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…

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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…

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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…

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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…

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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…

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How to Weigh an Eating Disordered Child or Teen

posted by Morgan O'Toole-Smith 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…

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Worried About Your Child’s Relationship To Food? Five Things You Should Know

posted by Julie O'Toole on June 29, 2017 at 12:22pm

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”,…

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Breakthroughs in the Genetics of Anorexia Nervosa

posted by Julie O'Toole on June 22, 2017 at 10:12am

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…

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Online Reviews

posted by Morgan O'Toole-Smith on June 8, 2017 at 11:20am

This post is from Kartini Clinic CEO Morgan O'Toole. 

Online reviews have become part of our everyday lives. Who hasn’t glanced at the star ratings when Googling a new hair salon or looking for a restaurant to try out? Most of the time, online reviews are just another useful data point when trying to make a casual purchasing decision.

But more essential services like doctor’s offices and health clinics come with Yelp pages and Google ratings these days, too. Kartini Clinic is one…

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Why Animal Therapy?

posted by Julie O'Toole on May 25, 2017 at 9:35am

8 AM: drop-off time at Kartini Clinic. It’s early, and patients and parents alike have a day of hard work ahead of them. But then... enter Ryla.

Family therapist Lisa Peacock says that one of her favorite moments of the day is seeing the mood in the waiting room transform when Ryla or Baxter, her two therapy dogs, run in to say good morning. That’s one of the simplest but most effective aspects of animal therapy: most people like animals, and having one around makes them happier.

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