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Viewing blog posts categorized under "Anorexia Nervosa"

Weight Restoration 2.0

posted by Julie O'Toole on February 19, 2014 at 5:59pm

At Kartini Clinic we have been embarking on something we call “weight restoration 2.0”.  In other words we are trying to move beyond mere weight restoration (as critical as that is) towards a deeper assessment of each patient’s full physical recovery.  We have noticed, over the years of faithfully weight restoring each and every patient, that people respond differently to recovery from starvation, depending no doubt on their genetics and on the duration of their illness. Just one…

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Why the basic sciences may save us all

posted by Julie O'Toole on February 12, 2014 at 3:10pm

In previous blogs I have spoken to the importance of bench science -- the kind done in the lab to decode the “basic” science that underlies human physiology -- to us as clinicians and to us as patients. And the branch of the sciences which explores the connection between bench science or lab science and clinical medicine, including mental health, is called translational medicine.

This last night I couldn’t sleep. This happens to me when I have any viral illness and I have learned to…

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How to diagnose the child who “won’t eat”

posted by Julie O'Toole on January 29, 2014 at 1:57pm

This blog will be short as I am preparing to attend and speak at the F.E.A.S.T. conference in Texas this week.  Very exciting!

Recently I was asked to consult on a child who “won’t eat” and who hasn’t eaten for several weeks. Her situation is complicated by English not being the family’s first language and by her entrance into the medical “system” being through the emergency room, but it did remind me how complicated making the correct diagnosis can be in a child who won’t eat. This…

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Vegetables and Kartini’s Meal Plan

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

Despite the fact that we occasionally receive criticism of our Meal Plan for its supposed “rigidity”, what has struck me after years of reading people’s food journals is the degree to which people self-limit their food choices.  This is especially true of vegetables.  I have also noticed that our families’ food journals fall roughly into two categories: those who seem to relish a more Mediterranean style of eating (the original intent of the Meal Plan, by the way) and those who eat a…

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Appeasing The Monster

posted by Julie O'Toole on December 18, 2013 at 2:55pm

Some blog topics draw in a continuous trickle of commentary long after they've been published.  One such blog is entitled “Determining Ideal Body Weight”. And little wonder.

The other day I answered a comment by a young reader named Charlotte. It started me thinking how urgent her question might be for others who may not have read the original blog (or at least not for some time).  Charlotte wrote:

"I am an 18 year old female with a history of initially EDNOS and then AN B/P…

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Anorexia and Siblings

posted by Julie O'Toole on December 11, 2013 at 8:58pm

From one of our favorite international (Australian) treatment teams comes an article published online November 2013 in the journal Advances in Eating Disorders: Theory Research and Practice discussing “Anorexia nervosa in the family: a sibling’s perspective”. (Simon Clarke, Michael Kohn, Sloane Madden et al.).

Every team treating pediatric eating disorders struggles with the effects of the illness on unaffected siblings. Siblings suffer right along with everyone else in the family…

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Eating for Life

posted by Julie O'Toole on November 27, 2013 at 2:59pm

A recent book by UCSF professor and pediatric endocrinologist Dr. Robert Lustig -- horridly titled Fat Chance -- has turned my mind to past discussions of our program’s dietary recommendations, aka the Kartini Meal Plan.

In its primary and original form the Kartini Meal Plan was developed to refeed children with restrictive eating disorders and weight loss following principles I have spoken about before: real food, cooked at home, eaten together in a spirit of joy.  Kartini’s Meal…

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The Locked Psychiatric Unit

posted by Julie O'Toole on November 20, 2013 at 12:46pm

No doubt I will make myself unpopular (again) with some of our psychiatric colleagues by speaking out in this way about the use of locked psychiatric units in the treatment of children with eating disorders, but we have had several recent transfers to Kartini Clinic instigated by parents who disagreed with their treatment team’s insistence that their child be admitted to their regional locked psychiatric unit.  The parents visited the unit and were scared by what they saw.

There is…

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Tolerating our own children’s distress

posted by Julie O'Toole on November 13, 2013 at 11:32am

Until I lived in the world of therapists and mental health professionals as part of the Kartini multidisciplinary team treating children with eating disorders, I had never actually heard the phrase “tolerating distress”, particularly as it pertained to parents.  Like most parents, I have a very difficult time tolerating pain in my own children, either physical or emotional and, when put in that situation, I immediately get busy trying to save them.

How can that be wrong?  It’s…

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The Very Young Child With Anorexia

posted by Julie O'Toole on October 30, 2013 at 3:18pm

Many people are shocked when they learn that we have patients with anorexia nervosa as young as six or seven, and, although it is rare, it certainly does occur.

Why are they shocked?  Because most of these folks, despite hearing me (and Dr. Tom Insel, among others) say “it’s a brain disorder”, still deeply believe that “the media” and our obsession with thinness causes anorexia.  They are horrified that someone so young could be “ruined by society”.  And blaming the parents for this…

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