In the powerful documentary, "Spotting the Tiger," narrated by Oscar Award Winner Jamie Lee Curtis, the film emphasizes the importance of recognizing early warning signs of eating disorders in children.…
Are social media platforms making eating disorders in children worse?
This post is from Kartini Clinic CEO Morgan O'Toole. Online reviews have become part of our everyday lives. Who hasn’t glanced at the star ratings when Googling a new hair…
Since the founding of Kartini Clinic in 1998 we have operated under the assumption (then almost unheard-of) that anorexia nervosa is a biologically based, heritable human illness of the brain.…
F.E.A.S.T. - by parents, for parents Some of you may be shocked by the concept of euthanasia for people with eating disorders -- we at Kartini Clinic certainly are. …
When I first thought about writing this blog I had patients with anorexia nervosa in mind. Patients with AN often struggle to find their voice, regardless of how smart, competent…
Over the past 20 years (yes 20!) of re-feeding children with eating disorders, we at Kartini Clinic have learned some tips and…
It's funny what one gets criticized for. Recently a couple of young patients have let me know that some other eating disorder providers in our community have tried to steer…
Here we go into our season of Thanksgiving again. And we, at Kartini Clinic, give thanks for a lot of things: for the healing of our patients, for the continued evolution…
When you practice as long as I have in the field of childhood eating disorders, one thing becomes abundantly clear: there are cycles to the frequency with which patients…
Is anorexia nervosa (AN) a chronic illness? What do we mean when we say that AN, or any other eating disorder, is a chronic illness? Wikipedia says: “The term chronic…
On Friday, Netflix released "To the Bone," a film about a young woman struggling with anorexia nervosa. The film has received a great deal of publicity, raising some questions…
This post was originally published on December 16, 2015. Possibly nothing has changed so much over the last ten years as the acceptance of parents’ role in the treatment of…
This post was originally published on February 13, 2012. I (among others) have recently been challenged by Laura Collins to get the message out that weight restoration is critical to…
This post was originally published on November 13, 2013. Until I lived in the world of therapists and mental health professionals as part of the Kartini multidisciplinary team treating children…
This post was originally published on June 12, 2013. We’ve all heard from parents whose child had (or has) an eating disorder and who re-feed them at home, single-handedly and…
The canny ability of eating disorders to twist even the most kindly meant words is something that is experienced by almost all our patients. We originally published this post back…
When I was first introduced to the Minnesota Semi-Starvation Study (MSSS), published in 1950 by Ancel Keys and his team, I was overwhelmed by the sheer volume of data…
The literature on lifetime mortality (the death rate) from anorexia nervosa has been cited as 20%, 10% and 5%, but I think whichever turns out to be the real number,…
One of the lesser known symptoms of early onset anorexia nervosa is “self abnegation” or even “self punishment.” Although these symptoms can be seen in older patients (adolescents) too, our…
In our clinic we spend a lot of time thinking and talking to our patients about the hormone leptin. In another instance of the concordance of important findings to obesity…
According to a June 29th article by Sam PK Collins for Thinkprogress.org., “last week, Missouri Gov. Jay Nixon (D) signed a bill that explicitly states the types of eating disorder…
Almost anyone who works in a specialized field (such as pediatric eating disorders) spends a great deal of time thinking about diagnostic criteria for diseases and conditions. This is true…
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,…
I can’t tell you how many parents report their child with anorexia nervosa (or bulimia nervosa, eating disorder, fill in the blank…) becoming very irritated, not to say ANGRY, at…
One thing I believe to have learned over the years is that those readers who are interested in anorexia nervosa seem to have little interest in obesity, which they regard…
For the purposes of this discussion I am somewhat arbitrarily defining “very early onset” as 12 years and younger. Despite what you might think, this is not synonymous with “pre-pubertal…
Last week I was pleased to discuss a paper by Walt Kaye and colleagues that I felt strongly supported ordered eating for people with anorexia nervosa. Ordered eating on our…
Two current Kartini parents handed me an excellent article the other day whose lead author, Walter Kaye, is likely well known to our readers. The article, Temperament-based Treatment for Anorexia…
One thing I've observed over the years is that those readers who are interested in anorexia nervosa seem to have little interest in obesity, which they often seem regard as…
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…
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,…
Advances in medicine come in all shapes and sizes: vaccines, antibiotics, anti-virals, immune system boosters and reducers, technological changes and recently, the hope that faster, cheaper and more accurate genetic…
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…
Eating disorders strike children at virtually all stages of development. Sometimes we think it’s most difficult when they strike a very young child, sometimes it seems the most difficult when…
Have you ever wondered what to tell your other children and family members about your child’s eating disorder? Have you ever wished you had a child friendly, succinct and upbeat…
Lots of ink is been spilled on the subject of the stigma associated with having an eating disorder. And in order to discuss the subject sensibly we need to get…
Providers are finally beginning to dip our toes in the waters which have flowed from the realization that psychiatric and psychological disorders are brain disorders. Case in point: social anxiety.…
Sometimes things happen to me that cause me to wonder what planet I have landed on. Five years ago -- to say nothing of ten or fifteen -- whenever I…
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…
I am asked this nearly every week by one parent or another, and I answer reflexively “of course”. In order to do what we do at Kartini Clinic we have…
Recently I was making our daily rounds at Randall Children’s Hospital and received a lesson from a very young patient of ours. I say it over and over: “your patients…
