Viewing blog posts categorized under "Recovery"

Congressional Presentation, November 29, 2012

posted by Julie O'Toole on December 8, 2012 at 2:01am

On Thursday November 29th I went with Laura Collins and the FEAST team to give "testimony" to congressional staffers about the plight of children with anorexia nervosa.  It was an impressive experience to enter the Dirksen building where  many of the senators (including our own Ron Wyden) have their offices.  Senator Schumer (NY) walked past us; the walls and floors were stone and marble and dark wood, the ceilings twenty feet high, the plaster frieze was carved with symbols of the…

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An early warning system for eating disorders

posted by Julie O'Toole on November 2, 2012 at 2:00pm

What would we do without our modern early warning systems?  The terrible weather ravaging New York, New Jersey and all along the East Coast this week has made me reflect a lot on this.  Not only do we at Kartini have treasured colleagues in those places but we also have many patients and former patients there, including one beloved patient currently in a New Jersey hospital.  Our thoughts have been continually with them these past few days.

As terrible as this storm has been, however,…

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Bart Walsh to speak at 20th Annual International Eating Disorder Conference

posted by Julie O'Toole on October 10, 2012 at 1:44am

I am delighted to announce that Bart Walsh, LCSW, Kartini Clinic’s individual and hypnotherapist of many years, will be presenting three workshops at the 20th Annual International Eating Disorder Conference, one of Europe’s leading eating disorders conferences, October 18-20. The conference takes place in the picture perfect alpine village of Alpbach, Austria. Bart's presentations are listed below; hopefully some of you will be able to join him!

Rapid Remission of Eating Disorder…

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One more reason to make the diagnosis early

posted by Julie O'Toole on September 7, 2012 at 3:00pm

And one more reason to make the diagnosis early

Professor Richard Crandall of Reed College, himself a renowned scientist, sent me an article he thought I might be interested in.  I have to say, after I read it I was dismayed on several levels.  Read it yourself and see.  The original source is the British Journal of Opthalmology.

The first level of my distress is that I had not known about this complication before.  While it is obvious that anorexia nervosa and attendant starvation is…

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Proud of her

posted by Julie O'Toole on August 10, 2012 at 3:00pm

Today I was seeing a young patient who had just been cleared to resume her sport activities.  At the start of the appointment she was nearly trembling with anxiety, for the results of her labs were to determine whether or not the timing was right for her to return to volleyball.  Fortunately (for all concerned!) the labs were good and I could clear her.

“But I still need to know something,” her dad said nervously “Honey, how will we know if your eating disorder is returning as a…

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What helps children with anorexia nervosa gain weight?

posted by Julie O'Toole on June 22, 2012 at 3:00pm

What helps children with anorexia nervosa gain weight?  How can you tell whose child will do well and whose may not?  Can you tell?

At Kartini Clinic we have always felt that three factors determine outcome in children with anorexia nervosa:  

  1. severity of illness  
  2. parental unity with treatment team 
  3. parental ability to enforce the meal plan/re-nutrition.  


And of those three, we think we have noticed over the years that #2 and #3 can trump severity of illness.  In other words, even…

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The stigma that will not go away

posted by Julie O'Toole on June 9, 2012 at 2:41am

I have written and blogged about this subject before.  In some ways it is the third rail of eating disorder treatment: touch it at your peril!  But touch it we must, as it rears its head again and again, enabling the eating disorder to confound attempts at real treatment and pitting one parent against the team or one parent against an other.  This hydra-headed monster is none other than the “also affected parent”.

It is quite common to uncover an eating disorder in first degree…

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Judgement and consequences: where to hospitalize an eating disordered child

posted by Julie O'Toole on April 28, 2012 at 1:50am

It is understandable for parents to hope treatment for their ill child could be as close to home as possible - and to wish for as little disruption to family life and work as could be managed - but I for one am very unhappy about what I see as a lack of judgment on the part of many physicians when it comes to hospitalization for a very ill eating disordered child.

Hospitalists, who would under any other circumstances adamantly decline to do surgery for which they were not trained - or…

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The Evidence Is There, Now Make It Work

posted by Julie O'Toole on April 13, 2012 at 8:29pm

Jacques, a friend and parent advocate, sent me an online summary of an article discussing the current evidence base for the use of Olanzapine in anorexia nervosa.  Keep in mind as you read the summary that, regardless of the evidence base for efficacy and safety of Olanzapine in general and with anorexia nervosa in particular, this is still an off label use of this drug.  Off label means it is a drug approved for one condition which is used by physicians to treat a different…

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Wrong in too many ways to count

posted by Julie O'Toole on March 30, 2012 at 2:59pm

I follow Laura Collin’s blog almost all of the time—but some personal medical issues have kept me from reading lately, until today.  I scanned her recent entries and saw this.??

Good God.  But it does raise a few questions/issues; in fact, way more than a few.??

  1. Parents don’t cause eating disorders. Since we founded the Kartini Clinic we have been saying loudly, unequivocally and clearly:  Parents don’t cause eating disorders and children don’t choose to have them.  Do we say this…
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