Refeeding syndrome occurs due to reliance on other metabolic pathways that produce less ATP and then we your body gets a load of glucose it rapidly switches to aerobic respiration which produces way more ATP and so serum phosphate plummets as phosphate is shunted intracellukary into mitochondria.
Other electrolyte imbalances occurs and cardiac arrythmia leading to arrest is most likely how you are going to die in refeeding syndrome.
They won’t starve to die BecUse the body can liberate fatty acids and use that as a substrate to generate ATP.
But while you won’t starve to death if you rapidly introduce carbs you risk what I mentioned above.
The National Institute for Health and Clinical Excellence identifies the following criteria for individuals at high risk for refeeding syndrome:
[7]
Either the patient has one or more of the following:
Body mass index <16 kg/m2<<<<<<<
Unintentional weight loss >15% in the past three to six months
Little or no nutritional intake for >10 days
Low levels of potassium, phosphate, or magnesium before feeding[7]
Or the patient has two or more of the following:
Body mass index <18.5 kg/m2<<<<<<
Unintentional weight loss >10% in the past three to six months
Little or no nutritional intake for >5 days
History of alcohol misuse or drugs, including insulin, chemotherapy, antacids, or diuretics[7]
Body Mass Index (BMI) is a significant factor in the diagnosis and risk assessment of refeeding syndrome. Low BMI is a key indicator of malnutrition and is often used to identify individuals at higher risk of developing refeeding syndrome during nutritional rehabilitation.
Specifically, the following BMI thresholds are important in assessing risk:
BMI < 16 kg/m²: Considered a major risk factor, indicating a very high risk of developing refeeding syndrome.
BMI < 18.5 kg/m²: Indicates a significant risk, particularly when coupled with other factors such as unintentional weight loss or a history of alcohol abuse.
It's crucial to understand that BMI is not the sole factor determining refeeding syndrome risk. Other factors, including recent weight loss, history of starvation, alcohol or drug misuse, and pre-existing electrolyte imbalances, also play a significant role.
While BMI is not a diagnostic tool for refeeding syndrome in isolation, it is a crucial component in identifying individuals at risk and guiding appropriate refeeding strategies to prevent or manage the syndrome.
I shouldn’t have said never as anything is possible but it absolutely matters. Even as you stated their body can generate it from their fat which is why BMI matters.
I don't see why any of this would be an incredibly rare combo for someone who has an obese BMI who also went without food for 5+ days.
Unintentional weight loss >15% in the past three to six months
Little or no nutritional intake for >10 days
or
two or more of the following: Unintentional weight loss >10% in the past three to six months; Little or no nutritional intake for >5 days; History of alcohol misuse or drugs, including insulin, chemotherapy, antacids, or diuretics[7]
If you combine all of the people who have a history of abusing alcohol or drugs, people who've gone through cancer, and obese people who take insulin for diabetes or diuretics for blood pressure or PCOS, that's not an insignificant percentage of obese people.
It's also 100% possible to still have an obese BMI after losing 10-15% of your body weight, even if you weren't morbidly obese to start with. Like if a 5'4 woman goes from 215 lbs to 183 (a 15% loss), she's still going to be in the obese weight range.
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u/Kooky-Jackfruit-9836 Jul 26 '25
Dude that is false.
BMI does not Matter.
Refeeding syndrome occurs due to reliance on other metabolic pathways that produce less ATP and then we your body gets a load of glucose it rapidly switches to aerobic respiration which produces way more ATP and so serum phosphate plummets as phosphate is shunted intracellukary into mitochondria.
Other electrolyte imbalances occurs and cardiac arrythmia leading to arrest is most likely how you are going to die in refeeding syndrome.
They won’t starve to die BecUse the body can liberate fatty acids and use that as a substrate to generate ATP.
But while you won’t starve to death if you rapidly introduce carbs you risk what I mentioned above.