Viewing blog posts tagged with "Anorexia"

The Very Young Child With Anorexia

posted by Julie O'Toole on October 31, 2013 at 12:18am

Many people are shocked when they learn that we have patients with anorexia nervosa as young as six or seven, and, although it is rare, it certainly does occur.

Why are they shocked?  Because most of these folks, despite hearing me (and Dr. Tom Insel, among others) say “it’s a brain disorder”, still deeply believe that “the media” and our obsession with thinness causes anorexia.  They are horrified that someone so young could be “ruined by society”.  And blaming the parents for this…

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The Kartini Meal Plan De-Mystified

posted by Julie O'Toole on October 17, 2013 at 12:17am

There is a common misconception out there that Kartini patients are fed on a strict meal plan for the rest of their lives.  But what exactly is our meal plan? And while we talking about it, what's our approach to meals and food in general?

Well…

  1. there’s the “parents in charge” (of all meals) thing

  2. there’s the recording on the food journal thing

  3. there’s the family dinners thing/ home cooking thing

  4. there’s the whole-milk-no-low-fat thing

  5. there’s the…

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Health Is A State, Not A Weight

posted by Julie O'Toole on August 7, 2013 at 11:40pm

This week’s blog covers a topic - menstruation in female patients - which I have written about before, but, given its critical importance to our female patients and their parents, I’d like to bring it up again.

First let me distinguish between menarche (first period) and the resumption of menses (monthly periods). Menses is an important marker of recovery in girls who menstruated prior to the onset of their eating disorder, and something I’ve written about before.  Today I would like…

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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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Why do some people just get it?

posted by Julie O'Toole on July 18, 2013 at 12:28am

This is a tribute to two people who just plain “get it.”  And, you know, it can be hard to get.  I certainly know many professionals who deeply do not get it, and some who claim they do and yet who really only give it lip service.

The two people I am referring to are mothers of children with eating disorders; they are F.E.A.S.T. mamas, and they are filmmakers.  I am referring, of course, to Charlotte Bevans and Mary Gutteridge, the Bobbsey twins of enlightened animation.

And what…

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Who You Callin’ Fat?

posted by Julie O'Toole on July 3, 2013 at 10:50pm

Patient:  I have battled with my weight all my life, doctor.  It's my major health issue.

Doctor:  What does that mean, Susan?

Patient:  (irritated) It means, doctor, that I have been fat since I was a kid.

Doctor:  I see.  Are other family members overweight too?

Patient:  The word is fat.  F.A.T.  Let's call it what it is.  And no, they aren't.  I was adopted.

Doctor:  In that case, Susan, it seems reasonable to assume that your weight problem is not a result of anything you…

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Diet and exercise: the obsessions that will not die

posted by Julie O'Toole on June 27, 2013 at 6:27am

Aaargh! 

Although dieting has been shown repeatedly to be destructive, counter-productive and useless in most settings (i.e. you re-gain everything you lose and then some…), it simply will not die as a panacea for improving health.  The belief in weight loss/dieting and exercise as a health tool is so entrenched that people, even highly educated people, continue to insist that the emperor does have clothes, despite all evidence to the contrary.

I was happily reading over-due emails…

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Gene Mutations and the Weight Problems That Plague Us

posted by Julie O'Toole on May 30, 2013 at 2:10am

You’ve heard it everywhere: your friends, your doctor, the New York Times, your personal trainer, virtually anyone who talks to you about health for more than five minutes will give you the same litany:  we need to lose weight to be healthy and all we need to do to achieve that loss is to change what we eat (fewer refined high glycemic index carbs, leaner meats, more fish, better quality fats, etc.) and, ultimately, how much of it we eat -- otherwise we will not only get fat and look…

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How Do We Measure Success in Eating Disorder Treatment?

posted by Julie O'Toole on February 28, 2013 at 11:47pm

When discussing the needs of families new to our treatment program, my son Morgan (and Kartini Clinic’s CEO) tells me everyone really wants to know just three things about any treatment:

  1. does it work?  
  2. how long will it take?
  3. and what will it cost?

In today’s blog I hope to be able to begin to answer the first two questions about treatment at Kartini Clinic.  Let’s start with “does it work?”  How many kids who come to us are able to achieve remission?

Physiologic remission is the…

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weight gain and percentiles after weight restoration

posted by Julie O'Toole on December 21, 2012 at 9:56pm

I was recently asked an important question which I was unable to address during my breakout workshop at this year's FEAST Symposium 2012.

The question: does a child who has completed their height growth need to continue to gain weight in order to stay on the same growth percentile “line” until they are 20 years old?

A glance at an average growth chart for girls shows a flattening out of the height curves somewhere around age 15.  This is because the average Caucasian girl achieves…

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