Eating disorders are severe disturbances in attitudes and behaviors around eating, weight, shape, and body image. These disorders are often accompanied by emotional (e.g., depression, anxiety) and interpersonal difficulties, as well as medical complications, which can lead to hospitalization. Unfortunately, eating disorders can be life-threatening and often require professional treatment. The UCSF Eating Disorders Program is a comprehensive, evidence-based program that provides outstanding clinical care for individuals with eating disorders (up to age 25) and their families. Our program is a collaboration between the Department of Psychiatry (Child and Adolescent Services) and the Department of Pediatrics (Division of Adolescent and Young Adult Medicine). We are unique in our ability to provide both inpatient and outpatient services, depending on medical and/or psychiatric need. Our services include comprehensive medical/psychiatric evaluations, as well as ongoing medical management, evidence-based individual and family therapies, and medication management.

The multidisciplinary treatment team meets weekly to discuss progress, treatment goals, and coordinate care for patients. Dr. Daniel Le Grange is a Benioff UCSF Professor in Children’s Health in the Departments of Psychiatry and Pediatrics at UCSF and Joint Director of the Eating Disorders Program in the Division of Child and Adolescent Psychiatry (Psychiatry) and Division of Adolescent & Young Adult Medicine (Pediatrics). Dr. Le Grange is also Emeritus Professor of Psychiatry and Behavioral Neuroscience at The University of Chicago, where he directed the Eating Disorders Program from 1998-2014. He received his doctoral education at the Institute of Psychiatry, the University of London and completed postdoctoral training at the University of London and at Stanford University School of Medicine. Dr. Le Grange’s research interests focus primarily on treatment trials for adolescents with eating disorders. He has authored or co-authored more than 400 manuscripts, books, book chapters, and abstracts, as well as more than 190 presentations for national and international scientific meetings.

Dr. Le Grange is a Fellow of the Academy for Eating Disorders, a member of the Eating Disorders Research Society, Associate Editor for the Journal of Eating Disorders and BMC Psychiatry, serves on the editorial boards of the European Eating Disorders Review and the International Journal of Eating Disorders, and is an ad hoc scientific reviewer for more than 25 journals. He has lectured extensively across North America, Europe, Australia, South East Asia, and South Africa. Over the past 15 years, Dr. Le Grange’s research has been supported by the NIH, as well as the National Health and Medical Research Council of Australia. He is currently Principal Investigator on several NIMH-funded treatment studies in the United States and a Principal Investigator on a 6-year treatment study funded by the Baker Foundation in the Department of Pediatrics at the University of Melbourne, Australia. Dr. Le Grange is the 2013-2014 recipient of the Presidential Chair Award at UCSF, and the 2014 recipient of the Academy for Eating Disorders Leadership in Research Award.

Dr. Sara Buckelew specializes in treating children, adolescents, and transitional age youth with eating disorders who started the Eating Disorders Program in 2007. Great Dane Puppies For Sale In Round Rock TxDr. Buckelew earned a medical degree at the University of Pennsylvania and a master’s degree in public health at UC Berkeley. Pool Cleaners Staten IslandShe is a member of the American College of Preventive Medicine, American Teachers of Preventive Medicine and Society for Adolescent Medicine.Prom Dresses In Donna Tx Justine Underhill is a skilled clinician, manager, and teacher who specializes in the psychological treatment of eating disorders. Prior to her current role as Clinical Director, she served as the Clinical Director of the Young Adult and Family Center (YAFC).

Underhill earned a master's degree in education at Harvard University and a master's in social work at San Francisco State University. She is a member of the National Association of Social Workers, the Association of Family Therapists of Northern California, the International Center for Excellence in Emotionally Focused Therapy, and the Academy of Eating Disorders. Please call our intake service at (415) 353-2002. For more information, please visit the UCSF Eating Disorders Program website.Pediatric Obesity SurgeryRelated PhysiciansPediatric SurgeonsMichael R. Harrison, M.D.Hanmin Lee, M.D.Tippi MacKenzie, M.D.Lan Vu, M.D. Childhood obesity has become an epidemic in the United States, posing a great health challenge to our society. Obese children and adolescents are at high risk of developing type 2 diabetes, cardiovascular disease, high blood pressure, high cholesterol, and other serious health problems. These children are also more likely to develop morbid obesity in adulthood.

