According to Gram Research analysis, intensive feeding interventions and physical restraints are used in 6.8% of US anorexia nervosa hospitalizations, with rates increasing significantly from 5.8% in 2017 to 8.1% in 2022. Nasogastric tubes (feeding tubes through the nose) are the most common intervention at 3.8%, followed by physical restraints at 1.7%. While these treatments can be lifesaving, experts emphasize the need for clearer ethical guidelines and exploration of less intensive alternatives.
A new study looked at how often doctors use feeding tubes and other intensive feeding methods when treating anorexia nervosa patients in US hospitals. Researchers examined data from nearly 67,000 hospital stays between 2017 and 2022. They found that these intensive treatments are becoming more common, especially nasogastric tubes (tubes that go through the nose to the stomach) and physical restraints. The study shows these interventions increased from about 6% of cases in 2017 to 8% in 2022. While these treatments can be lifesaving, experts say hospitals should explore gentler alternatives and develop clearer ethical guidelines for when to use them.
Key Statistics
A 2026 analysis of 66,785 US hospitalizations found that intensive nutritional interventions and restraints were used in 6.8% of anorexia nervosa cases, with nasogastric tube feeding being the most common at 3.8% of hospitalizations.
According to a 2026 national study of US hospital data from 2017-2022, the use of intensive feeding interventions and restraints in anorexia nervosa hospitalizations increased significantly from 5.8% to 8.1%, representing a 0.43 percentage point annual increase.
A 2026 analysis of 66,785 anorexia nervosa hospitalizations found that adult patients had the highest prevalence of intensive interventions at 7.2%, primarily driven by total parenteral nutrition and percutaneous endoscopic gastrostomy use.
Research from 2026 examining US hospital trends showed that urban teaching hospitals used intensive nutritional interventions and restraints more frequently than rural or non-teaching hospitals in treating anorexia nervosa patients.
The Quick Take
- What they studied: How often US hospitals use feeding tubes, nutrition lines, and physical restraints when treating patients hospitalized with anorexia nervosa, and whether these practices are increasing over time.
- Who participated: Data from 66,785 hospital stays for anorexia nervosa patients across the United States from 2017 to 2022, including patients of all ages and different racial and ethnic backgrounds.
- Key finding: Intensive feeding interventions and restraints were used in 6.8% of anorexia nervosa hospitalizations overall, but this rate increased significantly from 5.8% in 2017 to 8.1% in 2022—a 0.43 percentage point increase each year.
- What it means for you: If you or someone you know is hospitalized for anorexia nervosa, there’s an increasing chance intensive feeding methods might be used. Understanding these options and discussing alternatives with doctors is important, as experts note these interventions are controversial and should be considered carefully.
The Research Details
Researchers used national hospital data collected from 2017 to 2022 to track how often feeding tubes and restraints were used in anorexia nervosa cases. They looked at three main types of feeding interventions: nasogastric tubes (tubes through the nose), total parenteral nutrition (nutrition delivered directly into the bloodstream through a special line), and percutaneous endoscopic gastrostomy (a surgically placed feeding tube in the stomach). They also tracked physical restraint use. The team used statistical methods to identify trends over time and compared usage rates across different patient groups, hospital types, and geographic locations.
This approach is like taking a nationwide snapshot of hospital practices rather than studying just one hospital. The researchers could see the big picture of how these treatments are being used across America and whether practices are changing. They also looked at whether certain groups of patients—like adults versus teenagers, or patients in teaching hospitals versus smaller hospitals—received these interventions more often.
Understanding national trends in intensive feeding interventions is crucial because these treatments are controversial and can be distressing for patients. By tracking how often they’re used and whether usage is increasing, researchers can help hospitals make better decisions about when these interventions are truly necessary. This data also highlights the need for clearer ethical guidelines and encourages exploration of less invasive alternatives.
This study used a large, nationally representative dataset covering six years of hospital records, which makes the findings reliable for understanding US-wide trends. The researchers used appropriate statistical methods to identify real changes over time. However, the study only captures patients who were hospitalized—it doesn’t include people treated in outpatient settings. Additionally, the data comes from hospital billing records, which may not capture all the details about why specific interventions were chosen or how they were implemented.
What the Results Show
Intensive nutritional interventions and restraints were used in 6.8% of all anorexia nervosa hospitalizations studied. Breaking this down: nasogastric tube feeding was used in 3.8% of cases, physical restraint in 1.7%, total parenteral nutrition in 1.1%, and percutaneous endoscopic gastrostomy in 0.7%. These interventions are not mutually exclusive—some patients received multiple types.
The most striking finding is the upward trend. The overall rate of any intensive intervention increased from 5.8% in 2017 to 8.1% in 2022. This represents a statistically significant annual increase of 0.43 percentage points per year. The increase was primarily driven by greater use of nasogastric tubes and physical restraints, while the use of total parenteral nutrition and percutaneous endoscopic gastrostomy remained relatively stable.
Adult patients (ages 18 and older) showed the highest prevalence of intensive interventions at 7.2%, mainly due to higher use of total parenteral nutrition and percutaneous endoscopic gastrostomy. Urban teaching hospitals used these interventions more frequently than other hospital types. The study also found that usage patterns varied somewhat by race and ethnicity, though the differences were not dramatic.
