Research

Energy balance

Patients with anorexia nervosa require significantly higher caloric intake (70-100 kcal/kg/day) to achieve weight gain compared to healthy individuals, due to a hypermetabolic state and high diet-induced thermogenesis.

If you have anorexia nervosa, standard calorie counts will not work to restore your weight because your body burns energy excessively during recovery. You likely need to consume 70-100 calories per kilogram of body weight daily, starting lower and increasing gradually under medical supervision to avoid refeeding syndrome. This high intake is temporary and necessary to normalize your metabolism.

GoodSupportsHIGH confidence
AN individuals appear to become hypermetabolic during weight restoration, such that they need an increased caloric intake to maintain a safe weight after recovery... caloric intake would need to be increased, in steps over time, to somewhere between 60 to 100 kcal/kg/day to show sustained weight gain.
Enrica Marzola et al. · BMC Psychiatry · 2013

Why this rating

Based on a comprehensive review of literature (1960-2012) and clinical guidelines (APA, NICE), though specific RCTs are limited.

Source

Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment

Enrica Marzola et al. · BMC Psychiatry · 2013

DOI 10.1186/1471-244x-13-290

narrative_reviewCited 175×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →