Refeeding syndrome Puns

Hi ! I'm so close to finishing my first 72 hour water fast (had nothing else at all) and was ready to have watermelon (or juice) to start as my first meal before bed (11pm is when the 72 hours are up).

I started looking up more meals to have prior to eating back to normal and from reading bad experiences i'm worried about doing the wrong thing.

Are there any suggestions on post fast meals and duration ? Am i worrying too much for such a short fast ?

Thanks for reading !

I broke a 63 hour fast I was going for 72 but was behind on my electrolytes) with a bottle of Gatorade. I feel like I made a terrible mistake drinking that much sugar after fasting. I was feeling light headed so I decided to break fast and introduce some sugar but now I’m concerned that I may have triggered a massive shift of electrolytes and fluid volume.

I’m 2 full years into recovery. I have gained weight slowly, >!25!< lbs per year for a total of >!50!< lbs (I’m in the overweight BMI).

I did not experience hyper metabolism or extreme hunger at any point so I’ve been force feeding myself at least over >!2000!< calories in 2021.

The past 3-4ish days, I’ve been forcing myself to eat at least >!3000!< calories and really honor ANY amount of hunger I have, no matter how small and things are happening. It feels like my heart rate has gone up a bit already. I woke up with 71 bpm which hasn’t been normal for me at least in the past year. Measured it a few more times this morning and it’s been up to 80 bpm when it used to be around 65 not too long ago. Idk if these are heart palpitations?? My chest doesn’t hurt, I just feel my heart pumping stronger. I also woke up kind of sweaty.

I’ve also been pooping at least 3-4 times a day. And I’m fatigued even though I’m not doing anything except laying in bed and eating.

I’ve been nauseous at certain points- not continuously- but randomly it seems like. Maybe connected to the bloating and digestion, I can’t tell yet.

I’m mostly concerned if I’m basically giving myself refeeding syndrome right now. I will be calling a dietician as soon as possible but unfortunately I most likely can’t see anyone this week for a legal obligation I have no way of getting out of. I have a NP check up in 2 weeks. Do I continue eating a lot? Idk what to do.

Hey there. Trigger warning for weight numbers, for medical purposes only.

I’ve been bulimic for nearly a decade. My pattern has been restricting during the day, then binging and purging at night. However I was doing it, I was able to maintain a caloric intake sufficient to maintain a certain weight.

The good news is that I’ve been Mia-free for over two months. The bad news is that while I gained some weight initially, I swung to the other end, and started eating breakfast, then dinner like 10 hours later. Altogether I think my caloric intake was still around 1,000 - 1,200 day, which isn’t good. It’s been like that for a while, and I’ve dropped 10 lbs. my starting BMI was 21, and now my BMI is about 19.4.

I need to bump these numbers up, but I’m terrified of refeeding syndrome. I know risk factors include limited intake, weight drop, etc. I was monitored for it once, with no issues. But that was before Covid, and the hospitals in my area are maxed out, and I can’t wait a month for a PCP when I need bloodwork sooner.

What symptoms should I be looking out for? I ate a lot more than I usually do last night, and today I’m bloated and tired. I was reading that fatigue is a symptom. My instinct is to go back to restricting, but I know I shouldn’t. I’m just scared is all.

Am I at risk, and should I be worried? How can I prevent it?

Ok so i started gaining weight and ive never in my life hit 100 lbs. im 5-1 height but people always said im smaller. Now that im gaining weight i think i just been sick. I hit 100 lbs and now im sleeping a lot and my legs feel like they’re constantly burning.( plus the normal sticky sweats from recovery) In the past with gaining weight (id be like 92 then stay at a solid 96 for months then fluctuate.) Anyone else have pain or swelling from recovery weight?

Today I was scrolling through reddit and saw a post abt refeeding syndrome so I clicked it. I didn't understand it so i did some research and now i think i understand it, but now im kinda scared. I'm not ready to recover yet, but if I do someday will I be at risk?? how do I change that?

