Campos Del Portillo Rocío, Palma Milla Samara, Matía Martín Pilar, Loria-Kohen Viviana, Martínez Olmos Miguel Ángel, Mories Álvarez María Teresa, Castro Alija María José, Martín Palmero María Ángela, Carrillo Lozano Elena, Valero-Pérez Marlhyn, Campos Del Portillo Isabel, Sirvent Segovia Alejandro Esteban, Plaza Blázquez Pilar, de la Cruz López Diana Monserrat, Pita Gutiérrez Francisco
Servicio de Endocrinología y Nutrición. Hospital Universitario Puerta de Hierro Majadahonda.
Unidad de Nutrición Clínica y Dietética. Servicio de Endocrinología y Nutrición. Hospital Universitario La Paz. IdiPAZ.
Nutr Hosp. 2024 Mar 1;41(Spec No1):1-60. doi: 10.20960/nh.05175.
Anorexia nervosa (AN) is a multifactorial disorder. A possible role of the social network and the gut microbiota in pathogenesis has been added. Exogenous shocks such as the COVID19 pandemic have had a negative impact on patients with AN. The potential medical and nutritional impact of malnutrition and/or compensatory behaviors gives rise to a complex disease with a wide range of severity, the management of which requires a multidisciplinary team with a high level of subject matter expertise. Coordination between levels of care is necessary as well as understanding how to transition the patient from pediatric to adult care is essential. A proper clinical evaluation can detect possible complications, as well as establish the organic risk of the patient. This allows caregivers to tailor the medical-nutritional treatment for each patient. Reestablishing adequate nutritional behaviors is a fundamental pillar of treatment in AN. The design of a personalized nutritional treatment and education program is necessary for this purpose. Depending on the clinical severity, artificial nutrition may be necessary. Although the decision regarding the level of care necessary at diagnosis or during follow-up depends on a number of factors (awareness of the disease, medical stability, complications, suicidal risk, outpatient treatment failure, psychosocial context, etc.), outpatient treatment is the most frequent and most preferred choice. However, more intensive care (total or partial hospitalization) may be necessary in certain cases. In severely malnourished patients, the appearance of refeeding syndrome should be prevented during renourishment. The presence of AN in certain situations (pregnancy, vegetarianism, type 1 diabetes mellitus) requires specific care. Physical activity in these patients must also be addressed correctly.
