Building Trust in Food One Sandwich at a Time: Introducing Annastacia Weiss

posted by Julie O'Toole on October 26, 2017 at 1:49pm

It’s lunchtime at Kartini Clinic, and patients in our partial hospitalization program are settling in for their midday meal. Joining them at the table is Nutrition Counselor Annastacia Weiss. Annastacia came to Kartini Clinic with decades of culinary experience. She studied at Western Culinary Institute and the Institute for Integrative Nutrition in New York City, interned at farms, founded the much loved North Portland cafe SweeDeeDee, and incorporated her knowledge of food as…

Read More


posted by Julie O'Toole on October 12, 2017 at 12:32pm

In the treatment of children and adolescents with eating disorders, depression is a not uncommon finding. Sometimes we identify it on admission to Kartini Clinic, sometimes it has already been identified before the patient ever saw us, and sometimes it is a residual of otherwise successful treatment. The latter is especially frustrating.

There is a saying in medicine, “when you leave the appointment feeling depressed, you know the patient's diagnosis.” Which might be why many…

Read More

Back To School And The Risk Of Relapse

posted by Julie O'Toole on September 28, 2017 at 10:51am

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…

Read More

Mood and Treatment

posted by Julie O'Toole on September 13, 2017 at 1:45pm

Mood is a hard thing to measure, a chimera at times, hard to grasp, hard to define. Good mood, while often eluding exact definition, is obvious to the observer: the step is light, the smile is on, the shoulders are straight, the energy level is high. Low mood is just that: the shoulders are held low, the facial features droop, the light goes out of the eyes and energy is… low.

Depression seems to be expressed as consistently low mood. It is hard to experience and it is hard to be…

Read More


posted by Julie O'Toole on August 31, 2017 at 10:00am

Is anorexia nervosa (AN) a chronic illness? What do we mean when we say that AN, or any other eating disorder, is a chronic illness?

Wikipedia says: “The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include arthritis, asthma, cancer, COPD, diabetes and viral diseases such as hepatitis C and HIV/AIDS. In medicine, the opposite of chronic is acute.”

Lasts for more than three months? Oh yes. By that metric AN is…

Read More

The Importance of Parent Groups

posted by Julie O'Toole on August 17, 2017 at 9:06am

At Kartini Clinic, we have had a parent support group from the beginning. At first my husband Steve and I led parent group. After a few years it was taken over by a much more competent leader, Kartini family therapist Leslie Weisner LMFT, in whose hands it remains today. As our program grew and developed we added more groups, all free of charge, for our patients’ parents. Jean Malnati, our parent advocate and herself a parent of a child with an eating disorder, leads the parenting…

Read More

Selective Eating Disorder: Call For Participants

posted by Julie O'Toole on August 10, 2017 at 3:42pm

For many years I have been saddened by our inability to help families with a child with selective eating. This condition is described here and here

And since, for the most part, such children remain on their growth curve, there has been no medical urgency to this—which completely ignores the psychological urgency that many parents (and some patients) feel.

Now, however, we are exploring a new biological option, which, if we are successful, may offer hope of change for people…

Read More

How to Recognize Eating Disorders in Boys

posted by Morgan O'Toole-Smith on August 3, 2017 at 2:31pm

This video shows an 11 year old boy who has struggled with classic anorexia nervosa, including fear of fat, self-denial, increased and compulsive exercise,weight loss and intrusive thoughts of worthlessness and shaming. He is also an excellent student, excels at sports and is personally very tidy. He comes from an intact, highly functional and supportive family and there is a family history of OCD and perfectionism. He is able to talk about “voices” telling him not to eat and…

Read More

To The Bone: What You Should Know

posted by Morgan O'Toole-Smith on July 20, 2017 at 9:41am


On Friday, Netflix released "To the Bone," a film about a young woman struggling with anorexia nervosa. The film has received a great deal of publicity, raising some questions and concerns among parents of children and adolescents with eating disorders.

Here are five questions you may have about the film.


My child is recovering from an eating disorder; should they watch this movie?

The question we would ask is why? If it is to gain “insight” into a complex brain illness in…

Read More

How to Weigh an Eating Disordered Child or Teen

posted by Julie O'Toole on July 6, 2017 at 2:18pm

This is an update to a post originally shared on November 30, 2010.

When we discharge a patient from Kartini Clinic back to their primary care provider, it is usually with the instructions for weekly blind weights for about a month, then, if stable, every two weeks, then monthly for about half a year. But I am frequently asked by those primary care providers, “How do you weigh an eating disordered child?”  

So here is my advice for weighing an eating disordered child for any…

Read More
Page 2 of 31 pages   < 1 2 3 4 >  Last ›