Refeeding syndrome is a constellation of potentially life threatening symptoms occurring after prolonged starvation. The most dangerous are due to low serum electrolytes (K, Ph, Mg) due to the fluid shifts with an influx of glucose and insulin while in a very low-insulin state. The current approach to this is to titrate the calorie intake slowly but I’m wondering why fat/protein isn’t more highly utilized in the initial refeeding. It seems like this could entirely spare the physiological stressor of a huge glucose and insulin surge. I’m sure this is a manifestation of fat-phobia in medicine but I was curious about other thoughts.