In a 14-year-old with anorexia nervosa, which nutrition intervention is most appropriate at admission?

In a 14-year-old with anorexia nervosa, which nutrition intervention is most appropriate at admission?

• A. Peripheral parenteral nutrition
• B. High calorie diet with calorie counting
• C. Structured meal plan with supplemental enteral feedings
• D. Ad lib diet with 72 hour calorie count

Answer: (C)

When refeeding a malnourished adolescent with anorexia nervosa, the priority is safe, monitored energy restoration that supports healthy eating patterns. A structured meal plan with close supervision ensures regular, adequate intake and allows the nutrition team to track tolerance, adjust calories, and prevent dangerous electrolyte shifts that can occur with rapid refeeding. If oral consumption through the plan isn’t enough to meet energy goals, adding supplemental enteral feedings helps reach those goals without overwhelming the patient, using a schedule that complements meals and snacks. Peripheral parenteral nutrition is not preferred because it bypasses the gut and carries higher infection risk; it’s reserved for situations where the GI tract can’t be used. An ad lib diet with a long calorie-count period, or a high-calorie plan solely based on counting calories, lacks the structure needed to restore weight safely and can lead to inappropriate or inconsistent intake. This structured, integrated approach addresses both the physiological needs of refeeding and the behavioral aspects of eating in adolescence.

When refeeding a malnourished adolescent with anorexia nervosa, the priority is safe, monitored energy restoration that supports healthy eating patterns. A structured meal plan with close supervision ensures regular, adequate intake and allows the nutrition team to track tolerance, adjust calories, and prevent dangerous electrolyte shifts that can occur with rapid refeeding. If oral consumption through the plan isn’t enough to meet energy goals, adding supplemental enteral feedings helps reach those goals without overwhelming the patient, using a schedule that complements meals and snacks. Peripheral parenteral nutrition is not preferred because it bypasses the gut and carries higher infection risk; it’s reserved for situations where the GI tract can’t be used. An ad lib diet with a long calorie-count period, or a high-calorie plan solely based on counting calories, lacks the structure needed to restore weight safely and can lead to inappropriate or inconsistent intake. This structured, integrated approach addresses both the physiological needs of refeeding and the behavioral aspects of eating in adolescence.