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Viewing blog posts tagged with "Metabolic Testing"

Tough Calls Parents Have To Make

posted by Julie O'Toole on January 21, 2015 at 9:17am

For people who are high achieving and successful, patience is typically not one of their long suits, especially when “patience” involves rest and restraint.

It’s not enough that our patients are often self-driven high achievers, but as this temperament trait is also highly heritable, many of our parents are as well.  It is not unusual for our kids to be valedictorians, salutatorians, the lead in the school play, talented musicians, or competitive dancers or athletes, whose efforts…

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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

When The Smile Comes Back

posted by Julie O'Toole on December 3, 2014 at 8:29am
Re-feeding has its own rewards, though there can be misery and challenge to get there.  I know that some of you who have been through this, either at home or with a team not at home, will be able to relate to what I am talking about.  It’s when the smile comes back. It’s hard to predict when the tipping point will come.  For some it’s within the first 48 hours of beginning to eat: the circulation improves, the cheeks fill with more color, the eyes brighten and they just feel… Read More

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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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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Why the basic sciences may save us all

posted by Julie O'Toole on February 13, 2014 at 12:10am

In previous blogs I have spoken to the importance of bench science -- the kind done in the lab to decode the “basic” science that underlies human physiology -- to us as clinicians and to us as patients. And the branch of the sciences which explores the connection between bench science or lab science and clinical medicine, including mental health, is called translational medicine.

This last night I couldn’t sleep. This happens to me when I have any viral illness and I have learned to…

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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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Appeasing The Monster

posted by Julie O'Toole on December 18, 2013 at 11:55pm

Some blog topics draw in a continuous trickle of commentary long after they've been published.  One such blog is entitled “Determining Ideal Body Weight”. And little wonder.

 

The other day I answered a comment by a young reader named Charlotte. It started me thinking how urgent her question might be for others who may not have read the original blog (or at least not for some time).  Charlotte wrote:

"I am an 18 year old female with a history of initially EDNOS and then AN B/P…

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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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