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Helping Parents, Together

posted by Julie O'Toole on August 26, 2015 at 6:04pm

Mother nature built us to protect our offspring and, where necessary, the offspring of other members of our “tribe”.  Elephants and non-human primates have been reported to foster or adopt motherless infants and raise them as their own.  Few adults can bear to see the suffering of a child.

Life can throw some of us a lot of pain.  But perhaps the worst kind of pain we endure is the kind we experience when our own small children are suffering.  We are supposed to be able to protect…

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Can Measuring Leptin Lead to Happiness?

posted by Julie O'Toole on August 19, 2015 at 2:27pm

In our clinic we spend a lot of time thinking and talking to our patients about the hormone leptin.

In another instance of the concordance of important findings to obesity science and eating disorder science, the study of leptin and body weight, leptin and menstrual function and now leptin and mood, has revealed relevance to both of these groups.   According to an article titled Leptin Predicts Decreased Depressive Symptoms, from the Neuroendocrine Unit of the Department of…

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Where Are The Grown-Ups?

posted by Julie O'Toole on August 5, 2015 at 2:00pm

I read an article on Medpage the other day - “Docs have Role in Preventing Childhood Obesity” - about recent recommendations by the American Academy of Pediatrics (AAP), which I found both annoying and discouraging in equal amounts.

First the annoying part: a prominent, almost certainly staged picture of two overweight children with their mouths open, watching TV, a huge spread of take-out food on the coffee table before them.  Who allows their children to be photographed like that?…

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What Real Mental Health Parity Looks Like

posted by Julie O'Toole on July 30, 2015 at 1:21pm

According to a June 29th article by Sam PK Collins for Thinkprogress.org., “last week, Missouri Gov. Jay Nixon (D) signed a bill that explicitly states the types of eating disorder treatments insurance providers must cover. The new law builds on the mental health parity law by expanding the definition of “medically necessary” to include mental health treatment. It will also ensure that weight no longer serves as the sole determinant for whether someone may continues treatment.…

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The Trouble With Accurate Eating Disorder Diagnoses

posted by Julie O'Toole on July 15, 2015 at 4:20pm

Almost anyone who works in a specialized field (such as pediatric eating disorders) spends a great deal of time thinking about diagnostic criteria for diseases and conditions.  This is true throughout medicine and psychiatry, of course:  is it type 1 or type 2 diabetes?  Is it autism or pervasive developmental disorder?  Is it bulimia nervosa or binge purge anorexia nervosa? Is it eating disorder not otherwise specified (EDNOS, a term no longer included in DSM-5) or anorexia nervosa?Read More

Traveling with ED

posted by Julie O'Toole on May 28, 2015 at 1:48pm

I am writing to you from Berlin tonight and thinking about a recent article written by Dr. Bulik on the challenges of international travel for those with an eating disorder, in particular anorexia nervosa. In the article Dr. Bulik talked about time changes and irregular meals, of long distance transportation being a danger to those whose brain chemistry is less anxious when they don’t eat and more anxious when they do. It's how a person’s weight may slide down inadvertently, because…

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Telling your kid apart from “Ed”

posted by Julie O'Toole on May 15, 2015 at 5:01pm

I can’t tell you how many parents report their child with anorexia nervosa (or bulimia nervosa, binge eating disorder, fill in the blank…) becoming very irritated, not to say ANGRY, at them for something we call “externalizing the illness”.

What does this term mean?  It actually refers to a very positive attitude adjustment undergone by both parents and patients whereby they are able to separate the sufferer from the illness and blame the illness, not the sufferer, for how hard life…

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The Suffering of Others

posted by Julie O'Toole on May 8, 2015 at 10:04am

“With what incredible courage we are able to endure the suffering of others” -- My favorite quote from English garden writer Christopher Lloyd.  And nowhere does it apply more than in medicine.  And within the world of medicine, nowhere more than in the world of mental health.

When my neighbor is poor, he deserves it for his sloth and lack of thrift.  When I am poor, I am the victim of unfairness and persecution.  When a young man medicates his abdominal pain with narcotics, he just…

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Obesity: Something You Have, Not Something You Are

posted by Julie O'Toole on April 29, 2015 at 3:32pm

The other day I sent around to our staff at Kartini Clinic an article on the gut microbiome (our intestinal bacteria) which is now thought to have some effect on the increasing rates of obesity worldwide.  This article/video is a discussion between Dr Eric Topol (editor-in-chief of Medscape, and a cardiologist by training) and Dr Martin Blaser, of the Human Microbiome Center.  The article covered new discoveries between increasing rates of human obesity and antibiotics as they affect…

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Kartini Clinic’s New Food Phobia Program

posted by Julie O'Toole on April 22, 2015 at 6:04pm

Kartini Clinic has a new home, and we are excited for a number of reasons. For starters, this time around we were able to design our units especially for our kids; they’re full of light and air and space to do art, a new classroom, a roof deck, not to mention our very own commercial kitchen - designed to provide space for parent cooking class as well - from which we serve all of our meals. Our food is sourced from the neighborhood’s New Season’s Market, conveniently located across…

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