Viewing blog posts tagged with "Meal Plan"

Whole Milk and Kartini’s Meal Plan

posted by Julie O'Toole on November 18, 2015 at 3:49pm

I can’t tell you how often a look of horror and surprise crosses parents’ faces when I explain to them that Kartini Clinic’s Meal Plan, in our spirit of real, undoctored (no pun intended) food, uses only full fat dairy products: whole milk, whole milk yogurt, whole milk cottage cheese, etc. “But doctor,” more than one father has said, “I have high cholesterol!”  

“How high?”, I ask. Usually they don’t know, but sometimes say that their doctor told them their cholesterol was “kind of…

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Traveling with ED

posted by Julie O'Toole on May 28, 2015 at 1:48pm

I am writing to you from Berlin tonight and thinking about a recent article written by Dr. Bulik on the challenges of international travel for those with an eating disorder, in particular anorexia nervosa. In the article Dr. Bulik talked about time changes and irregular meals, of long distance transportation being a danger to those whose brain chemistry is less anxious when they don’t eat and more anxious when they do. It's how a person’s weight may slide down inadvertently, because…

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Game Plan For The Holidays

posted by Julie O'Toole on December 18, 2014 at 8:05am
Christmas is not just one single holiday at Kartini Clinic, it is several. In fact it’s a season involving many celebrations and special events. Some of our patients’ families do not celebrate Christmas as such, of course, but for those who do, some “highlights”: Baking… baking… baking. It’s a problem in many ways. And the truth is, no matter how appealing the picture of doing so may be, or how often it’s been done before in your family, probably not everyone should… Read More

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

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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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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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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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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