I read that if you lost 15% of your weight in 3-6 months you could be at risk, or if you are malnourished and not eating enough.

I lost almost 20% of my weight in less than 3 months. Im not restricting too heavily, and my blood exams tells me that my glucose and iron is pretty low.

Am I at risk??? Can someone please explain what is refeeding syndrome? I don't think I totally understand it :/ And how can I recover without having the risk?

I really need to recover, because if I don't, I'm literally pretty sure I will die. I'm trying to follow my nutritionist's recommendation to increase 200 calories a week, started yesterday by just increasing about 100. Previously I was eating about 950-1050. Yesterday I ate 1153 (I really carefully weigh or measure every single bite I consume, so I'm pretty sure of accuracy here).

Today I feel nauseous, sweaty, dizzy, and anxious. But also I only got 4 hours of sleep. Does this possibly sound like refeeding syndrome, or just a coincidence? If the former, at what point would you actively consider going to the ER or something, based on your experiences?

Okay, here is my refeeding post of shame. Quick background if you haven't seen any of my 30-day fasting posts: I started a 30-day water fast, supplementing electrolytes to stay alive and alert. I did fine during most of it except for a bit of heartburn toward the end. I decided to stop the fast after 24 days, because I was feeling progressively weak and neauseous.

I had a refeeding plan. I planned to do bone broth for 2 days, followed by soft canned vegetables, followed by soups, sauerkraut, etc. All the things they tell you to break the fast with. I knew about the dangers of breaking a long fast. I knew I was supposed to take it slow. In reality, here's what happened.

Day 1. When I decided to break my fast, I had already finished my electrolyte powder for the day. That's about 1000mg of sodium and I cant remember the magnesium and potassium. I broke the fast on bone broth. The brand I chose for the first broth tasted terrible. It took a couple of hours to slurp it down. I was left with a terrible taste in my mouth. I wasn't hungry at all. My stomach did not want food at all. But I was desperate to get rid of the taste. So a couple of hours after the broth, I had a fork full of sauerkraut. It was delicious. But still, that taste in my mouth was still there. (Yes, I tried brushing my teeth and tongue.) I finished the day with one more cup of bone broth, this time I switched to my normal brand. It was delicious, but I really wasn't hungry. I waited 16 hours to reintroduce the next mouthful of food.

Day 2, I woke up very thirsty, but I did not want to drink. I didn't want to eat either, but I knew I'd never get my digestive system back up and running if I didn't try something. Had some bone broth. Barely any water. Yucky taste in mouth was still there. At lunch, I pushed a bit and had a bowl of canned vegetable soup, which did have some noodles in it. At dinner, bone broth and about 1/4 cup of sauerkraut.

Day 3, I started to break the rules. I was hungry for something more substantial and was tired of that bad taste. For breakfast, I had a can of split pea soup. I felt afterward like I had just eaten Thanksgiving dinner. Very full. Despite already feeling full, for lunch, I had this great big corned beef and salami sandwich on rye bread with crunchy sourdough pretzels on the side. And at dinner, a can of lentil soup. This was way too much food on day 3. I should not have even eaten solids or carbs at this point. I vowed, I would return to bone

I'm starting a 30 day fast on Monday and have read the linked reddit post in the FAQ, but don't understand what this looks like from a practical perspective. How much should I be supplementing? How many days before do I take the thiamine? What does "not too much water and salt" look like?

