Viewing blog posts tagged with "Eating Disorder Treatment"

What helps children with anorexia nervosa gain weight?

posted by Julie O'Toole on June 22, 2012 at 3:00pm

What helps children with anorexia nervosa gain weight?  How can you tell whose child will do well and whose may not?  Can you tell?

At Kartini Clinic we have always felt that three factors determine outcome in children with anorexia nervosa:  

  1. severity of illness  
  2. parental unity with treatment team 
  3. parental ability to enforce the meal plan/re-nutrition.  


And of those three, we think we have noticed over the years that #2 and #3 can trump severity of illness.  In other words, even…

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The stigma that will not go away

posted by Julie O'Toole on June 9, 2012 at 2:41am

I have written and blogged about this subject before.  In some ways it is the third rail of eating disorder treatment: touch it at your peril!  But touch it we must, as it rears its head again and again, enabling the eating disorder to confound attempts at real treatment and pitting one parent against the team or one parent against an other.  This hydra-headed monster is none other than the “also affected parent”.

It is quite common to uncover an eating disorder in first degree…

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Judgement and consequences: where to hospitalize an eating disordered child

posted by Julie O'Toole on April 28, 2012 at 1:50am

It is understandable for parents to hope treatment for their ill child could be as close to home as possible - and to wish for as little disruption to family life and work as could be managed - but I for one am very unhappy about what I see as a lack of judgment on the part of many physicians when it comes to hospitalization for a very ill eating disordered child.

Hospitalists, who would under any other circumstances adamantly decline to do surgery for which they were not trained - or…

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The Evidence Is There, Now Make It Work

posted by Julie O'Toole on April 13, 2012 at 8:29pm

Jacques, a friend and parent advocate, sent me an online summary of an article discussing the current evidence base for the use of Olanzapine in anorexia nervosa.  Keep in mind as you read the summary that, regardless of the evidence base for efficacy and safety of Olanzapine in general and with anorexia nervosa in particular, this is still an off label use of this drug.  Off label means it is a drug approved for one condition which is used by physicians to treat a different…

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Wrong in too many ways to count

posted by Julie O'Toole on March 30, 2012 at 2:59pm

I follow Laura Collin’s blog almost all of the time—but some personal medical issues have kept me from reading lately, until today.  I scanned her recent entries and saw this.??

Good God.  But it does raise a few questions/issues; in fact, way more than a few.??

  1. Parents don’t cause eating disorders. Since we founded the Kartini Clinic we have been saying loudly, unequivocally and clearly:  Parents don’t cause eating disorders and children don’t choose to have them.  Do we say this…
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Re-training the brain and modifying behavior in eating disorder treatment

posted by Julie O'Toole on March 18, 2012 at 1:11am

Ah the brain, it's so complex; we are so complex!  What of our behavior is under our control?  What is amenable to cajoling, influence and even coercion? Does this change with age?  How is general willingness and ability to learn affected by a specific brain disorder, or can we generalize?

These issues quite frequently come to the fore during the treatment of food phobia, and even infrequently in the treatment of early onset anorexia nervosa.

Some percentage of our young food phobia…

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Exercise and the Severely Anorexic Patient

posted by Julie O'Toole on March 2, 2012 at 11:15pm

On February 18 I attended the annual conference of the Columbia River Eating Disorder Network (CREDN) and heard Dr Ken Weiner of ERC speak there.  Ken spoke about the uselessness, hopelessness and mirage of dieting, but he also spoke about some of the issues pertinent to managing the patient with anorexia nervosa.

In Dr. Weiner’s experience, and the experience of his colleague Dr Craig Johnson (founding editor of the International Journal of Eating Disorders and founding member of…

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Coming from afar

posted by Julie O'Toole on February 3, 2012 at 2:00pm

This week I have had the privilege of treating a young person whose parents moved heaven and earth to fly them across the entire United States to seek what they believe to be the best care available anywhere.

Can you imagine how humbling that is for us?  To be thought the best care by parents who are entrusting you with the most precious thing they have: their child?  It’s not that they come with stars in their eyes and “yes doctor, whatever you say” written cross their…

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A wolf in sheep’s clothing

posted by Julie O'Toole on January 20, 2012 at 2:00pm

Every researcher in the field of eating disorders tries their best to reduce the burden of suffering for patients.  They try to contribute to the meaningful scientific discussion.  Having said that, however, I am going to proceed to critique an article by Natalie Godart, Sylvie Berthoz, Florence Curt and colleagues at the Institut Mutualiste Montsouris in Paris, France; the French National Institute for Health and Medical Research; King’s College, London Institute of Psychiatry; the…

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Richard Morton’s Description of Anorexia Nervosa in a Young Man

posted by Julie O'Toole on January 6, 2012 at 2:00pm

This is the second and final case presentation Dr. Morton makes of two illustrative examples of anorexia nervosa.  This time it is a young man.  He mentions that the patient is the son of a friend—so imagine how motivated he was to establish the correct diagnosis and find a successful treatment! First Morton discusses the differential diagnosis, establishes the correct diagnosis, discusses failed treatments and finally discusses his successful treatment of what, to him, is a chronic…

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