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 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
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
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
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
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
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
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
1) Weight loss in children isn’t normal
Imagine you’re a parent of a bright, active 12 year old boy. He gets good grades and has lots of friends. He excels at sports. Then something changes; he begins to lose weight. At his last checkup his pediatrician registers a heart rate in the low 50s. He starts to withdraw, not doing many things he used to enjoy, with the exception of exercise. He now exercises with a new intensity.
His doctor tells you not to worry. “It’s just a stage”,…Read More
In 1998 when Kartini Clinic was founded to serve children with “all conditions of disordered eating,” those with anorexia nervosa (AN) represented the majority of our young patients. At the time, I was nearly alone in my belief that AN was a biologically based disorder and probably highly heritable (i.e. “runs in families”). Even those colleagues who later came to agree with this point of view (Bryan Lask!) were, in those days, quite skeptical—not to say hostile—to this…Read More