Weight fluctuations during early refeeding period in anorexia nervosa: case reports

OBJECTIVE: This study reports wide weight fluctuations during a week of early refeeding for 2 patients with anorexia nervosa and discusses possible mechanisms. METHOD: Laboratory tests that consist of complete blood count, biochemistry panel, and serum protein levels were performed. Fluid intake and daily urine output of the patients were measured. RESULTS: Laboratory tests were within normal limits for both patients except for leukopenia in one patient. By the end of the Week 1, both patients had achieved significant weight gain (9 kg and 3 kg, respectively) concurrent with edema. Their daily fluid intake and urine output measurements indicated increased total body water levels. DISCUSSION: Although the pathophysiology of refeeding edema is not entirely understood, it is well known that insulin induces sodium retention by increasing distal tubular sodium reabsorption. In our patients, refeeding-induced insulin secretion may be chiefly responsible for the edema and weight gain during the early refeeding period.