At UCSF, we take a comprehensive team approach to treating children and adolescents with obesity. Weight Assessment and Non-Surgical Treatment If your child is overweight or obese, the first step is to ask your pediatrician for a referral to the UCSF WATCH (Weight Assessment for Teen and Child Health) clinic. The clinic brings together doctors, nutritionists, exercise physiologists, and psychologists with expertise in diagnosing and treating childhood obesity. These experts will evaluate your child and develop a plan to manage your child's weight through nutrition education and behavior modification. Please visit the WATCH clinic website for more information. Every effort is made to achieve weight loss non-surgically, but for a small group of children, medical, behavioral, and nutritional approaches to weight loss may not be enough. In these cases, the WATCH medical team may refer you and your child to see a pediatric surgeon to discuss surgical options. We will work together with you and the WATCH clinic team to tailor treatment to your child's individual needs.

Due to the considerable lifestyle changes that surgery will bring about, your family and child must continue to commit to a strict program of healthy eating and exercise before he or she can be a candidate for surgery. Surgical Treatment of Obesity For children who meet the criteria for obesity surgery, the goal of surgery is to be a tool to assist in improving your child's health. It is important to understand that obesity surgery is not cosmetic surgery, nor is it an "easy way out." Surgery is a tool-not a cure-for sustained and effective long-term weight loss in children for whom other weight management strategies have failed. We currently offer only one type of obesity surgery for children: laparoscopic gastric banding. Our team does not perform gastric bypass surgery for children due to the high risk of serious complications, the irreversible nature of the procedure, and the unknown long term consequences. Laparoscopic gastric banding (aka lap-band) is a minimally invasive surgical procedure.

While your child is under anesthesia, the surgeon will use a miniature camera and small surgical instruments inserted through 3-5 tiny holes to place an adjustable silicone band around the stomach. A port, which allows for tightening of the band, will also be placed underneath the skin. The band will divide the stomach into a small upper pouch and a larger lower pouch. The small size of the upper pouch limits the amount of food your child can eat by making him or her feel full much sooner. The surgeon can adjust the tightness of the band by adding or removing fluid through the port, which decreases or increases the size of the upper pouch. The frequency of band adjustments will depend on the child's weight loss, appetite, activity level, and the overall goals of the child, family, and surgeon. When will my child be able to go home? Your child will typically go home within 23 hours after the surgery. What do I need to do after the operation? For the first 2-3 weeks after surgery, your child will be on a diet of clear liquids.

He or she will then begin a soft diet, and will move on to small amounts of solid food as directed by the surgeon. Food must be chewed thoroughly, liquids should be consumed separately from solids, and each meal should consist of no more than 4-6 ounces of food. Your child will need to exercise for 30 minutes 3-6 times a week. You and your child will continue to meet with the WATCH clinic team and the surgeons after surgery. What care is needed at home after surgery? Care of the incision: The tiny laparoscopic holes (probably 3-5) need minimal care. You may remove the plastic tape and gauze 3 days after surgery. There will be thin pieces of paper tape (Steri-Strips®) over the incisions. The Steri-Strips® should stay on until they fall off on their own. Bathing: Your child can shower after surgery, but the incision sites should be kept covered for at least 3 days. After 3 days, the patient may take tub baths. Activity limitations: There are no activity limitations.

Your child will tire easily, but it is safe for them to do any activity that they did before the surgery. Diet: Lap-band patients have extensive instructions on their postoperative diet. In addition to the general guidelines listed above, please refer all questions to the nutritionist whom you met with before the surgery. Medication: With laparoscopic surgeries, there is minimal pain after the operation. By the day after surgery, liquid Tylenol or an occasional oral, mild narcotic is all that is necessary. If your child's pain does not get better with these medications, or if pain returns, please contact your surgeon immediately. Follow-up: You will have a follow-up appointment with your surgeon 2 weeks after your operation. To make an appointment, please call 415-476-2538. Complications after surgery: Please call us if you develop any of the following: fever, increased pain or pain that is not controlled with prescribed medications, bleeding, vomiting, diarrhea, or dehydration.

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