I find so much mixed information online, does anyone have any PRACTICAL experience doing this?

i’m 17 (F), >!156cm!< and >!44kg!<. i’ve been eating 3 meals 3 snacks etc but have dropped weight from 47kg slowly through compulsive exercise and such. i need to gain weight or else i could end up back in ip. if i try to increase my intake will i be at risk of refeeding syndrome? i had a blood test in july and everything was fine

So I haven’t heard about this yet and decided to dig in a little when I felt eh symptoms. TW: Numbers For the past month I’ve been eating around >!400-800!< per day and for the past 2 days I binged and reached around 2k cal which was double to triple my usual. I had a ton of work to do and I ate bc of stress and during the first few hours yesterday night after the big binge my stomach started hurting, I felt very very nauseous and my head hurt. I thought nothing of it and continued then later went to bed at 3am. The next morning was when it was aweful, for at least 4 hours straight I had bad cramps, stabbing chest pain, nausea, I felt really dizzy and my heart was beating in odd patterns and fluttering as if skipping or adding an extra beat per min. My breathing was really difficult and heavy and it was just awful. The pain continued but slowly subsided and kept turning on and off. Today is day 2 and it’s night rn and I still feel it all but idk if it’s refeeding syndrome or not. Could anybody help?

I cannot afford a dietitian and my country does not help people with my BMI with refeeding

trigger warning - numbers including counting calories

Sorry about my other post. It was nonsense because I had refeeding syndrome and was acting insane and crazy.

I had a seizure, trying to recover. My electrolytes were bad and I had heart abnormalities.

I’m back down to eating 1000kcal, yesterday I was eating 900kcal etc. I will add 100kcal a day until I reach 1500kcal. But, in the guidelines given to me, it recommends jumping from 1500kcal to 2000kcal the next day. I’m not going to do this I am going to go 1500,1750 and so on every two days.. do you think even that is safe? I am obviously extremely cautious right now because my life is at risk and having a seizure has terrified me.

I am taking these supplements: Multi minerals (375mg magnesium, 300mg phosphorus, iron, potassium, zinc x5 per day) , strong multi vitamin, strong b vitamin and x2 100mg thiamine per day. Oh and vitamin d

I will also go to the hospital to have blood tests and ecgs at various times when I am upping.

Knowing my body, I will do all this and still my stupid electrolytes will try to kill me again.. seriously, this is so stupid, and I am struggling a lot.

Will this plan be okay? Will I need to be careful of macronutrients? Thanks

i know nothing can be diagnosed & a doctor would be a better bet but i’m hoping someone’s maybe experienced similar.

i’ve been restricting for awhile at dangerous levels & decided i probably needed to eat more so i don’t die. i had been eating the same 3 foods so in hindsight maybe sticking to similar foods would’ve been a better idea, but as a fuck u to the anorexia i decided to have a cheeseburger. thirty minutes later i’m having what i’m gonna call an episode, heart rate is really erratic, laying on the floor because i feel like i’m gonna pass out, kinda twitching & fidgeting around cuz it feels like my body might stop if i stop moving.

eventually it stopped after i had some toast (easier to digest) & some electrolytes (which i know have to do w refeeding syndrome). but over the next couple days i tried to still eat more including more variety of things, & i still keep getting that feeling/those episodes. not quite as bad, but the confusing thing is i never felt like this when restricting. i felt fine. & now i’m eating so you’d think i’d feel better but this is happening & i feel worse? it’s worth noting i didn’t just crank up to maintenance i only about doubled my daily intake which wasn’t a lot to start with. to try & make it easier on my body.

so yeah idk anyone experienced this?

Is anyone else too far gone to try and fix it on their own? I haven’t had food in a long long time and I’m wondering if I’m at risk for refeeding syndrome if I ever try or am forced by family to eat and then put my life at risk because of that. I don’t know. Just a scary thought.

I volunteer at an animal shelter in Asia. Often when dogs come to us they are severely under-weight and malnourished.

What's the best way to help them rapidly gain weight but still avoid refeeding syndrome or other complications?

Our vet says it's ok to just feed them until they are full, but I'm worried that may cause other health issues

[here is an example of the weight] (https://imgur.com/a/m4vFf8M)

So my number 1 priority is phosphorus.

I'm planning to use a multivitamin from Life Extension, snake juice and I'm considering buying this. Has anyone tried it before?

