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Viewing blog posts categorized under "Anorexia Nervosa"

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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Intranasal Treatment for Anxiety

posted by Julie O'Toole on July 2, 2014 at 3:36pm

Providers are finally beginning to dip our toes in the waters which have flowed from the realization that psychiatric and psychological disorders are brain disorders.  Case in point: social anxiety.

I don’t know whether we see quite a few eating disordered patients with social anxiety because these diagnoses frequently run together or because social anxiety is so prevalent in the general population, but we do.

And now comes an article by Michael Liebowitz and colleagues from Columbia…

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Do Parents Cause Eating Disorders?

posted by Julie O'Toole on June 18, 2014 at 2:59pm

Sometimes things happen to me that cause me to wonder what planet I have landed on.  Five years ago -- to say nothing of ten or fifteen -- whenever I insisted that parents didn’t cause eating disorders, any more than they cause schizophrenia or bipolar disorder or autism, I was treated like I hadn’t done my homework.  Thankfully, that has changed. Virtually no responsible eating disorder professional of any stature believes that parents cause severe mental illnesses, of which…

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Hard News About Exercise And Recovery

posted by Julie O'Toole on June 4, 2014 at 2:37pm

I was recently sent an article from which I will be quoting extensively here (it’s also included in this newsletter - ed.). The article is by Heidi Mills, writing for Outside magazine and features the work of Dr. Emily Cooper of Seattle Performance Medicine. Dr. Cooper has consulted with Kartini Clinic on metabolic health and weight balancing for some time.  Originally, we worked together to try and solve the conundrum of patients with AN who appear to be weight restored but who…

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Can My Child Get Well?

posted by Julie O'Toole on May 14, 2014 at 1:52pm

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.…

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Mixed Symptoms

posted by Julie O'Toole on April 2, 2014 at 11:10am

Recently I was making our daily rounds at Randall Children’s Hospital and received a lesson from a very young patient of ours.  I say it over and over: “your patients are your teachers”, and it is really true.  I was first told this by Dr. Mizuo Tottori, pediatrician and mentor to many other pediatricians in Hawaii. And life itself has borne out the truth of it, again and again.

This particular little patient has anorexia nervosa and has done very well.  Her parents are competent and…

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Looking For A Few Good (Wo)men

posted by Julie O'Toole on March 26, 2014 at 2:14pm

I’m not sure how many of you know it, but Kartini Clinic is looking forward to a major expansion.  We have signed the lease in a new building which will allow us more space for our kids and for the rather expansive ideas we are always coming up with.  We are continually looking for more ways to support our families, to integrate kids in the Day Treatment Unit (DTU) with their own schools, to improve the experience for families whose child needs medical stabilization across the street…

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