I (among other people)  have recently been challenged by Laura Collins to get the message out that weight restoration is critical to psychological recovery in anorexia nervosa.  Some authority, Laura says, must declare definitively that psychological recovery is tied to weight restoration.

Some authority….ok…but who?

Since the late 1990’s the AAP (American Academy of Pediatrics) has issued guidelines for hospitalization (after all, a serious intervention) based on medical parameters…

This week I have had the privilege of treating a young person whose parents moved heaven and earth to fly them across the entire United States to seek what they believe to be the best care available anywhere.

Can you imagine how humbling that is for us?  To be thought the best care by parents who are entrusting you with the most precious thing they have: their child?  It’s not that they come with stars in their eyes and “yes doctor, whatever you say” written cross their foreheads—far…

Every researcher in the field of eating disorders tries their best to reduce the burden of suffering for patients.  They try to contribute to the meaningful scientific discussion.  Having said that, however, I am going to proceed to critique an article by Natalie Godart, Sylvie Berthoz, Florence Curt and colleagues at the Institut Mutualiste Montsouris in Paris, France; the French National Institute for Health and Medical Research; King’s College, London Institute of Psychiatry; the…

This is the second and final case presentation Dr. Morton makes of two illustrative examples of anorexia nervosa.  This time it is a young man.  He mentions that the patient is the son of a friend—so imagine how motivated he was to establish the correct diagnosis and find a successful treatment! First Morton discusses the differential diagnosis, establishes the correct diagnosis, discusses failed treatments and finally discusses his successful treatment of what, to him, is a chronic…

As promised, here is the first patient case report by Richard Morton in his 1689 book, Pthisiologia. My comments are in regular italics and his original text in bold (with original, Stuart England grammar and spelling!).

History 1

Mr. Duke’s Daughter in S Mary Axe (a medieval parish in London memorialized by a modern London street of that name) in the year 1684. and the Eighteenth Year of her Age, in the month of July fell into a total Supression of her monthly Courses from a Multitude…

There seems to be a discussion that simply will not die in the world of eating disorders (particularly when it comes to anorexia nervosa) around whether the “desire for thinness” is culturally bound and whether AN is a “modern phenomenon”.

A few years ago I was fortunate enough to acquire a copy of Pthsiologia, a book written in 1689 by Richard Morton, an astute observer and physician of his day.  Morton’s description of two cases—one in a boy and one in a girl-- of what we now call…

I am often surprised and pleased at the way we—pediatric providers who believe in the biological basis for eating disorders and parents who are caring for their children-- stumble our way forward trying to make things work and find ourselves on the same track.

I was given this lovely plate after the FEAST conference, by a mom, with the following kind words:

Dr. O'Toole,

Thank You for believing in parents and for all your hard work and dedication in the treatment of EDs, and…

If your child or adolescent is admitted to a hospital for the medical complications of an eating disorder, you need to carefully assess adequacy of care at that hospital.  

Common sense would dictate that we not become aggressive, belittling or demanding of professionals on whom our child is temporarily dependent for medical intervention, however you should not hesitate to inform yourself, rely on your intuition and experience and ask questions.  The days of “because I said so and I…

I have a lot to give thanks for, great and small, and I bet you do too: for the soft, cold rain instead of icy roads, for the warm cup of coffee at the start of a hard day, for a season where oranges are fresh, for good books and seed catalogues…..

I give thanks this week for the continued good health of my children and grandchildren.
And while I cannot (yet) give thanks for the health of my husband, I give thanks for the physicians he has encountered who care enough to transplant him.…

Friends:  at the F.E.A.S.T. conference in Washington DC, I was approached by a mother (we’ll call her Kathy) who thanked me for helping her out from a distance with my blog titled “Determining Ideal Body Weight”.  She told me how she struggled to come to grips with the weight gain her daughter truly needed to get well.  I was very impressed by her eloquence, humility and dedication to her daughter.  I asked her if she would consider writing a guest blog so that other parents…