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Table 4 National Institute for Clinical Excellence (NICE) guidelines for anorexia nervosa

From: Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment

Managing weight gain in AN

 

In most patients with anorexia nervosa an average weekly weight gain of 0.5 to 1 kg in inpatient settings and 0.5 kg in outpatient settings should be an aim of treatment. This requires about 3,500 to 7,000 extra calories a week.

C

Regular physical monitoring, and in some cases treatment with a multivitamin/multi-mineral supplement in oral form is recommended for people with anorexia nervosa during both inpatient and outpatient weight restoration.

C

Total parenteral nutrition should not be used for people with anorexia nervosa, unless there is significant gastrointestinal dysfunction.

C

Managing risk in AN

 

Health care professionals should monitor physical risk in patients with anorexia nervosa. If this leads to the identification of increased physical risk, the frequency and the monitoring and nature of the investigations should be adjusted accordingly.

C

People with anorexia nervosa and their carers should be informed if the risk to their physical health is high.

C

The involvement of a physician or paediatrician with expertise in the treatment of physically at-risk patients with anorexia nervosa should be considered for all individuals who are physically at risk.

C

Pregnant women with either current or remitted anorexia nervosa may need more intensive prenatal care to ensure adequate prenatal nutrition and fetal development.

C

Oestrogen administration should not be used to treat bone density problems in children and adolescents as this may lead to premature fusion of the epiphyses.

C

  1. Legend:
  2. Evidence C: This grading indicates that directly applicable clinical studies of good quality are absent or not readily available.