Refeeding Syndrome

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Submitted by Dr T on January 12, 2014 – 2:00pm

Question: 
I’m 18,5’7,and have been anorexic/bulimic for 2 1/2 years now. 3 weeks ago, I was 131 lbs but then I relapsed and started eating 0-400 calories and now I am at 116 lbs. I HAVE to be in the 130’s in three weeks for my doctors’ appointments. How much can I gain each week without experiencing re-feeding syndrome symptoms?
Can you get re-feeding syndrome after only starving for 3 weeks?
I am outpatient, by the way. My heart was pretty bad at one point (I lost 80 lbs in 2 years) but it’s pretty okay right now.
What if I lose the 15 lbs again after it?
I’m just worried that I won’t weigh enough and I am worried that I’m going to strain my heart gaining 15 lbs in 3 weeks but I haven’t been starving that long have I,it was only 3 weeks of starvation?Not long enough to cause re-feeding syndrome?
I want to know if gaining 15 lbs in 3 weeks will strain my heart or cause my electrolytes to unbalance.I don’t think 15 lbs is a huge jump to be honest.Nor do I think it is a big loss.
I’ve been inpatient three times and it didn’t work.I ended up going back to 156 lbs and my doctors were glad when I got to 135 lbs again.So don’t mention inpatient.I’m going to college in less than 3 weeks.

Hi Corinna,

Re: I want to know if gaining 15 lbs in 3 weeks will strain my heart or cause my electrolytes to unbalance. Yes!

You are definitely at risk for Refeeding Syndrome, which usually occurs within four days of starting to re-feed. It can be fatal if not recognized and treated properly. You may develop acute fluid and electrolyte disorders (especially your glucose & insulin, phosphate, magnesium and potassium levels), that may cause neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications, including:

Above all, you will not fool your doctor! Even you were to avoid the overt symptoms of acute overeating, your blood work will still be very abnormal. You need your doctor’s help now!

Hope this helps,

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