A Dose of Optimism
A Dose of Optimism is a podcast dedicated to exploring the world of healthcare innovation and the optimists driving meaningful change.
Hosted by Omkar Kulkarni, this show shines a light on bold ideas, transformative solutions, and the passionate individuals working every day to make healthcare better for children and their families.
Each episode dives into the real-world challenges facing the healthcare industry and highlights the people and organizations pushing the boundaries of what’s possible. From tackling mental health and food allergies to reimagining hospital care and harnessing Artificial Intelligence for better outcomes. Listeners will discover game-changing solutions, hear stories of creativity and resilience, and gain inspiration from leaders who believe in building a healthier, more hopeful future.
From medical professionals and entrepreneurs to patients and community advocates, the podcast brings together diverse voices united by a shared commitment to improving healthcare delivery. Whether you’re working inside the industry or simply curious about the innovations shaping tomorrow’s care, A Dose of Optimism offers insight, connection, and inspiration.
“The content, views, opinions, and information presented on this podcast do not reflect the views of Children’s Hospital Los Angeles or of the sponsors of the podcast. CHLA does not endorse the views, opinions and information presented on this podcast and CHLA specifically disclaims any legal liability or responsibility for the podcast’s content.”
A Dose of Optimism
New Behavioral Health Care Models for Kids
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Children’s mental health challenges are rising worldwide, yet access to effective care remains limited. In this episode, we explore new approaches to pediatric mental health with three leaders working to expand access and improve outcomes.
Kristina Saffran, CEO of Equip, explains why eating disorders are one of the most misunderstood public health crises affecting children and adults, and how evidence-based family-based treatment can dramatically improve recovery when delivered earlier and more broadly.
Dana Klein, co-founder of Gheorg, shares how a new generation of child-centered digital tools is helping children ages 7–12 build emotional resilience, develop coping skills, and identify mental health challenges before they escalate.
Sophia Waitt, Marriage & Family Therapist Associate, adds the perspective of a therapist working directly with teens and young adults, discussing the mental health impact of social media, identity pressure, and digital environments on developing minds.
Together, the conversation explores how innovation, technology, and early intervention can help address one of the most urgent pediatric health challenges of our time.
Episode Resources:
National Alliance For Eating Disorders
Dr Louise Metcalf, Gheorg Founder & Psychologist
Connect with Kristina Saffran:
Connect with Dana Klein:
Connect with Sophia Watt:
Sophia Waitt - Marriage & Family Therapist Associate, AMFT
Connect with us:
Children's Hospital L.A. Website
Children's Hospital L.A. Instagram
Children's Hospital L.A. LinkedIn
I've been interested in diving into the world of reimagining care models for kids with behavioral health needs. In today's episode, we're going to get into some really creative new ideas around how we can treat populations that are really struggling with access to getting timely care for really important behavioral health needs. So the first one we're going to talk about is eating disorders. I think we often don't talk about this behavioral health need enough. And we often forget that it's a much bigger population that's in need than we typically think about. After that, we're going to talk about kids who are young, elementary school age kids who are often being underscreened or under-diagnosed for anxiety and depression and perhaps even thoughts of suicide. And we're going to talk about an innovator that's doing some interesting things using games and a gamified experience to help kids as young as kindergartners to help navigate and self-cope and self-manage some of what they do in elementary school. And then finally, we're going to have a conversation about teenagers and adolescents and some of the challenges they're facing, particularly with social media, how that could relate to behavioral health problems and some solutions that she thinks we should be thinking about as we have kids who are adolescents and approaching adulthood, how we can help them use social media for good in a way that will help them with their behavioral health as they enter into adulthood. I hope you'll enjoy the show. Welcome to the Dose of Optimism, where I talk to the optimists in healthcare. My name is Omkar Kulkarni, and I work at one of the world's best children's hospitals where I lead innovation. I started Kids X, which is a premier international startup accelerator for pediatric innovation. And over the years I've met thousands of startups, investors, and innovators. Every one of them has a story, and every one of them is optimistic about the problems they're solving. On this podcast, you'll meet amazing people who will share their stories and what makes them optimistic about the future of healthcare. All right, let's get started. So, my first guest is Christina Saffron. She is the co-founder and CEO of an amazing company called Equip. They are a virtual provider of eating disorder treatment that's evidence-based and it's built out of clinical rigor and a lot of her own lived experience. She has gone on this journey herself, and she talks a little bit about that in our interview. She's got a really interesting background. She founded a program called Project Heal. She spent years and years and years in this space, and you you see it in the product that she's built. And so I hope you'll enjoy the interview with Christina from Equip talking about eating disorders. So this topic is one that is of real interest to me because I think we don't talk about it enough, but it impacts so many kids, boys and girls in this country, young adults and adults, the whole population.
SPEAKER_01So eating disorders are a big public health crisis. 30 million Americans will struggle with an eating disorder at some point in their lifetime. That is 10% of the population. Only about 20% of them will actually get treatment. And beyond that, less than 5% actually get access to treatment that works. So there's a huge gap in available treatment. And of that treatment, much of it is not evidence-based, not leading to lasting recovery. We also know that eating disorders are the second deadliest mental illness, second only to opioid use disorder. Every 52 minutes, somebody dies of an eating disorder. And they start as young as four years old and go into, we are treating people in their 70s right now. And I love that you highlighted that this issue does not discriminate. We know that up to 40% of those who suffer are boys and men. The majority of people who struggle with an eating disorder are not underweight. You can't tell just by looking at them. They affect people from different races, classes, ethnicities fairly equally. And we actually know that as food insecurity rises in a population, eating disorders directly rise.
