Calorie Needs of Older People With Restrictive Eating Disorders Undergoing Refeeding

Area of Science:

• Nutritional Psychiatry
• Eating Disorders Research
• Geriatric Medicine

Background:

• Restrictive eating disorders (EDs), including anorexia nervosa, restricting subtype (AN-R), and avoidant/restrictive food intake disorder (ARFID), affect women across the lifespan.
• Effective refeeding interventions for older patients with EDs are not well understood.
• Limited research exists on age-related differences in caloric requirements for weight restoration in EDs.

Purpose of the Study:

• To investigate if age influences caloric needs during refeeding for women with AN-R or ARFID.
• To determine if caloric requirements for weight gain differ between AN-R and ARFID diagnoses.

Main Methods:

• A retrospective cohort study analyzed data from 417 female inpatients undergoing medical stabilization for AN-R or ARFID.
• Average kilocalorie (kcal) needs per one-point increase in body mass index (BMI) were assessed.
• Linear regression and chi-square tests compared kcal needs across age groups (<20, 20-29, 30-39, 40+ years) and diagnoses.

Main Results:

• The average kcal needed for a one-point BMI increase was 1870 kcal (SD=1410).
• No statistically significant differences in kcal needs per BMI point were found among the age groups (p=0.30).
• Patients with AN-R required significantly fewer kcal for weight gain compared to patients with ARFID.

Conclusions:

• Caloric needs for weight restoration in a high-acuity inpatient sample were consistent across adult age groups.
• Patients with ARFID demonstrated higher caloric requirements than those with AN-R.
• Individualized, diagnosis-informed refeeding plans are recommended, as age-based caloric reductions may be unwarranted.