Any tips on what to break a longer fast with? I've seen greek yogurt recommended, but I'm not sure if that's meant for a really long fast. Bone broth seems terribly overrated, according to this analysis a home made broth with bones from grass-fed bison cooked in a vinegar-water mix for 24 hours only had 68 mg/L of phosphorus!

Anything else I should know?

In malnourished states as in anorexia nervosa, rapid refeeding can cause electrolyte imbalance. It's a shift from catabolic to anabolic state. Hypophosphatemia can occur as increased cellular uptake of po4......leads to decreased atp production and availability.......most affected organ is heart.......leads to arrhythmias.

So I've been doing a bit of in-depth research before jumping into an extended fast, and I'm seeing phosphorus deficiency popping up quite a bit as a key reason for refeeding syndrome.

I do realise though that not much is mentioned about phosphorus in fasting discussions. Does anyone have any insight as to why that might be?

Also, does anyone who has done extended fasts (21+ days) have any experience supplementing phosphorus? If yes, how do you go about it, and how does it compare to fasting without it, assuming you've done both?

So I made a post last night while I was in bed about if extreme hunger has any potential side effects since I was shaking, dizzy, really thirsty, and my heart was beating really quickly even though I was lying down. A couple hours passed and the symptoms got worse; I woke my Mom up to tell her I didn’t feel good and we phoned the non-emergency doctors thing and they told me to go to hospital immediately. I also started jerking and twitching at this point so I knew something was definitely up. But yeah, after blood tests and heart scans my electrolytes were imbalanced and my body was going into a state of shock. I’ve spent the night there, they’ve sorted me out and I’m back home now but jeez that was horrible. Please be careful guys- totally give into the extreme hunger, even the doctors told me to carry on doing that. But if you start feeling unwell in anyway, especially with the symptoms like I listed, pleaseeeee phone a doctor right away since refeeding syndrome isn’t anything to ignore :( I‘m glad I went to my Mom, I was leaving it for as long as possible to see if I got any better but it started getting worse, I probably got to the hospital in the nick of time. Refeeding syndrome isn’t anything to be messed about with or ignored. I can’t believe I experienced that :(

So I’ve been going through the refeeding/malnutrition process & although I’m more so working on maintaining, my dietitian mentioned that she wants to see weight gain. Anyways, I’ve been trying to follow my refeeding meal plan but it seems like I’m losing some weight/noticing weight loss. Is this normal?

I don’t want to gain because I’m fine maintaining but I don’t want her to increase my meal plan just because I’m losing some (she said she’d increase if I were losing on this meal plan).

I’m not trying to lose but also obviously don’t mind losing more.

I’m just wondering if it’s normal..

It’s weird that I can notice because my body dysmorphia is so bad most of the time. So I notice loss but also feel/see myself as massive.

Yesterday I ended a 7 day fast, (172 hours) and started stressing about my first meal. I've seen refeeding syndrome mentioned here a-plenty, not only in relation to long fasts (10+days) but also 2/3 day fasts. And honestly, after doing some research I can't help but feel this sub is way over the top. From what I researched it is only really relevant if the fastee has been malnourished for an extended period of time, is severely underweight, has a disease which results in malnourishment, or the fast continues for an extended time, 10+ days. And normally those at a real substantial risk will have a combination of these factors or one to an extreme.

Of course, erring on the side of caution is never a bad thing, but I think by upholding this obsession with refeeding "in the proper way" we add an unnecessary stress to what should be a positive experience. I can honestly see the concept of refeeding syndrome preventing some people from experimenting with fasting at all or naysayers using it to support their ideas that fasting is always bad and unhealthy.

I put my mind at rest and broke my fast with takeaway pizza as the end coincided with my partner's birthday. We had fun, we ate a lot (a lot!) and apart from feeling bloated, I had absolutely no negative effects. No carb headache, no rushing to the bathroom, no racing heart, nothing. The way some people talk on this sub my pizza adventure should have ended in an ER visit haha.

