High-caloric supplements in anorexia treatment

Objective This study compares weight gain and therapy duration in two groups of patients with anorexia nervosa, the first receiving a normal diet aimed at promoting weight gain, the second receiving high‐caloric supplements in addition to this normal diet. The study includes patients from two clinics with comparable psychotherapeutic treatment settings except for the substitution. Methods Eighty‐four patients were examined. Of these, 29 patients with substitution were compared with 29 patients without substitution. In addition, 13 patients without substitution from the first clinic were compared with 13 patients without substitution from the second clinic to exclude potential differences between the two institutions independent of the substitution. Results Substitution leads to more rapid weight gain, to greater weight on discharge, and to shorter therapy duration. Differences could be observed between patients severely or less severely underweight on admission and between patients with restrictive or bulimic anorexia. Conclusion Within the framework of inpatient psychosomatic treatment involving a psychotherapeutic treatment setting, substitution facilitates weight gain. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 32: 135–145, 2002.