Viewing blog posts categorized under "Recovery"

Diet and exercise: the obsessions that will not die

posted by Julie O'Toole on June 27, 2013 at 6:27am

Aaargh! 

Although dieting has been shown repeatedly to be destructive, counter-productive and useless in most settings (i.e. you re-gain everything you lose and then some…), it simply will not die as a panacea for improving health.  The belief in weight loss/dieting and exercise as a health tool is so entrenched that people, even highly educated people, continue to insist that the emperor does have clothes, despite all evidence to the contrary.

I was happily reading over-due emails…

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Gene Mutations and the Weight Problems That Plague Us

posted by Julie O'Toole on May 30, 2013 at 2:10am

You’ve heard it everywhere: your friends, your doctor, the New York Times, your personal trainer, virtually anyone who talks to you about health for more than five minutes will give you the same litany:  we need to lose weight to be healthy and all we need to do to achieve that loss is to change what we eat (fewer refined high glycemic index carbs, leaner meats, more fish, better quality fats, etc.) and, ultimately, how much of it we eat -- otherwise we will not only get fat and look…

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The Day Treatment Model for Pediatric Patients

posted by Julie O'Toole on May 9, 2013 at 7:21am

With the publication of results for models of family-based home treatments, the treatment of children with eating disorders has changed a lot in the past five or six years, or at least it has in many communities.  In some places,however, it is still the “same ol’, same ol’” of individual eclectic therapy, nutritional advice and a doctor’s infrequent monitoring - a combination known for some time to give substandard results.  

For some patients  “Maudsley” and other forms of newer…

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Cook, My Darling Daughter!

posted by Julie O'Toole on April 19, 2013 at 9:14am

Cook, My Darling Daughter! is the title of a cookbook from the 1950’s I found in a secondhand bookstore and gave my eldest daughter as a young adult.  She had little experience of cooking, since in our family parents cook for their kids, and even though her brother and at least one of her younger sisters were determined foodies and excellent cooks, she had never been interested.  She was content to be fed, and since this was consistent with the culture of our family, her disinterest…

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In an article recently in the New York Times, author Harriet Brown reviews a subject that was hotly debated at the London International Conference for Eating Disorders by Glenn Waller, Roz Shafran and Howard Steiger, among others. The issue was what is called “evidence-based” interventions in eating disorders.

For example, cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and family-based therapy (FBT) are  purportedly evidence-based interventions in the field…

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Selective Eating in Children

posted by Julie O'Toole on March 15, 2013 at 2:48am

[Ed. Note: a more recent blog on this subject can be found here).

There is a little talked-about pediatric eating disorder that I have not covered extensively in my blogs, nor is it covered well in most discussions elsewhere, including the various iterations of the DSM.  As a general pediatrician, like all other pediatricians, I ran into it, but it wasn’t until I read Dr. Rachel Bryant-Waugh and Dr. Bryan Lask’s  Eating Disorders: A Parents' Guide  years ago, that I was introduced…

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How Do We Measure Success in Eating Disorder Treatment?

posted by Julie O'Toole on February 28, 2013 at 11:47pm

When discussing the needs of families new to our treatment program, my son Morgan (and Kartini Clinic’s CEO) tells me everyone really wants to know just three things about any treatment:

  1. does it work?  
  2. how long will it take?
  3. and what will it cost?

In today’s blog I hope to be able to begin to answer the first two questions about treatment at Kartini Clinic.  Let’s start with “does it work?”  How many kids who come to us are able to achieve remission?

Physiologic remission is the…

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Physiology of Binge Eating and What Motivates Us

posted by Julie O'Toole on January 26, 2013 at 2:26am

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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The Creative Destruction of Medicine

posted by Julie O'Toole on January 11, 2013 at 5:41am

I have been reading a book that I highly recommend to readers of my blog.  It's called The Creative Destruction of Medicineby cardiologist Eric Topol.  This book is a discussion of the inevitability and utility of the convergence of the Internet, digitalization of humans, and genotyping.  It is about the resultant new science of individualized medical care, and the democratization of medicine. 

I have come to think that without radical, game-changing, paradigm-busting shifts in the…

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weight gain and percentiles after weight restoration

posted by Julie O'Toole on December 21, 2012 at 9:56pm

I was recently asked an important question which I was unable to address during my breakout workshop at this year's FEAST Symposium 2012.

The question: does a child who has completed their height growth need to continue to gain weight in order to stay on the same growth percentile “line” until they are 20 years old?

A glance at an average growth chart for girls shows a flattening out of the height curves somewhere around age 15.  This is because the average Caucasian girl achieves…

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