Lots of ink is been spilled on the subject of the stigma associated with having an eating disorder. And in order to discuss the subject sensibly we need to get a few terms straight. It was considered a giant step forward in our field when Dr. Thomas Insel, head of NIMH, began blogging, writing and speaking about the fact that all mental illnesses are brain disorders, and that anorexia nervosa in particular was a severe mental illness. Prior to that it had been possible to…Read More
Providers are finally beginning to dip our toes in the waters which have flowed from the realization that psychiatric and psychological disorders are brain disorders. Case in point: social anxiety.
I don’t know whether we see quite a few eating disordered patients with social anxiety because these diagnoses frequently run together or because social anxiety is so prevalent in the general population, but we do.
And now comes an article by Michael Liebowitz and colleagues from Columbia…Read More
Recently a patient of ours returned from a treatment setting where she had been presented with “challenge foods”. In her case she had been given cheetos and soda pop. Now I ask you, why on earth would someone encourage a child to eat such a thing?
A lot of ink has been spilled on teaching Americans in general and children in particular to make good food choices. Just because you have anorexia nervosa as a child, and desperately need to gain and maintain adequate weight, does not…Read More
Sometimes things happen to me that cause me to wonder what planet I have landed on. Five years ago -- to say nothing of ten or fifteen -- whenever I insisted that parents didn’t cause eating disorders, any more than they cause schizophrenia or bipolar disorder or autism, I was treated like I hadn’t done my homework. Thankfully, that has changed. Virtually no responsible eating disorder professional of any stature believes that parents cause severe mental illnesses, of which…Read More
I was recently sent an article from which I will be quoting extensively here (it’s also included in this newsletter - ed.). The article is by Heidi Mills, writing for Outside magazine and features the work of Dr. Emily Cooper of Seattle Performance Medicine. Dr. Cooper has consulted with Kartini Clinic on metabolic health and weight balancing for some time. Originally, we worked together to try and solve the conundrum of patients with AN who appear to be weight restored but who…Read More
I am asked this nearly every week by one parent or another, and I answer reflexively “of course”. In order to do what we do at Kartini Clinic we have to believe our patients can get well, that our efforts and the herculean efforts of the parents can be rewarded. There are no guarantees in life, but there needs to be hope. Hope based on real evidence.
It is true that some patients with eating disorders never do get well. They experience a lifetime of disability and mental illness.…Read More
Sometimes I get discouraged by what appears to me to be the excruciating slowness with which new ideas enter the mainstream of medical and psychological teaching and practice. In the same way that many of us dress in the style that was favored in our youth, many of us do not move far from what we were taught in college or professional school, even when the science has whipped past those teachings with the speed of light. Some professionals even spend their entire lives and careers…Read More
I feel so weary writing this, I almost can’t start. And I am not talking about provider fatigue, for that is a different subject altogether. No, I mean the fatigue I have watched parents feel over all these years of treating children with eating disorders.
Parents are human, even when they can do inhumanly difficult things for the sake of their children. None are saints, of course, but they can come close to one when circumstances require. At least some of them can (and do).
Do you…Read More
At Kartini Clinic our evolution to the current levels of care we offer has been a long one. In the first days of the clinic we offered only inpatient (hospital rounds for medical stabilization) and outpatient care. In 2000 we developed the day treatment (partial hospital) level of care. This was a big step forward and allowed us to “gently land” patients, who required brief medical stabilization in hospital, to a lower level of care. In day treatment, such patients could get a lot…Read More
Talking to a mother whose son has just entered our Food Phobia treatment program I realized that I may not have done a very good job stating clearly what our “recipe” for success with this illness has been. What can a parent expect? What can a child look forward to? What if a provider is forced to treat a child with food phobia in an outlying hospital; how might they proceed?
First, a bit about the diagnosis.
Food phobia is the term Kartini Clinic uses for the sudden onset of…Read More