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 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…

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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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Selective Eating

posted by Julie O'Toole on May 11, 2017 at 10:19am

Selective eating (SE) is a condition present since earliest childhood where a child eats only a very narrow range of foods and refuses all others and yet where his or her linear growth is normal. Such children are not amenable to persuasion; neither bribes, punishments, “gold stars” nor being left at the table “until they finish their food” helps in the slightest. Parents of selective eaters report regularly having tried all these things and more -- often to appease grandparents or…

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The Role of Parents in Treatment

posted by Julie O'Toole on April 27, 2017 at 9:30am

This post was originally published on December 16, 2015. 

Possibly nothing has changed so much over the last ten years as the acceptance of parents’ role in the treatment of children and adolescents with eating disorders.

When I founded Kartini Clinic in 1998, “dysfunctional” parents were widely considered to cause eating disorders in general and anorexia nervosa in particular. Toxic and enmeshed mothers were commonly cited by therapists, doctors and lay people as the common…

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Processed Food the Foodie Way

posted by on April 13, 2017 at 9:29am

Nearly every day I am anxiously asked whether or not our young patients can have rice “milk,” almond “milk,” soy “milk” or coconut “milk” instead of the whole milk that is on our menu. These inaptly named “milks” are about as related to milk as cheese whiz is to cheese, and although not harmful (and even delicious), should not be mistaken for the white beverage given to early mankind by dairy animals as a source of protein, fat, calcium and vitamins. They are perhaps more properly…

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posted by Julie O'Toole on March 30, 2017 at 9:49am

Approximately 1.25 million American children and adults have type 1 diabetes (T1DM), according to the American Diabetes Association. Type 1 diabetes is an autoimmune process whereby the insulin-producing cells of the pancreas are irreversibly destroyed and the ability to use food as energy is impaired. It can lead to growth stunting, intellectual impairment, blindness, vomiting, poor circulation and even limb amputation. It is not the kind of diabetes that you read about in the press…

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