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Anorexia nervosa (AN) is the most prevalent of eating disorders in children and adolescents, and its treatment is long and complex, involving a multidisciplinary team. Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment. However, current recommendations on initial energy requirements for these patients are inconsistent, with a clear lack of controlled studies, available scientific evidence and global consensus on the most effective and safe refeeding practices in hospitalized adolescents with anorexia nervosa (AN). Conservative refeeding recommendations have been classically established in order to prevent the refeeding syndrome. Nevertheless, various works have recently appeared advocating a higher initial caloric intake, without observing more complications or refeeding syndrome, and allowing a shorter average stay. We present our experience in the treatment of restricting AN with a conservative progressive treatment. We have obtained good results with this approach, which was well tolerated by patients, with no observing complications. As a consequence, the medical team could establish a pact about the therapeutic goals with the patients in an easier way.

Producción Científica Anorexia nervosa (AN) is the most prevalent of eating disorders in children and adolescents, and its treatment is long and complex, involving a multidisciplinary team. Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment. However, current recommendations on initial energy requirements for these patients are inconsistent, with a clear lack of controlled studies, available scientifi c evidence and global consensus on the most effective and safe refeeding practices in hospitalized adolescents with anorexia nervosa (AN). Conservative refeeding recommendations have been classically established in order to prevent the refeeding syndrome. Nevertheless, various works have recently appeared advocating a higher initial caloric intake, without observing more complications or refeeding syndrome, and allowing a shorter average stay. We present our experience in the treatment of restricting AN with a conservative progressive treatment. We have obtained good results with this approach, which was well tolerated by patients, with no observing complications. As a consequence, the medical team could establish a pact about the therapeutic goals with the patients in an easier way. La anorexia nerviosa (AN) es el trastorno del comportamiento alimentario más prevalente en niños y adolescentes; su tratamiento es largo y complejo, e involucra a múltiples profesionales. La rehabilitación nutricional y la recuperación de un peso corporal normal es uno de los objetivos centrales en las fases iniciales del tratamiento del paciente ingresado. Sin embargo, las recomendaciones actuales sobre los requerimientos energéticos iniciales para estos pacientes son inconsistentes, con una clara ausencia de estudios controlados, evidencia científi ca disponible y consenso global sobre la forma de realimentación más efectiva y segura en adolescentes ingresados con anorexia nerviosa (AN). Clásicamente se han recomendado una realimentación conservadora para prevenir el síndrome de realimentación. No obstante, han aparecido recientemente varios trabajos recomendado una ingesta calórica inicial más elevada, sin observar más complicaciones ni síndrome de realimentación, y asociadas a estancias medias más cortas. Presentamos aquí nuestra experiencia en el tratamiento de la AN restrictiva con un tratamiento progresivo conservador. Hemos obtenido buenos resultados con este abordaje, bien tolerando por los pacientes, y sin observar complicaciones. Gracias a él, el equipo médico pudo establecer más fácilmente un acuerdo sobre los objetivos terapéuticos con el paciente.