I was a patient at Kartini some time ago and am now in the position to have a family of my own. I have drawn on much of the wisdom...
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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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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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But For The Grace of God

posted by Julie O'Toole on March 12, 2014 at 2:32pm

When I was a girl, my brothers and sister and I had the usual kid-like responses to the world around us.  One of them was innocent astonishment at those less fortunate than we: the man at the bus stop without a leg, the “retarded” kid on the playground, homeless people.  If we were unwise enough to comment on them negatively in our father’s presence we felt the full force of his disapproval, the full weight of his teaching.  “When you see someone less fortunate than you, you are…

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What We Say Matters

posted by Julie O'Toole on March 5, 2014 at 4:18pm

I just returned from Tampa, Florida and the 2014 IAEDP conference of professionals involved in the treatment of eating disorders.  I was there to talk about the very young child with anorexia nervosa, and I was slated to talk for three hours. And talk I did. For three hours! That’s an unusually long presentation time, but I was surprised that the audience and I found plenty to say on the subject.  

At the beginning of my presentation I asked everyone to briefly state who they were…

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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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Back To School And The Risk Of Relapse

posted by Julie O'Toole on September 18, 2013 at 1:15pm

When you practice as long as I have in the field of childhood eating disorders one thing becomes abundantly clear: there are cycles to the frequency with which patients appear on our doorstep for treatment -- and on the doorsteps of all the other treatment centers as well.  The trouble is, it has proven difficult to understand the peaks and troughs of these cycles and correlate them to much of anything.  But there do seem to be a few tentatively recognizable patterns. And these peaks…

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Health Is A State, Not A Weight

posted by Julie O'Toole on August 7, 2013 at 1:40pm

This week’s blog covers a topic - menstruation in female patients - which I have written about before, but, given its critical importance to our female patients and their parents, I’d like to bring it up again.

First let me distinguish between menarche (first period) and the resumption of menses (monthly periods). Menses is an important marker of recovery in girls who menstruated prior to the onset of their eating disorder, and something I’ve written about before.  Today I would like…

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The Eleventh Hour

posted by Julie O'Toole on July 25, 2013 at 9:36am

I’m sure all specialties have their frustrations, but here is a major one of mine: patients who come to Kartini Clinic needing -- indeed deserving -- help but at the “eleventh hour.”

What do I mean by this?  I mean families who come in seeking help for a condition which is characterized by anosognosia, having waited for a variety of reasons, until shortly before their child’s 18th birthday, at which age their child will be able to refuse treatment, and often will do.  Even in states…

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Why do some people just get it?

posted by Julie O'Toole on July 17, 2013 at 2:28pm

This is a tribute to two people who just plain “get it.”  And, you know, it can be hard to get.  I certainly know many professionals who deeply do not get it, and some who claim they do and yet who really only give it lip service.

The two people I am referring to are mothers of children with eating disorders; they are F.E.A.S.T. mamas, and they are filmmakers.  I am referring, of course, to Charlotte Bevans and Mary Gutteridge, the Bobbsey twins of enlightened animation.

And what…

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Physiology of Binge Eating and What Motivates Us

posted by Julie O'Toole on January 25, 2013 at 5:26pm

On the recommendation of Dr. Rod McClymont, of the Center for Eating and Dieting Disorders, Bathurst, Australia, I have been reading a new book, Animal Models of Eating Disorders (Humana Press 2013) edited by Nicole Avena.  The second chapter, by Mary M Boggiano Ph.D., stopped me in my tracks:  “Binge-Prone Versus Binge-Resistant Rats”.

Don’t laugh.  We are mammals; they are mammals.  We study rats to understand the physiology of cancer.  We study rats to understand the physiology of…

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