Ask Mary

Refeeding syndrome occurs when beginning to “refeed” a severely malnourished person.  Malnutrition may be due to famine, disease or anorexia nervosa.  The syndrome is exacerbated by a sudden shift from burning fats to burning carbohydrates. It causes a dramatic fall in serum electrolytes accompanied by sodium and water retention.  The fluid and electrolyte imbalances can lead to life-threatening complications including convulsions, coma and death. To prevent the syndrome, refeeding is begun with a high-protein, low-carbohydrate, very low calorie-diet and calories are increased very gradually while monitoring electrolytes and physical signs.  Read more about Refeeding Syndrome at About.com.