Psychiatrists also can play an important role in this refeeding process, Dr. Garber said. "One of the questions ... is whether these diets will be tolerated psychiatrically. What is the psychiatric and psychological impact of refeeding with this high number of calories?" Not only is this an opportunity for future research, but an area where psychiatrists could offer significant support to patients hospitalized with anorexia.
"Studies have shown there is an enormous amount of anxiety associated with refeeding in the hospital," Dr. Garber said.
Dr. B. Timothy Walsh offered another perspective.
"Probably, the clinician who does not specialize in this area should recognize the potential medical complexities and have a low threshold for referring cases to specialist centers where there is greater awareness of the dangers of refeeding 'too slow' or too fast,' " Dr. Walsh, Ruane Professor of Pediatric Psychopharmacology in the department of psychiatry at the College of Physicians & Surgeons, Columbia University, said in an interview.
Dr. Garber and Dr. Marks said they had no relevant financial disclosures.