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Viewing blog posts tagged with "Exercise"

Hard News About Exercise And Recovery

posted by Julie O'Toole on June 5, 2014 at 12:37am

I was recently sent an article from which I will be quoting extensively here (it’s also included in this newsletter - ed.). The article is by Heidi Mills, writing for Outside magazine and features the work of Dr. Emily Cooper of Seattle Performance Medicine. Dr. Cooper has consulted with Kartini Clinic on metabolic health and weight balancing for some time.  Originally, we worked together to try and solve the conundrum of patients with AN who appear to be weight restored but who…

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Thinking About Obesity

posted by Julie O'Toole on February 26, 2014 at 6:40pm

Thinking about obesity: calmly, rationally and outside the box

When I was a rotating intern at Sacred Heart Medical Center, long ago, I attended rounds with the then head of medicine Dr. Patrick Tennison. Dr. Tennison was a thin, dark haired, intense guy who years later would save my life, but at that time was obsessed with imbuing young doctors with a sense of urgency about diagnostic dilemmas. He was more like a highly competitive detective than your typical doctor.  

“The main…

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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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Eating for Life

posted by Julie O'Toole on November 27, 2013 at 11:59pm

A recent book by UCSF professor and pediatric endocrinologist Dr. Robert Lustig -- horridly titled Fat Chance -- has turned my mind to past discussions of our program’s dietary recommendations, aka the Kartini Meal Plan.

In its primary and original form the Kartini Meal Plan was developed to refeed children with restrictive eating disorders and weight loss following principles I have spoken about before: real food, cooked at home, eaten together in a spirit of joy.  Kartini’s Meal…

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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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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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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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License to eat: obesity and longevity

posted by Julie O'Toole on February 22, 2013 at 12:23am

According to Wikipedia Medscape is: a web resource for physicians and other health professionals. It features peer-reviewed original medical journal articles, CME (Continuing Medical Education), a customized version of the National Library of Medicine's MEDLINE database, daily medical news, major conference coverage, and drug information—including a drug database (Medscape Drug Reference, or MDR) and drug interaction checker. All content in Medscape is available free of charge for…

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Proud of her

posted by Julie O'Toole on August 10, 2012 at 3:00pm

Today I was seeing a young patient who had just been cleared to resume her sport activities.  At the start of the appointment she was nearly trembling with anxiety, for the results of her labs were to determine whether or not the timing was right for her to return to volleyball.  Fortunately (for all concerned!) the labs were good and I could clear her.

“But I still need to know something,” her dad said nervously “Honey, how will we know if your eating disorder is returning as a…

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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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