Now my stats, I'm female, I have a healthy BMI,( but trying to lose 20lbs) and ordinarily I eat keto. I only drank water during my fast and took electrolytes. I think keeping up with the electrolytes is probably key to be able to break the fast with pretty much anything and not feel unwell. So let's just keep pushing the electrolytes which this sub is excellent at. I know mileage may vary but we're all humans, I don't think anyone would be in any medical danger (unless fit into the category of one of the factors above) doing what I have done. I doubt I'd be in any medical danger had my fast been significantly longer.

Again caution is a good thing, but I think over-caution, such as responding to "How can I safely end my 3 day fast" with "avoid blah blah, eat only a small bit of blah blah" only adds to this notion that fasting is risky, difficult or unhealthy. I mean, how can anything that turns food into poison in only a matter of days be a good idea?

Of course refeeding should be considered when someone is undertaking a half

I was just wondering what’re your guys’ experiences with refeeding syndrome cuz I’ve been looking symptoms up online and I’m not sure if that can explain what happened to me

Hi all! Long time lurker, new time poster here. For quite some time I have been on/off doing OMAD and occasional 24-48 hr fasts. I've been hesitant to try anything longer than 3 days on account of that I've been worried about electrolyte supplementation, but I think for the most part I now have a firm understanding of the main three (potassium, magnesium, and sodium).

One thing I'm having a lot of trouble understanding is refeeding syndrome and how to avoid it, and how to safely break an extended fast. I plan on doing a three day fast followed by a seven day fast sometime within the next month and I'd like to be prepared. Eventually, I would like to build up to a 21 day fast and a 30 day fast, but way before then I want to have a firm grasp of this condition.

So here are some of my questions (and any additional information provided would be more than welcome) (also I did read the links provided I'm just having trouble dumbing it down for easy reference for myself):

1. What is refeeding syndrome?
2. At how many days of a fast does refeeding syndrome become a concern?
3. What supplements should I take after I am done fasting before I break my fast?
4. How many days should I refeed(?) in proportion to how long my fast was?
5. What is an example of a safe refeed for a 30 day fast, including supplements, if applicable?
6. Can you safely break a fast on a keto refeed? If yes, please provide an example refeeding plan.

And I think that's about it for now, but if there's any additional information please let me know!

Thanks in advance and stay awesome!

TW: hospital / refeeding syndrome / weighing one's self / electrolytes / eating / restricting / vague mention of food

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So last night, after a good and particularly invigorating therapy session, I kind of jumped the gun. I went from restricting extremely low (no numbers) to ordering out with my husband. I knew I was scared because I said,

'We gotta do this fast before I change my mind.'

It was a large meal. I ate my main course (a large burger), a handful of the side, and even a couple of the appetizer. Shortly after, I threw up, and my face and fingers started to go numb. My speech started to slur, and I was confused, weak, and dizzy as heck.

After laying on the bathroom's cool tile floor for a bit, I decided to go to the hospital.

They kept me for HOURS trying to get my electrolytes balanced, and watching my heart for arrhythmia. They took multiple things of blood, and wouldn't let me drink any water (for fear of me throwing up more). My pupils were dilated, and my hand-eye coordination was off particularly my left.

And I was diagnosed as having refeeding syndrome. They got me situated, back and balanced, and sent me home close to 2 in the morning. My husband wouldn't sleep. He came to get me.

I think I have finally accepted, despite all the evidence stacked against me, that I have an eating disorder. I know that sounds so stupid but I have accepted it. Despite doing all the things I was doing, despite seeking therapy and the clinic, the tests, I still thought, I'm too old for this. This can't happen to me.

In spite of the late night, the burger, the refeeding syndrome, the doctors...

This morning I still weighed myself.

Still.

And for some reason, that seemed the most important part, the most important thing I do... Before I ingest anything, before I drank any water, after going to the bathroom, before I was fully awake after sleeping in...

I weighed myself.

