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Viewing blog posts categorized under "Binge Eating"

Christmas and a New Year

posted by Julie O'Toole on December 23, 2015 at 4:47pm

Everyone in our field knows that the Holiday season provides special challenges to those with eating disorders, be those restricting, bingeing and purging or predominantly bingeing eating disorders.  Add to this the fact that this is typically a very important time of year to children and you have, well, a mess. It’s over in January though, and that’s the good news!

What makes it a mess? Holidays raise expectations in everyone, expectations that even for adults are often not met and…

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The Role of Parents in Treatment

posted by Julie O'Toole on December 16, 2015 at 4:30pm

Possibly nothing has changed so much over the last ten years as the acceptance of parents’ role in the treatment of children and adolescents with eating disorders.

When I founded Kartini Clinic in 1998, “dysfunctional” parents were widely considered to cause eating disorders in general and anorexia nervosa in particular.  Toxic and enmeshed mothers were commonly cited by therapists, doctors and lay people as the common denominator in these illnesses.  In fact, eating disorders were…

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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

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Avoiding negative energy balance

posted by Julie O'Toole on February 26, 2015 at 5:01pm

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…

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Taking A Moment To Vent

posted by Julie O'Toole on November 19, 2014 at 9:27am
My good friend and colleague Therese Waterhous, a PhD, RD eating disorder specialist and board member of the parent organization F.E.A.S.T., called me the other day.  She needed to vent, and now, apparently, I do too. It’s not that her annoying experience was rare or new, it’s just the fact that such ignorance persists and that at this point -- given the avalanche of new information about pediatric eating disorders --  such ignorance seems willful. You can update your database.… Read More

What To Do With An Affected Parent?

posted by Julie O'Toole on November 5, 2014 at 9:15am
This blog is asking for help from those of you who have a child with anorexia nervosa but who may have experienced an eating disorder yourself. Any clinic or provider who treats pediatric eating disorders will sooner or later see children whose families have more than one affected (or partially affected) family member. This is the fancy way of saying that when you do a careful history you are likely to find other family members who have eating disorders in addition to the child.… Read More

Save Yourself First

posted by Julie O'Toole on August 28, 2014 at 1:18am

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 10:43pm

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…

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Parental Supervision

posted by Julie O'Toole on August 7, 2014 at 1:45am

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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The Stigma of Mental Illness

posted by Julie O'Toole on July 17, 2014 at 2:28am

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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