of any mental illness, with only one in ten people receiving treatment.
