Maximizing weight gain in hospitalized eating disordered patients has been associated with long-term weight restoration, improved cognitive and physical functioning, and decreased anorexic thinking. However, rapid weight gain can be difficult to attain as patients with anorexia nervosa become hypermetabolic during refeeding. Current recommendations of the American Dietetic Association and American Psychiatric Association support cautious oral refeeding in order to avoid refeeding syndrome, but resultant use of hypocaloric diets frequently leads to initial weight loss and prolonged length of admission. Recent studies have begun to challenge the traditional means of slow refeeding and are showing more rapid weight gain without detrimental effects. Our aim was to evaluate current refeeding practices at our institution. We performed a retrospective chart review of adolescents, ages 12 to 21 years, diagnosed with either anorexia nervosa (AN) or eating disorder not otherwise specified (ED NOS) admitted for inpatient refeeding over the past three years. Power analysis, based on prior studies, determined that 21 subjects would be needed to know the average length of stay within three days range with 95% confidence. In addition to basic demographic information, we collected detailed anthropometric data, including daily weights from admission to discharge. We also documented feeding regimen, including daily calorie counts and rate and timing of increase in daily calories. Length of stay was recorded along with any electrolyte abnormalities associated with refeeding syndrome. Descriptive statistics were performed. We reviewed charts of 21 adolescents, admitted from March, 2009 to May, 2012. Mean (S.D.) age was 16.2 (1.67) years, and 95% were female (n = 20). The majority (81%, n = 17) were diagnosed with anorexia nervosa. Mean (S.D.) length of stay was 17.3 (11.1) days, and mean weight gain during admission was 2.03 (1.94) kg. Percent ideal body weight increased from 75.4% (6.53) on admission to 79.0% (6.07) on discharge. However, 71% (n = 15) of patients experienced initial weight loss after admission. Daily calorie counts increased from 1271 (536) on hospital day one to 2304 (641) on the final day of hospitalization. The dietician frequently recommended increasing intake by 200 calories every other day, although the recommendations were often not followed by the primary team, mainly due to patient complaints (e.g. nausea, abdominal pain). Three adolescents (14%) had hypophosphatemia early in their hospital course (days one through three), but none received supplementation and phosphorus values self-corrected to normal the following day. One patient (5%) had hypokalemia for three consecutive days and was started on oral potassium supplement. No patients had clinically significant refeeding syndrome. In this retrospective chart review, conservative refeeding was employed for adolescents hospitalized with AN or ED NOS. Patients experienced initial weight loss with modest weight gain despite relatively long hospital stays. A few patients experienced brief hypophosphatemia early in admission, which self-corrected within 12 to 24 hours, arguing against true refeeding syndrome. In our next study, we hope to implement more aggressive means of refeeding in the same setting and examine rates of weight gain, length of admission, tolerance, and safety with faster refeeding practices.