Viewing blog posts tagged with "Anorexia Nervosa"

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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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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On Individualized Treatment

posted by Julie O'Toole on July 8, 2016 at 10:11am

I was reading an online opinion piece by one of my colleagues, Dr Ovidio Bermudez, who like me is an adolescent medicine physician and eating disorder doctor.  This one sentence jumped out at me since it reflects what I have said in many ways before, only Ovidio said it better and more succinctly: “Families like to hear that care is tailored to their loved one’s unique recovery need, but core principles of treatment, including symptom interruption and weight restoration, should not…

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The Surprising Similarities Between Anorexia and Obesity

posted by Julie O'Toole on January 28, 2015 at 10:14am

One thing I've observed over the years is that those readers who are interested in anorexia nervosa seem to have little interest in obesity, which they often seem regard as an lifestyle choice irrelevant to them, while those who study obesity often ask themselves what this rare condition (AN) has to do with their vastly more prevalent (read: important) condition of obesity (OB)? Quite a lot, as it turns out. And by the way, it’s worth repeating at the outset, neither condition is one…

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Do Parents Cause Eating Disorders?

posted by Julie O'Toole on June 19, 2014 at 12:59am

Sometimes things happen to me that cause me to wonder what planet I have landed on.  Five years ago -- to say nothing of ten or fifteen -- whenever I insisted that parents didn’t cause eating disorders, any more than they cause schizophrenia or bipolar disorder or autism, I was treated like I hadn’t done my homework.  Thankfully, that has changed. Virtually no responsible eating disorder professional of any stature believes that parents cause severe mental illnesses, of which…

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The little boy who cried wolf

posted by Julie O'Toole on July 31, 2013 at 9:50pm

On  Science Friday recently Ira Flato interviewed Professor Susan Swithers about her research on artificial sweeteners.  You know the keywords: Splenda, Stevia, Equal, diet soda, zero calorie drinks, sugar-free gum….

 

These items have never been included in the Kartini meal plan and we ask our parents not to have them in the home.  Dr. Swithers now brings a relevant and interesting perspective on such super-sweet chemicals, especially in light of some of our newer metabolic tests…

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The Eleventh Hour

posted by Julie O'Toole on July 25, 2013 at 7:36pm

I’m sure all specialties have their frustrations, but here is a major one of mine: patients who come to Kartini Clinic needing -- indeed deserving -- help but at the “eleventh hour.”

 

What do I mean by this?  I mean families who come in seeking help for a condition which is characterized by anosognosia, having waited for a variety of reasons, until shortly before their child’s 18th birthday, at which age their child will be able to refuse treatment, and often will do.  Even in…

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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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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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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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