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
Viewing blog posts categorized under "Anorexia Nervosa"
Last week I was pleased to discuss a paper by Walt Kaye and colleagues that I felt strongly supported ordered eating for people with anorexia nervosa. Ordered eating on our Kartini meal plan has always been the cornerstone of our weight restoration strategy for children and young adults who suffer from this condition. It works and Dr Kaye’s research tells us why.
This week I would like to refer you to a blog written by Cindy Bulik of the University of North Carolina. Cindy is a…Read More
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…Read More
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…Read More
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…Read More
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
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
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