I’m not sure how many of you know it, but Kartini Clinic is looking forward to a major expansion. We have signed the lease in a new building which will…
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…
When I was a girl, my brothers and sister and I had the usual kid-like responses to the world around us. One of them was innocent astonishment at those less…
I just returned from Tampa, Florida and the 2014 IAEDP conference of professionals involved in the treatment of eating disorders. I was there to talk about the very young child…
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…
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…
This blog will be short as I am preparing to attend and speak at the F.E.A.S.T. conference in Texas this week. Very exciting! Recently I was asked to consult on…
Despite the fact that we occasionally receive criticism of our Meal Plan for its supposed “rigidity”, what has struck me after years of reading people’s food journals is the degree…
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…
From one of our favorite international (Australian) treatment teams comes an article published online November 2013 in the journal Advances in Eating Disorders: Theory Research and Practice discussing “Anorexia nervosa…
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…
No doubt I will make myself unpopular (again) with some of our psychiatric colleagues by speaking out in this way about the use of locked psychiatric units in the treatment…
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…
There is a common misconception out there that Kartini patients are fed on a strict meal plan for the rest of their lives. But what exactly is our meal plan? And…
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’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…
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…
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…
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…
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…
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…
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,…
When discussing the needs of families new to our treatment program, everyone really wants to know just three things about any treatment: does it work? how long will it…
On the recommendation of Dr. Rod McClymont, of the Center for Eating and Dieting Disorders, Bathurst, Australia, I have been reading a new book, Animal Models of Eating Disorders (Humana Press 2013) edited…
I was recently asked an important question which I was unable to address during my breakout workshop at this year's FEAST Symposium 2012.The question: does a child who has completed…
On Thursday November 29th I went with Laura Collins and the FEAST team to give "testimony" to congressional staffers about the plight of children with anorexia nervosa. It was an…
I am delighted to announce that Bart Walsh, LCSW, Kartini Clinic’s individual and hypnotherapist of many years, will be presenting three workshops at the 20th Annual International Eating Disorder Conference,…
Recently an article was published looking at the caloric intake of children at various ages and the relationship of this intake to their weight. The article was published in the…
And one more reason to make the diagnosis earlyProfessor Richard Crandall of Reed College, himself a renowned scientist, sent me an article he thought I might be interested in. I…
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…
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…
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…
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…
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…
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,…
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…
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…
As promised, here is the first patient case report by Richard Morton in his 1689 book, Pthisiologia. My comments are in regular italics and his original text in bold (with…
There seems to be a discussion that simply will not die in the world of eating disorders (particularly when it comes to anorexia nervosa) around whether the “desire for thinness”…
If your child or adolescent is admitted to a hospital for the medical complications of an eating disorder, you need to carefully assess adequacy of care at that hospital. Common…
Friends: at the F.E.A.S.T. conference in Washington DC, I was approached by a mother (we’ll call her Kathy) who thanked me for helping her out from a distance with my…
This is a difficult time of the year for our patients and, I imagine, for eating disordered patients everywhere. All over the country people are making plans for family to…
I made this dialogue up, pieced it together from things that have been said to mothers and fathers seeking our care for their eating disordered children many times over the…
I sit at my desk drinking coffee; our patient census over the years is approaching two thousand children and young adults, the majority of whom have had anorexia nervosa or…
We get a lot of questions about how to handle college for an eating disordered young adult. There is no one right way to handle all situations, but I will…
Family-based treatment for the young adult patientFor most of us when we are 17, 18, 19 or slightly older, independence from our family of origin can’t come a moment too…
I am often asked: “do we really need to have all this treatment for our child’s eating disorder? Can’t she/he just talk to someone once a week and not have…
What does it mean to say a family member of a patient with anorexia nervosa is “affected” or “partially affected” with an eating disorder? When Other Family Members are Affected…
Academics and researchers argue about what they refer to as "outcome" all the time. How should treatment outcome be defined? How do you know that the patient is "there"? These…
There are many by-words in contemporary medicine and ever more coming along. “Vertical integration” is one of them, but what exactly does it mean?It means something that we have been…
The other day a young patient of mine asked me “which is more important: psychological remission or physical remission?” Of course she was asking because she wanted to know how…
I am occasionally asked whether or not anorexia nervosa is a chronic illness. As far as I am concerned, anorexia nervosa is a chronic illness of remission and exacerbation, which…
Tel: (971) 319-6800
Fax: (503) 282-3409
3530 N Vancouver, Suite 400
Portland, OR 97227
Find us on Google Maps
Mon – Fri 9:00am – 5:00pm
