Anorexia nervosa (AN) is showing the highest mortality in psychiatric illness, especially because of its somatic consequences. A special program for refeeding patients with extreme severe underweight has been established in Munich.

From 2000–2010 about 80 patients with any eating disorder were admitted. Data of 53 patients with AN were analysed. After admission most of the patients (n = 43) received a percutaneous gastric feeding tube. A high caloric solution (Fresubin energy) was administered adjusted to bodyweight aiming a weight gain of 700–1000 g per week. After reaching BMI 17 most patients were send for illness specific psychotherapy to a specialized clinic.

The sample consists of 50 (94.3%) females. Patients were diagnosed as having AN restrictive subtype in 25 cases (47.2%), AN binge/purge subtype in 24 cases (45,2%) and AN purging subtype in 4 cases (7.6%). Mean age at admission was 25.4 years (SD 7.0) and mean duration of illness until admission was 8.4 years (SD 5.7). Average length of stay in the intensive care unit was 135 days (SD 79.4). Mean BMI at admission was 12.3 (SD 1.6) and mean BMI at discharge 16.6 (SD 1.6). Thus, mean weight increase was 11.4 kg (SD 5.4).

This intensive care program was established to enable patients with extreme severe AN to participate in psychotherapeutic programs afterwards as it was reported that cognitive function changed in regard to bodyweight. Further evaluation has to consider the occurrence of a refeeding syndrome.