Viewing blog posts categorized under "Anorexia Nervosa"

It is understandable for parents to hope treatment for their ill child could be as close to home as possible - and to wish for as little disruption to family life and work as could be managed - but I for one am very unhappy about what I see as a lack of judgment on the part of many physicians when it comes to hospitalization for a very ill eating disordered child.

Hospitalists, who would under any other circumstances adamantly decline to do surgery for which they were not trained - or…

Jacques, a friend and parent advocate, sent me an online summary of an article discussing the current evidence base for the use of Olanzapine in anorexia nervosa.  Keep in mind as you read the summary that, regardless of the evidence base for efficacy and safety of Olanzapine in general and with anorexia nervosa in particular, this is still an off label use of this drug.  Off label means it is a drug approved for one condition which is used by physicians to treat a different…

I follow Laura Collin’s blog almost all of the time—but some personal medical issues have kept me from reading lately, until today.  I scanned her recent entries and saw this.

Good God.  But it does raise a few questions/issues; in fact, way more than a few.

1. Parents don’t cause eating disorders. Since we founded the Kartini Clinic we have been saying loudly, unequivocally and clearly:  Parents don’t cause eating disorders and children don’t choose to have them.    

Do we say this to…

Ah the brain, it's so complex; we are so complex!  What of our behavior is under our control?  What is amenable to cajoling, influence and even coercion? Does this change with age?  How is general willingness and ability to learn affected by a specific brain disorder, or can we generalize?

These issues quite frequently come to the fore during the treatment of food phobia, and even infrequently in the treatment of early onset anorexia nervosa.

Some percentage of our young food phobia…

On February 18 I attended the annual conference of the Columbia River Eating Disorder Network (CREDN) and heard Dr Ken Weiner of ERC speak there.  Ken spoke about the uselessness, hopelessness and mirage of dieting, but he also spoke about some of the issues pertinent to managing the patient with anorexia nervosa.

In Dr. Weiner’s experience, and the experience of his colleague Dr Craig Johnson (founding editor of the International Journal of Eating Disorders and founding member of…

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…

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…