Viewing blog posts tagged with "Eating Disorder Treatment"

Portrait of a Nurse

posted by Julie O'Toole on August 28, 2013 at 8:10pm

Depictions of nurses and of the relationship between nurses and doctors have been the subject of many films and books and stories.  Doctors are usually portrayed as leading and demanding, telling the nurses what to do.  Nurses are usually portrayed as carrying out the doctor’s orders, and occasionally talking back or standing up to them.  My mother and one of my favorite aunts were both nurses in the old mold, largely deferential to doctors, they wore uniform dresses of modest length…

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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 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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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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10 Steps to an Accurate Eating Disorder Diagnosis

posted by Julie O'Toole on July 11, 2013 at 12:59am

Inspired to think outside my usual box by Dr. Eric Topol, author of  Creative Destruction of Medicine this morning, I began to ask myself: how can I help parents who may not have access to experienced care, who fear that their child may have an eating disorder, make that diagnosis and get help?  Where do I start?

Well, start first with self-examination.  

We doctors are made very uncomfortable by any talk of patient autonomy or patient empowerment. The words “self diagnosis” are said…

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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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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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Cook, My Darling Daughter!

posted by Julie O'Toole on April 19, 2013 at 9:14am

Cook, My Darling Daughter! is the title of a cookbook from the 1950’s I found in a secondhand bookstore and gave my eldest daughter as a young adult.  She had little experience of cooking, since in our family parents cook for their kids, and even though her brother and at least one of her younger sisters were determined foodies and excellent cooks, she had never been interested.  She was content to be fed, and since this was consistent with the culture of our family, her disinterest…

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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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