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Psychological Implications of Artificial Nutrition in Eating and Feeding Disorders and Medical Disorders

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (25 April 2024) | Viewed by 1220

Special Issue Editor


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Guest Editor
Department of Neuroscience, University of Turin, 10100 Turin, Italy
Interests: eating and feeding disorders; anorexia nervosa; personality; psychopathology; treatment outcomes; neurosciences

Special Issue Information

Dear Colleagues,

This Special Issue is focused on the following topic: artificial nutrition via nasogastric tubes in patients with anorexia nervosa, and its clinical and psychological implications.

The introduction of a nasogastric tube (NGT) in order to nourish patients who are affected by anorexia nervosa (AN) is a practise that may be applicable in cases of complete feeding refusal, severe malnutrition with incomplete oral feeding, when oral nutrition is not indicated for medical reasons, or in subjects with insufficient bowel absorption. Notwithstanding its frequent nutritional recommendation and the research supporting its efficacy from a medical perspective, no study has systematically explored the psychological consequences of the introduction of a NGT in patients with AN, particularly in relation to variations in their weight. Moreover, treatment with NGTs could be enhanced via the tailored selection of the composition of the products employed and the careful monitoring of the possible complications (e.g., refeeding syndrome) that artificial nutrition may engender.

Some evidence underlines the fact that, despite the initial negative perception of NGTs due to prejudices and initial physical discomfort, this instrument is effective in increasing the weight of an individual, gradually and steadily, and progressively reducing their discomfort.

This Special Issue of Nutrients aims to collect contributions from clinicians involved in AN treatment and research on the psychological, relational, nutritional, and clinical correlates associated with the use of NGTs in patients affected by AN. Therefore, the aim of this Special Issue is to explore whether NGTs are a useful feeding instrument for patients with complicated AN nutrition and whether they may represent an acceptable therapeutic option, without inducing negative psychological and clinical consequences for these patients.

Prof. Dr. Federico Amianto
Guest Editor

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Keywords

  • anorexia nervosa
  • artificial nutrition
  • nasogastric tube
  • psychological correlates
  • clinical outcome

Published Papers (2 papers)

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Research

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12 pages, 277 KiB  
Article
Nasogastric Tube Feeding in Anorexia Nervosa: A Propensity Score-Matched Analysis on Clinical Efficacy and Treatment Satisfaction
by Matteo Martini, Paola Longo, Clara Di Benedetto, Nadia Delsedime, Matteo Panero, Giovanni Abbate-Daga and Federica Toppino
Nutrients 2024, 16(11), 1664; https://doi.org/10.3390/nu16111664 - 29 May 2024
Viewed by 610
Abstract
The choice of a refeeding strategy is essential in the inpatient treatment of Anorexia Nervosa (AN). Oral nutrition is usually the first choice, but enteral nutrition through the use of a Nasogastric Tube (NGT) often becomes necessary in hospitalized patients. The literature provides [...] Read more.
The choice of a refeeding strategy is essential in the inpatient treatment of Anorexia Nervosa (AN). Oral nutrition is usually the first choice, but enteral nutrition through the use of a Nasogastric Tube (NGT) often becomes necessary in hospitalized patients. The literature provides mixed results on the efficacy of this method in weight gain, and there is a scarcity of studies researching its psychological correlates. This study aims to analyze the effectiveness of oral versus enteral refeeding strategies in inpatients with AN, focusing on Body Mass Index (BMI) increase and treatment satisfaction, alongside assessing personality traits. We analyzed data from 241 inpatients, comparing a group of treated vs. non-treated individuals, balancing confounding factors using propensity score matching, and applied regression analysis to matched groups. The findings indicate that enteral therapy significantly enhances BMI without impacting treatment satisfaction, accounting for the therapeutic alliance. Personality traits showed no significant differences between patients undergoing oral or enteral refeeding. The study highlights the clinical efficacy of enteral feeding in weight gain, supporting its use in severe AN cases when oral refeeding is inadequate without adversely affecting patient satisfaction or being influenced by personality traits. Full article

Review

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18 pages, 663 KiB  
Review
Psychological Effects of Nasogastric Tube (NGT) in Patients with Anorexia Nervosa: A Systematic Review
by Federico Amianto, Tomaso Oliaro, Francesca Righettoni, Chiara Davico, Daniele Marcotulli and Benedetto Vitiello
Nutrients 2024, 16(14), 2316; https://doi.org/10.3390/nu16142316 - 18 Jul 2024
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Abstract
Aim: After the COVID-19 pandemic, the need for intensive nutritional care in patients affected with anorexia nervosa (AN) increased. The use of NGT was often used to overcome renutrition difficulties. This systematic review explores the evidence concerning the psychological effects of an enteral [...] Read more.
Aim: After the COVID-19 pandemic, the need for intensive nutritional care in patients affected with anorexia nervosa (AN) increased. The use of NGT was often used to overcome renutrition difficulties. This systematic review explores the evidence concerning the psychological effects of an enteral nasogastric tube (NGT) feeding on patients with AN. Methods: A systematic review following PRISMA guidelines was conducted on electronic databases, including papers from January 2010 to December 2023. The keywords used combined anorexia nervosa, NGT, nasogastric tube, and tube feeding, with MeSH terms. No language limit was imposed. Reviews were excluded from the search. Results: A total of 241 studies matched the keywords. Nevertheless, 236 studies were excluded from the review because they did not match the inclusion criteria. A total of six studies met the inclusion criteria. Of these, three studies were case series, one was a quantitative study of follow up and one was a qualitative exploratory study. The included studies described the hospitalization of patients with AN treated with a nasogastric tube; among these, only one study focused directly on the psychological correlates of nasogastric tube treatment using interviews with patients and medical staff. Included studies suggest that NGT feeding, even if faced in the first instance with prejudices and fears by patients, parents, and staff, is useful not only for weight increase in treatment-resistant patients with AN, but also alleviates their stress from feeding and, in general, it is psychologically well tolerated. Nevertheless, recent in-depth research on the issue is lacking and the existing has a low methodological quality; thus, many psychological effects of NGT application remain underexplored. Conclusions: Although the results suggest good psychological tolerance of the device, the limited data available recommend that more attention should be addressed by the researchers to the psychological consequences of the use of NGT in the treatment of AN since it is a nutrition disorder with prominent psychological roots. Further studies are needed. Full article
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