Viewing blog posts tagged with "Anorexia"

Mixed Symptoms

posted by Julie O'Toole on April 2, 2014 at 9:10pm

Recently I was making our daily rounds at Randall Children’s Hospital and received a lesson from a very young patient of ours.  I say it over and over: “your patients are your teachers”, and it is really true.  I was first told this by Dr. Mizuo Tottori, pediatrician and mentor to many other pediatricians in Hawaii. And life itself has borne out the truth of it, again and again.

This particular little patient has anorexia nervosa and has done very well.  Her parents are competent and…

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Refeeding at Home

posted by Julie O'Toole on March 20, 2014 at 5:22pm

I was recently asked by a professional skeptic, a parent & friend of mine, “why can’t parents re-feed their own children at home without the stamp of approval of the ‘professionals’”?

Well, they can, they DO, they SHOULD!  

Home re-feeding is ideal when it works, as virtually any intervention that can be done at home is preferable to one that requires the input of (even caring) strangers.  BUT -- and there are several buts-- it does not always work for several reasons:

  1. Example:…

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Why the basic sciences may save us all

posted by Julie O'Toole on February 13, 2014 at 12:10am

In previous blogs I have spoken to the importance of bench science -- the kind done in the lab to decode the “basic” science that underlies human physiology -- to us as clinicians and to us as patients. And the branch of the sciences which explores the connection between bench science or lab science and clinical medicine, including mental health, is called translational medicine.

This last night I couldn’t sleep. This happens to me when I have any viral illness and I have learned to…

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FEAST 2014 and Weight Restoration 2.0

posted by Julie O'Toole on February 5, 2014 at 11:44pm

Morgan and I just returned from the parent-founded and parent-lead F.E.A.S.T. conference, familiar to many of you as an online resource for parents whose children are struggling with an eating disorder.

The conference lasted two days, and we spoke at noon on the second day, to a group of (mainly) parents and a few activist providers.  The following comments are just some of my personal impressions, not necessarily shared by anyone else.

The keynote speaker was Laura Hill, PhD.,…

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How to diagnose the child who “won’t eat”

posted by Julie O'Toole on January 29, 2014 at 10:57pm

This blog will be short as I am preparing to attend and speak at the F.E.A.S.T. conference in Texas this week.  Very exciting!

Recently I was asked to consult on a child who “won’t eat” and who hasn’t eaten for several weeks. Her situation is complicated by English not being the family’s first language and by her entrance into the medical “system” being through the emergency room, but it did remind me how complicated making the correct diagnosis can be in a child who won’t eat. This…

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Vegetables and Kartini’s Meal Plan

posted by Julie O'Toole on January 22, 2014 at 11:33pm

Despite the fact that we occasionally receive criticism of our Meal Plan for its supposed “rigidity”, what has struck me after years of reading people’s food journals is the degree to which people self-limit their food choices.  This is especially true of vegetables.  I have also noticed that our families’ food journals fall roughly into two categories: those who seem to relish a more Mediterranean style of eating (the original intent of the Meal Plan, by the way) and those who eat a…

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Appeasing The Monster

posted by Julie O'Toole on December 18, 2013 at 11:55pm

Some blog topics draw in a continuous trickle of commentary long after they've been published.  One such blog is entitled “Determining Ideal Body Weight”. And little wonder.

 

The other day I answered a comment by a young reader named Charlotte. It started me thinking how urgent her question might be for others who may not have read the original blog (or at least not for some time).  Charlotte wrote:

"I am an 18 year old female with a history of initially EDNOS and then AN B/P…

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Anorexia and Siblings

posted by Julie O'Toole on December 12, 2013 at 5:58am

From one of our favorite international (Australian) treatment teams comes an article published online November 2013 in the journal Advances in Eating Disorders: Theory Research and Practice discussing “Anorexia nervosa in the family: a sibling’s perspective”. (Simon Clarke, Michael Kohn, Sloane Madden et al.).

Every team treating pediatric eating disorders struggles with the effects of the illness on unaffected siblings. Siblings suffer right along with everyone else in the family…

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Eating for Life

posted by Julie O'Toole on November 27, 2013 at 11:59pm

A recent book by UCSF professor and pediatric endocrinologist Dr. Robert Lustig -- horridly titled Fat Chance -- has turned my mind to past discussions of our program’s dietary recommendations, aka the Kartini Meal Plan.

In its primary and original form the Kartini Meal Plan was developed to refeed children with restrictive eating disorders and weight loss following principles I have spoken about before: real food, cooked at home, eaten together in a spirit of joy.  Kartini’s Meal…

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The Locked Psychiatric Unit

posted by Julie O'Toole on November 20, 2013 at 9:46pm

No doubt I will make myself unpopular (again) with some of our psychiatric colleagues by speaking out in this way about the use of locked psychiatric units in the treatment of children with eating disorders, but we have had several recent transfers to Kartini Clinic instigated by parents who disagreed with their treatment team’s insistence that their child be admitted to their regional locked psychiatric unit.  The parents visited the unit and were scared by what they saw.

There is…

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