Health Questions and Answers

Question: Is there any place for intensively nutritional support in anorexia?


Support of the anorectic with enteral nutrition using a nasogastric tube or nasoenteric tube is certainly possible. Known in past days as “force feeding,” it has the drawback that the patient is uncooperative and may pull out the tube or induce vomiting. A more sophisticated version is nutritional support using total parenteral nutrition (TPN). Perhaps surprisingly, anorectic patients often accept TPN relatively well. Of course, TPN does little to correct their abnormal dietary patterns. The justification for any of these highly aggressive procedures is that they correct malnutrition, which is the main consequence of the disease, and may allow the patient to “start over again” with the nutritional deficit corrected. Aggressive nutritional support may therefore buy some time during which the patient can undergo psychotherapy in order to correct the underlying problem. It is indicated, if at all, only for the patient who is literally dying of malnutrition.

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