Viewing blog posts tagged with "Diets"

Back To School And The Risk Of Relapse

posted by Julie O'Toole on September 9, 2016 at 12:51pm

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 peaks…

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The Biological Similarities Between Anorexia and Obesity

posted by Morgan O'Toole-Smith on April 15, 2015 at 5:42pm

One thing I believe to have learned over the years is that those readers who are interested in anorexia nervosa seem to have little interest in obesity, which they 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)? Well, as it turns out, quite a lot.

And by the way, it’s worth repeating at the outset, neither…

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Avoiding negative energy balance

posted by Julie O'Toole on February 26, 2015 at 5:01pm

Last week I was pleased to discuss a paper by Walt Kaye and colleagues that I felt strongly supported ordered eating for people with anorexia nervosa.  Ordered eating on our Kartini meal plan has always been the cornerstone of our weight restoration strategy for children and young adults who suffer from this condition. It works and Dr Kaye’s research tells us why.

This week I would like to refer you to a blog written by Cindy Bulik of the University of North Carolina. Cindy is a…

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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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The Dangers of Staying Slightly Below Weight

posted by Julie O'Toole on December 10, 2014 at 8:35am
I am a pediatric eating disorder doctor and try my best to limit my practice to patients 22 and younger. Why is this hard? Because I have a great treatment team and good treatment is hard to come by, so we sometimes run into deserving and desperate adult patients, whom we simply must refer to adult providers. I say this so that readers of this blog may put my recommendations into the context of the age group with which I am most familiar, although it is my opinion that this topic is… Read More

Taking A Moment To Vent

posted by Julie O'Toole on November 19, 2014 at 9:27am
My good friend and colleague Therese Waterhous, a PhD, RD eating disorder specialist and board member of the parent organization F.E.A.S.T., called me the other day.  She needed to vent, and now, apparently, I do too. It’s not that her annoying experience was rare or new, it’s just the fact that such ignorance persists and that at this point -- given the avalanche of new information about pediatric eating disorders --  such ignorance seems willful. You can update your database.… Read More

Yes, But Where’s The Evidence?

posted by Julie O'Toole on November 13, 2014 at 9:32am
You may have heard me say it before: medicine is as prone to fads as the fashion industry. And worse: tightly held “truths” in medicine can be as entrenched as religious beliefs and providers will respond to being challenged with as much heat and resentment as if you had challenged their religion. Didn’t your grandmother tell you (mine did) to avoid talking politics and religion in polite society? Well… here I go anyway. And sorry for the many citations. If you’re going… Read More
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Can I speak to the chef, please?

posted by Julie O'Toole on October 22, 2014 at 7:33am
It’s not very common for me to hear things out of the mouths of our patients that I have not heard before—I have heard most things many, many times. For example: “exercise (insert dance, soccer, cheer, ballet, etc) is my only social life, I don’t have any friends without it,” or “school is the most important thing to me. I can’t get behind because of treatment,” or “I don’t care abut how much weight I gain, as long as it’s muscle,” or “I don’t tolerate… Read More

Making ‘em Mad

posted by Julie O'Toole on August 13, 2014 at 10:43pm

I’m sometimes not sure whom I make madder: some kids, some parents, or some insurance companies!

Making kids mad:

Me:  “Jill, help me understand why your weight would be way down this week?”

Jill (shrugging):  “I don’t know.  I actually exercised less and ate exactly what I was supposed to.”

Me:  “OK. I guess your body is just telling us you need more food.”

Jill:  “What!!?? No way!  I refuse to have more food.”

Me:  “Well…. unless you can think of something that didn’t go…

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Eating Junk

posted by Julie O'Toole on June 26, 2014 at 1:12am

Recently a patient of ours returned from a treatment setting where she had been presented with “challenge foods”.  In her case she had been given cheetos and soda pop.  Now I ask you, why on earth would someone encourage a child to eat such a thing?

A lot of ink has been spilled on teaching Americans in general and children in particular to make good food choices.  Just because you have anorexia nervosa as a child, and desperately need to gain and maintain adequate weight, does not…

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