And as I was leaving the bathroom, it was like a small little switch that just clicked and a quiet thought said, "You're mentally ill, you know that, don't you?"

And I answered aloud, "Yeah, I know, thanks."

Like I didn't need reminding, but for some reason I did. And I don't know if that's my 'authentic voice' or my 'Ed voice' mocking me. But that's also something my mother has said to me before. So who is it? Is it Ed? My mother? Or is this just how I deal with things?

It's strange, because I have days where I accept that I'm sick, and others where

I have not eaten anything for (x) days - (sorry, I’m worried about breaking rule 10, but basically it’s the number of days that is classified as refeeding syndrome risk). I feel very dizzy and light headed, irritable, etc. I have had RF syndrome before but it was supported in a hospital setting and I was given appropriate supplements. I also had severe hypoglycaemia during a similar incident but again this was monitored and managed in hospital. This time I am at home, I have a blood test and ECG on Tuesday and not due to speak to my ED nurse til Wednesday. I am really scared about eating anything at all even though I feel horrific. I’m not sure what action to take right now. I’m scared to eat because of the ED as well as the RFS risk. I really don’t feel very well and I’m scared what will happen both if I do eat and if I don’t eat. Could really do with some advice. Thanks.

Any tips on how to avoid it? I just want to eat normal and be fucking healthy again😔

Im pms-ing (i guessed) but Im also getting a refeeding syndrome or something...in just two days I ate the amount I normally eat in 3weeks. I was so sick I almost had to call ambulance. Now after several hours its more bearable but still everything hurts and I want to eat more. Idk what to do. I feel so bad physically and mentally..

Hi! I am a 23 year old woman. I'm 5'5, and suffer with anorexia(not weight related. I have a severe phobia of vomiting so I became fearful of eating.) and I am doing the refeeding process at home due to covid and emetephobia+agoraphobia. I was eating about.. 2 times a week for maybe a month. After a month of eating well. (I'm in constant contact with my doctor and dietitian) I am absolutely terrified of developing refeeding syndrome so I have not gone above 200 calories. (Yet) I'm on day six of refeeding and I've been going up by 50 calorie increments. I started at 30 calories day 1. Here is a photo link of my smart scale weight thingy..weight.

Edit; this was January compared to today.

Hello everyone,

I have been very underweight my whole life and have not been able to gain weight, but in the last few months things have gotten bad and I lost over 10% of my body weight, weighing in at a mere 84-85 lbs (37 kilos). I am also 5'3" (160 cm) for reference, making my BMI fall around just under 15. I have severe stomach pain every day and have undergone so many different tests with absolutely no findings, so it has been labelled IBS for lack of a better explanation. With this weight loss, I developed POTS-like symptoms and hair loss, as well as not being able to tolerate exercise. Once my weight dropped to 85 pounds, my mother urged me to see a nutritionist to help me figure out a diet that would work with all my IBS food sensitivities. Upon our very first meeting, the nutritionist tells me that I need to go inpatient before she can really help me. I was shocked, I was honestly just expecting her to help me with meal planning and stuff to gain weight, not go from 0 to 100 with going from my dorm room to an inpatient ED facility. My parents told me to go get evaluated by a doctor, so the next morning I spent over 3 hours there. I was just expecting to be weighed and looked at, appearance-wise, to get a second opinion, but they ended up running several blood tests and an EKG. In addition to being diagnosed with an eating disorder than morning, she also diagnosed me with OCD in less than 5 minutes while talking to me. I feel like we've got the ball rolling so fast that I can't keep up. Fortunately, everything has come back normal so far, but my nutritionist told me that normal results are normal for people with an eating disorder, until they're not. She told me I still need to go before things are no longer normal. She also said that I may not even have IBS, and all these issues are caused by the ARFID. Additionally, she said she is concerned about me developing Refeeding Syndrome, which I did not know was a thing until yesterday.

