"Almost one year later and our daughter is doing great! She seems to have almost no issues around food...Our vigilance never ceases...
"Ruth" – New York City, NY | read more »

Can I speak to the chef, please?

posted by Julie O'Toole on October 22, 2014 at 2:33pm

It's not very common for me to hear things out of the mouths of our patients that I have not heard before -- I have heard most things many, many times.  For example:  “exercise (insert dance, soccer, cheer, ballet, etc) is my only social life, I don’t have any friends without it,” or “school is the most important thing to me.  I can’t get behind because of treatment,” or “I don’t care abut how much weight I gain, as long as it’s muscle,” or “I don’t tolerate milk products, fatty…

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What To Do When The Weight Comes Back

posted by Julie O'Toole on October 8, 2014 at 11:12am

I get asked all the time: will the “extra weight” come off her stomach or his face?  Many people are appalled to hear that parents whose child was starved and wasted could become focused on worrying that “they might have gained a little too much weight”.  But it happens all the time. We talk and talk about weight re-distribution to families, but it’s hard.

I am grateful, therefore, for an article that appeared in the September 2014 issue of the journal Nutrients titled Anorexia…

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You Will See the Doctor Now

posted by Julie O'Toole on October 1, 2014 at 3:32pm

I was born in 1949, the second World War had been over for a mere four years.  As a girl raised in the 50’s and 60’s I was taught to read books, wear dresses, skirts and pinafores, and to sit still.  As long as I had a book the sitting still was no problem.  And I always had a book.  At sixteen I participated in the American ritual of learning to drive a car, and never looked back. At eighteen I went to college and sat in class with everyone else, my class choices limited by what was…

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Genetics of Brain Disorders

posted by Morgan O'Toole-Smith on September 17, 2014 at 9:31am

Medicine is moving at the speed of light.  And that’s a good thing.  We have a long road ahead of us to move out of the pre-scientific eras, where no one required an evidence base to do most anything.  And we face an even longer road to shed the paternalistic roots of “doctor knows best” (not to mention parent blaming for brain disorders!).  But perhaps the longest road of all is the road that is now leading us to real “individualized” or “personalized” medicine.

Actually, I prefer…

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The Promise of Personalized Medicine

posted by Julie O'Toole on September 3, 2014 at 10:15am

Advances in medicine come in all shapes and sizes: vaccines, antibiotics, anti-virals, immune system boosters and reducers, technological changes and recently, the hope that faster, cheaper and more accurate genetic analysis can bring us the new approach to medicine and medications: personalized medicine.

As I have mentioned in a previous blog, a leading proponent of personalized medicine has been Dr Eric Topol, editor-in-chief of Medscape and director the Scripps Translational…

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Save Yourself First

posted by Julie O'Toole on August 27, 2014 at 3:18pm

It has become almost trite to advise parents struggling with the “severe pushback” of doing battle with their child’s eating disorder to remember that flight attendants caution parents travelling with small children to “first place the oxygen mask on yourself (really counter-intuitive for parents) and then place it on your child.” When I first heard this advice on a plane (astonishingly not what would have come naturally to me) I thought “of course! If I am unconscious then my…

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Making ‘em Mad

posted by Julie O'Toole on August 13, 2014 at 12:43pm

I’m sometimes not sure whom I make madder: some kids, some parents, or some insurance companies!

Making kids mad:

Me:  “Jill, help me understand why your weight would be way down this week?”

Jill (shrugging):  “I don’t know.  I actually exercised less and ate exactly what I was supposed to.”

Me:  “OK. I guess your body is just telling us you need more food.”

Jill:  “What!!?? No way!  I refuse to have more food.”

Me:  “Well…. unless you can think of something that didn’t go quite the…

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Parental Supervision

posted by Julie O'Toole on August 6, 2014 at 3:45pm

Eating disorders strike children at virtually all stages of development. Sometimes we think it’s most difficult when they strike a very young child, sometimes it seems the most difficult when a “child” is about to go off to college, or a student exchange program, or start a new school. Personally I think mid adolescence is one of the most difficult times for an eating disorder to strike a child.

Childhood and early adolescence are characterized by learning new skills, but also by…

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Can I Tell You About Eating Disorders?

posted by Julie O'Toole on July 24, 2014 at 3:27pm

Have you ever wondered what to tell your other children and family members about your child’s eating disorder?  Have you ever wished you had a child friendly, succinct and upbeat resource to share?

Along comes a small book to be published shortly from from Jessica Kingsley Publishers, written by Bryan Lask and Lucy Watson called Can I tell You About Eating Disorders?   This little book is apparently one of a series of books written about what the authors refer to as “limiting…

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The Stigma of Mental Illness

posted by Julie O'Toole on July 16, 2014 at 4:28pm

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…

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