Viewing blog posts categorized under "Recovery"

Don’t take no for an answer

posted by Julie O'Toole on October 28, 2011 at 3:00pm

I made this dialogue up, pieced it together from things that have been said to mothers and fathers seeking our care for their eating disordered children many times over the years.  

“Doctor, I am really worried about Simon.  He seems thin to me and recently all he does is study and exercise, he rarely goes out with his friends any more and he used to be such a social kid.”

“Don’t worry, Mom.  Kids go through all kinds of stages.  They have to experience who they are and often try on…

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Boys with anorexia nervosa

posted by Julie O'Toole on September 30, 2011 at 3:00pm

I sit at my desk drinking coffee; our patient census over the years is approaching two thousand children and young adults, the majority of whom have had anorexia nervosa or its variants.  And I am thinking about our boys.  

Given the approximate accepted statistic that 90% of patients with AN will be female, (even though the percentage is higher in younger patients), that still gives us around 200 boys.

Remember, with that many, if you think you recognize someone from these…

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Going off to college (with an eating disorder): 4 Tips for Parents

posted by Julie O'Toole on September 24, 2011 at 12:57am

We get a lot of questions about how to handle college for an eating disordered young adult.  There is no one right way to handle all situations, but I will list a few of our ideas here.

#1:   Make a plan!  Do not just cross your fingers and hope that things will go well for your child. Wishful thinking is not your friend.

#2:   If  your college-bound child is currently active in their eating disorder, for example bingeing or purging at any frequency, losing weight, restricting their…

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Family-based eating disorder treatment for the young adult patient

posted by Julie O'Toole on September 16, 2011 at 2:59pm

Family-based treatment for the young adult patient

For most of us when we are 17, 18, 19 or slightly older, independence from our family of origin can’t come a moment too soon.  We are anxious to be independent, and highly allergic to ‘being told what to do’.  And usually—though young folks often do not credit this—our parents are equally anxious for us to do so.  Although many of us parents are very tearful at the ‘loss’ of our child to our home, we are also excited to see them…

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Think what’s at stake

posted by Julie O'Toole on August 30, 2011 at 3:40am

I am often asked: “do we really need to have all this treatment for our child’s eating disorder?  Can’t she/he just talk to someone once a week and not have it interfere with school/soccer/summer vacation/my work schedule?"

I imagine they could.  But then you’d get what people used to get: spotty and unreliable results.  In past decades, people with anorexia nervosa were ill for years, often long into adulthood.  Restricting eating disorders became more entrenched and soon purging was…

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When Other Family Members are Affected by an Eating Disorder Too

posted by Julie O'Toole on August 12, 2011 at 8:46pm

What does it mean to say a family member of a patient with anorexia nervosa is “affected” or “partially affected” with an eating disorder?

The last ten years have brought us a lot of new information about eating disorders in general and anorexia nervosa in particular.  One such bit of new information is the evidence of heritability of anorexia nervosa.  In a study published in the Archives of General Psychiatry Dr Cynthia Bulik, a well known researcher from the University of North…

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What does good treatment outcome for anorexia in children look like?

posted by Julie O'Toole on June 25, 2011 at 1:48am

Academics and researchers argue about what they refer to as "outcome" all the time.  How should treatment outcome be defined? How do you know that the patient is "there"?

These are important questions because "good outcome" will need to be defined before we can answer questions like: what percentage of children will achieve a certain outcome? How long will it take?  What factors can affect outcome? How can families influence the likelihood of a good outcome for their own child? What…

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Vertical Integration of Eating Disorder Treatment

posted by Julie O'Toole on June 18, 2011 at 1:15am

There are many by-words in contemporary medicine and ever more coming along.  “Vertical integration” is one of them, but what exactly does it mean?

It means something that we have been doing at Kartini Clinic since 2000 and something we would like to refine further as we move into the future of care for children with eating disorders.  Once, vertical integration was an innovation, now it is becoming standard.  Vertical integration is a system of care where, as the patient moves…

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The other day a young patient of mine asked me “which is more important: psychological remission or physical remission?”  Of course she was asking because she wanted to know how she could get out of the DTU most quickly, but it was a good question nonetheless.

Which is more important?  Well, let’s see…which is more important: breathing or heart beating?  Yes, it’s just like that.  There is no psychological remission without physical remission.  That’s been tried.  In fact, we spent…

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Relapse in Patients with Anorexia Nervosa

posted by Julie O'Toole on May 18, 2010 at 11:03pm

I am occasionally asked whether or not anorexia nervosa is a chronic illness.  As far as I am concerned, anorexia nervosa is a chronic illness of remission and exacerbation, which is a medical way of saying an illness that often returns after a period of stability.  Anorexia can be gotten into good remission, which may last many years, but it can flare up with a recurrence of symptoms during times of stress, life change or for no apparent reason.  We call this relapse.

As with the…

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