Now, I know I am not special and my fears are no more extreme than others, but I am so scared. I have severe anxiety issues, and I'm afraid of them putting restrictions on me like they would for an anorexic/bulimic person (For example, bathroom monitoring, not allowing bathroom breaks). I do not have anorexia or bulimia, I have ARFID. I am so anxious by not having a private bathroom for my IBS that I have my own bathroom in college that I share with no one. I also have severe Emetophobia, so being around anyone who vomi

hi, i (f16) have ARFID and i have lost over 20 pounds since august 2020. the last time i talked to my doctor was today but she saw that i hadn’t gained any weight and that i was struggling but she didn’t say much. i’ve eaten a lot more than usual today, and even though my stomach isn’t grumbling and i don’t feel hungry, i really want to make some food. i’m really worried about getting refeeding syndrome as for months now i’ve either gone days with no food, or only eating “safe” foods (pasta, boxed mac and cheese, certain beans of chips, etc..). ive been malnourished for a while now but i’m not sure how bad. my bmi is currently 17.9 i believe. i’m really worried about eating food and getting refeeding syndrome and no one believing me. should i go to the hospital for treatment to avoid refeeding syndrome, or am i going to be okay?

Just a thought

If she would want to recover, how difficult would it be to do it without medical intervention? I know you can't just start eating a normal amount, as that's how some Holocaust survivors died. Along with monitoring her vitals/organs/mental health/ possible medications. She basically needs to be treated by a doctor.

I'm kinda in a not-the-greatest spot right now. Have been averaging ~400 kcal/day for 6ish weeks now, and my weight has dropped from BMI 17 to BMI 15. Today I am having really, really strong urges to binge and purge, but I am worried that if I binge I may be at risk for refeeding syndrome. Is this a real concern?

IDK if this sort of question is allowed (please tell me to delete if not), I just don't want to make things even worse for myself right now. Fighting this disorder has been harder than ever lately...I reached out for help from a new doctor but haven't received any recommendations for treatment yet. Anyway, I appreciate any advice from people who may be more knowledgeable about refeeding; thanks.

Using a throwaway account for this since I'm asking for a friend of mine, and don't feel like it's my place to give away details about their situation if it could be linked back to them.

My friend and I live together, and I'm currently caring for them.

I realize this is an issue on which we should have involved medical professionals *much* sooner, but we wanted to avoid clinics and hospitals as much as possible due to the ongoing pandemic (our surrounding area is being hit hard at the moment). This is a case of us not realizing the severity of the issue at first, me thinking I knew what to do, and then realizing I'm in way over my head. Please don't judge me for this.

My friend has been trying to gain weight for the past year or so, but struggled with eating enough. I tried to push them to eat more, and often got them foods with a lot of calories to try and help them maintain or gain weight. However, their appetite has been constantly dwindling, to the point of living off of only some cup noodles every day around November last year.

Around the same time, another friend of theirs suggests they drink protein shakes to count for another daily meal. They did this, but also stopped eating entirely for about a week, living only off of those shakes. Following that, I tried to get my friend to eat more again, and they'd happily eat a small sandwich with some chicken and ham, but wouldn't eat anything else for the rest of the day. Over the course of November to now, they've lost about 5 kg of weight, and is now sitting at a BMI of 15.9.

On Friday, I began pushing them to eat more again and specifically made foods I know they like, and while they did eat more, they also had adverse effects due to it (overall fatigue, stomach aches). I looked into this a bit and learned it may have something to do with a thing called "refeeding syndrome". Looking into this more, I found sources saying that this is caused by a shift in metabolism, and by deficiencies in phosphates, vitamin B1, magnesium, and potassium.

On Saturday, I bought supplements for vitamin B1, magnesium, and potassium, but couldn't find any available for phosphates. To make up for that, I tried to get my friend to drink milk and prepared meals that contained a lot of chicken, both of which supposedly contain phosphates in relatively large amounts. I also asked them to drink primarily orange juice as a way to introduce nutrients without needing to eat that much more food, as a temporary measure. They'