The research revealed important differences between hospital settings. Teaching hospitals in urban areas used intensive interventions more frequently than rural hospitals or non-teaching hospitals. This likely reflects differences in patient severity, hospital resources, and referral patterns. The study also noted that the lower national estimates compared to previous single-hospital studies suggest that the most severe cases may be concentrated in specialized treatment centers, while many community hospitals treat less severe cases.
This is the first study to provide comprehensive national-level data on intensive nutritional interventions and restraint use in anorexia nervosa hospitalizations. Previous research has focused on individual hospitals or treatment centers, which typically reported higher rates of these interventions. The current study’s lower overall rates suggest that specialized eating disorder treatment centers may see more severe cases requiring intensive interventions, while general hospitals treat a broader range of severity levels.
The study only includes hospitalized patients, so it doesn’t capture the full picture of anorexia nervosa treatment in America. Patients treated in outpatient settings or residential treatment programs aren’t included. The data comes from hospital billing records, which may not have detailed clinical information about why specific interventions were chosen or how they were implemented. Additionally, the study cannot determine whether the increase in interventions reflects more severe illness, changing clinical practices, or other factors. The researchers also note that coding practices in hospital billing systems may have changed over the study period, which could partially explain the observed trends.
The Bottom Line
If you’re hospitalized for anorexia nervosa, ask your medical team about all available treatment options, including less intensive alternatives to feeding tubes and restraints. Have open conversations about the risks and benefits of each approach. Work with your treatment team to develop a care plan that respects your dignity while addressing your medical needs. Strong evidence supports the use of intensive interventions when medically necessary, but they should be used thoughtfully and with clear clinical justification.
This research matters for patients with anorexia nervosa and their families, hospital administrators and doctors who treat eating disorders, mental health advocates, and policymakers developing healthcare guidelines. If you’re struggling with an eating disorder or know someone who is, understanding these treatment options can help you make informed decisions about care. Healthcare providers should use this data to evaluate their own practices and ensure they’re using intensive interventions appropriately.
The decision to use feeding tubes or restraints is typically made during acute hospitalization when medical stability is at risk. Benefits of nutritional support appear within days to weeks as the body begins to recover. However, the long-term success of anorexia nervosa treatment depends on comprehensive care including therapy, medical monitoring, and nutritional rehabilitation—a process that typically takes months to years.
Frequently Asked Questions
What is a nasogastric tube and why do anorexia nervosa patients need one?
A nasogastric tube is a thin tube inserted through the nose into the stomach to deliver nutrition directly. It’s used when patients cannot or will not eat enough to maintain their health. The 2026 study found this was the most common intensive intervention, used in 3.8% of anorexia nervosa hospitalizations.
Are feeding tubes and restraints becoming more common in eating disorder treatment?
Yes. A 2026 national study found these interventions increased from 5.8% of hospitalizations in 2017 to 8.1% in 2022. The increase was primarily driven by nasogastric tubes and physical restraints, raising questions about whether less intensive alternatives are being adequately explored.
Why do some hospitals use restraints on anorexia nervosa patients?
Physical restraints may be used when patients are medically unstable and at immediate risk of harm, to prevent them from removing feeding tubes or engaging in dangerous behaviors. However, the 2026 study notes these practices are controversial and highlights the need for clearer ethical guidelines.
What is total parenteral nutrition and when is it used?
Total parenteral nutrition (TPN) is nutrition delivered directly into the bloodstream through a special catheter when the digestive system cannot be used. The 2026 study found it was used in 1.1% of anorexia nervosa hospitalizations, more commonly in adult patients requiring intensive medical intervention.
Should I be worried about needing a feeding tube if I’m hospitalized for anorexia nervosa?
While feeding tubes are used in less than 4% of anorexia nervosa hospitalizations, discuss your concerns with your treatment team before hospitalization. Ask about alternatives and develop a care plan that reflects your preferences. Intensive interventions are used when medically necessary to prevent serious complications.
Want to Apply This Research?
- If hospitalized, track daily nutritional intake goals, feeding method used (if applicable), and how you’re feeling physically and emotionally. Record any discussions with your care team about treatment options and alternatives. This creates a record you can review with your outpatient team after discharge.
- Before hospitalization, work with your treatment team to develop a detailed care plan that specifies your preferences regarding intensive interventions. Document any concerns about restraints or feeding tubes. After discharge, use the app to monitor your nutritional intake and meal patterns to help prevent future hospitalizations.
- Track your weight, energy levels, and adherence to your meal plan weekly. Set reminders for therapy appointments and medical check-ups. Monitor any warning signs of relapse (restricting food, excessive exercise, body image concerns) and report them to your treatment team immediately. Use the app to maintain communication with your healthcare providers about your recovery progress.
This research describes current hospital practices for treating anorexia nervosa but does not constitute medical advice. Decisions about intensive nutritional interventions, restraints, or other treatments should be made by qualified healthcare providers in consultation with patients and families. If you or someone you know is struggling with an eating disorder, contact the National Eating Disorders Association (NEDA) at 1-800-931-2237 or visit their website for support and resources. In medical emergencies, call 911 or go to the nearest emergency room.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.