Management

As an inpatient

1) Early nutritional rehabilitation is key to improving the patient’s condition. Food is the best medicine for a patient with an eating disorder, in the same way antibiotics are the best treatment for a patient with a bacterial infection. This includes

• Meal plans with dietician input
• Oral supplements of phosphate, thiamine, vitamin B and multivitamins

2) Regular psychiatric review

3) Management of any medical complication arising from the eating disorder, such as electrolyte abnormality, dehydration or a concurrent illness.

4) Bed rest

5) Regular monitoring

• Continuous ECG monitoring if abnormalities present
• Regular blood sugars
• Regular weights
• Refeeding bloods

Patients should be closely monitored for refeeding syndrome. When feeding recommences suddenly after a prolonged period of starvation, the increase in electrolyte requirements as metabolism shifts can be potentially fatal. Phosphate levels can drop quickly during the first week, so daily blood tests are required for this period.