Viewing blog posts tagged with "Eating Disorder Treatment"

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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You Will See the Doctor Now

posted by Julie O'Toole on October 2, 2014 at 1:32am

I was born in 1949, the second World War had been over for a mere four years.  As a girl raised in the 50’s and 60’s I was taught to read books, wear dresses, skirts and pinafores, and to sit still.  As long as I had a book the sitting still was no problem.  And I always had a book.  At sixteen I participated in the American ritual of learning to drive a car, and never looked back. At eighteen I went to college and sat in class with everyone else, my class choices limited by what was…

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The Semmelweis Reflex

posted by Julie O'Toole on May 2, 2014 at 7:30pm

Sometimes I get discouraged by what appears to me to be the excruciating slowness with which new ideas enter the mainstream of medical and psychological teaching and practice.  In the same way that many of us dress in the style that was favored in our youth, many of us do not move far from what we were taught in college or professional school, even when the science has whipped past those teachings with the speed of light. Some professionals even spend their entire lives and careers…

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Levels of Care

posted by Julie O'Toole on April 17, 2014 at 2:49am

At Kartini Clinic our evolution to the current levels of care we offer has been a long one.  In the first days of the clinic we offered only inpatient (hospital rounds for medical stabilization) and outpatient care.  In 2000 we developed the day treatment (partial hospital) level of care.  This was a big step forward and allowed us to “gently land” patients, who required brief medical stabilization in hospital, to a lower level of care. In day treatment, such patients could get a lot…

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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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Looking For A Few Good (Wo)men

posted by Julie O'Toole on March 26, 2014 at 11:14pm

I’m not sure how many of you know it, but Kartini Clinic is looking forward to a major expansion.  We have signed the lease in a new building which will allow us more space for our kids and for the rather expansive ideas we are always coming up with.  We are continually looking for more ways to support our families, to integrate kids in the Day Treatment Unit (DTU) with their own schools, to improve the experience for families whose child needs medical stabilization across the street…

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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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Weight Restoration 2.0

posted by Julie O'Toole on February 20, 2014 at 2:59am

At Kartini Clinic we have been embarking on something we call “weight restoration 2.0”.  In other words we are trying to move beyond mere weight restoration (as critical as that is) towards a deeper assessment of each patient’s full physical recovery.  We have noticed, over the years of faithfully weight restoring each and every patient, that people respond differently to recovery from starvation, depending no doubt on their genetics and on the duration of their illness. Just one…

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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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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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