Viewing blog posts categorized under "Anorexia Nervosa"

Thanksgiving with your child

posted by Julie O'Toole on November 21, 2017 at 10:56am

Here we go into our season of Thanksgiving again. And we, at Kartini Clinic, give thanks for a lot of things: for the healing of our patients, for the continued evolution of  (more) affordable healthcare for families, for enough food to put on the table, for the health and safety of our loved ones. 

That’s the good side of Thanksgiving for us, but there is a challenging side as well.  Thanksgiving is not just about gratitude in this country.  Traditionally it has also been about…

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Back To School And The Risk Of Relapse

posted by Julie O'Toole on September 28, 2017 at 10:51am
 

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…

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Relapse

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 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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Diabetes

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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Five Things Every Parent Should Know About Childhood Eating Disorders

posted by Julie O'Toole on February 28, 2017 at 3:00pm

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”, she…

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Why Weight Restoration in Eating Disorder Treatment Must Come First

posted by Julie O'Toole on December 29, 2016 at 8:46am

This post was originally published on February 13, 2012.

I (among others) have recently been challenged by Laura Collins to get the message out that weight restoration is critical to psychological recovery in anorexia nervosa. Some authority, Laura says, must declare definitively that psychological recovery is tied to weight restoration.

Some authority… okay… but who?

Since the late 1990’s the AAP (American Academy of Pediatrics) has issued guidelines for hospitalization (after…

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Tolerating our own children’s distress

posted by Julie O'Toole on October 20, 2016 at 8:32am

This post was originally published on November 13, 2013.

Until I lived in the world of therapists and mental health professionals as part of the Kartini multidisciplinary team treating children with eating disorders, I had never actually heard the phrase “tolerating distress”, particularly as it pertained to parents.  Like most parents, I have a very difficult time tolerating pain in my own children, either physical or emotional and, when put in that situation, I immediately get…

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Family-based Treatment: why is it so wretchedly hard?

posted by Julie O'Toole on October 13, 2016 at 10:19am

This post was originally published on June 12, 2013. 

We’ve all heard from parents whose child had (or has) an eating disorder and who re-feed them at home, single-handedly and successfully. The Around the Dinner Table forum is full of such stories from parents who help other parents trying to do the same. But not all children’s illnesses can be so managed. At Kartini Clinic we practice a day treatment model of family-based care (as well as inpatient medical stabilization and…

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The Secret Language of Eating Disorders

posted by Julie O'Toole on September 29, 2016 at 10:30am

The canny ability of eating disorders to twist even the most kindly meant words is something that is experienced by almost all our patients. We originally published this post back in the summer of 2011 and have decided to share it again because an awareness of of this facet of ED is so valuable to patients, families and care providers at every stage of recovery.


I find myself explaining this many times to parents and friends of our patients: there is a secret language to eating…

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