SPEAKER_00So let's dig on that a little bit more. I think many people could think of what a patient with an eating disorder may typically look like. But to your point, there may be a broader population that sometimes goes unnoticed or underdiagnosed.
SPEAKER_01The reality is even people who fit the stereotype don't get diagnosed with eating disorder. So we have a big problem. I often talk about the fact that you all can't see me, but I pretty much fit the stereotypical mold of what we think an eating disorder sufferer looks like. I was diagnosed when I was an adolescent, young, white, thin, upper middle class girl. And I share that I was diagnosed when I was 10. I relapsed when I was 13 and went into my pediatrician fitting that stereotype with a history of anorexia, having lost 10 pounds. And my pediatrician didn't bat an eyelash. So if I'm getting missed, everybody is getting missed. And this is a huge problem because we know everything else in healthcare, early intervention is the best shot for a quick and lasting recovery. And so we are missing a tremendous amount of people. Most folks aren't diagnosed at all. And even if they are, it's not until three years into their illness.
SPEAKER_00In the medical community, is there a perception that eating disorders are preventable in some sort of way? Are there things that parents or people can do to prevent them?
SPEAKER_01It's a very complex topic, but I would say this is something that has occurred for centuries and centuries. What we often say is that genetics load the gun environment pulls the trigger. And so if you are genetically predisposed to an eating disorder, the heritability here is incredibly strong, like similar heritability loadings as something like schizophrenia. If your close family member has anorexia, you are 10 times more likely to be diagnosed with anorexia. These genes are incredibly strong. And we live in a society where the trigger is constantly being pulled. We know what sort of triggers an eating disorder is taking in less calories than your body needs, and living in a world that is constantly telling you we should be thinking about weight loss. And are you sure you want to eat that? And do you want to go on a GLP one and concerned about the obesity epidemic? That is going to trigger a lot more people to go into negative caloric deficit. And for those who are predisposed to an eating disorder genetically, more will be turned on.
SPEAKER_00So if a large percentage of population goes undiagnosed, parents and the way food is introduced and food is talked about, and all of that is talked about, the way kids think about food and eating and caloric intake.
SPEAKER_01There's a genetic predisposition and then also the lived environment of what is your parent doing? And kids pick up on things. I often tell parents though, parents do not cause eating disorders, but we can be our best ally in helping to get kids better from eating disorders. And a lot of that is really modeling around all foods fit, modeling around health at every size, that weight is not a great proxy for health. We want to engage in healthy behaviors. And it's not because we're trying to see a certain number on the scale or look a certain way, really taking the focus off of weight and onto help promoting behaviors for everybody.
SPEAKER_00What can parents look for as early signs?
SPEAKER_01One of the easiest ones is if a kid is losing weight, kids shouldn't be losing weight. Kids should be gaining weight growing. In addition, if somebody is falling off their growth curve, maybe they're not necessarily losing weight, but we have a 12-year-old who weighs the same thing that they did when they were eight years old. That's certainly a red flag and a red sign. And then parents really trusting your gut around changes that you've noticed in your child, if you have a gut sense that something is wrong, you're probably right. And I think oftentimes parents wait too long because they don't want to make an issue out of something or they don't want to cause something. And that is not at all borne out in the research and literature. The quicker that you can intervene and talk to your child, the better. And so if you're noticing that your child used to really love dessert and has been cutting out dessert, if you notice that they've been avoiding going out to pizza after school with their friends and that was something that they like to do, I would say absolutely take action quickly because these things can exacerbate very quickly.
SPEAKER_00Now, historically, what were the options that families had?
SPEAKER_01It was pretty sparse. There's a huge lack of access in the field. There's about 5,000 eating disorder specialists in the country for 5 million people today, right now, who have eating disorders. We have a severe access shortage. And then again, of those, only about 20% actually utilize evidence-based treatment. And so a lot of people don't get treatment. And then for those who do, it can exacerbate really quickly and folks end up being treated in facility level care. And so this was my story. I spent my entire freshman year of high school in and out of four different hospitals for a total of seven months. Thankfully, got out. And when I started to relapse, doctors said my parents sent her to a long-term facility and don't have a lot of hope for recovery. And I'm grateful that they didn't listen to that and instead dove into the research and found out about family-based treatment, which we now know is the leading evidence-based treatment for kids and adolescents with eating disorders. And a high-level family-based treatment understands that eating disorders make you fight your brain many times a day. And you really need people to help you with that process. And so it really empowers the family to take an active role in the recovery process, i.e., preparing the meals, plating the meals, supervising the meals. And while I always say it was the hardest year of my life, it was undoubtedly the thing that got me better. And so that's what we've we founded equipped to do, to really provide access to high-quality evidence-based treatment that we've had around for many decades, but unfortunately has been incredibly stuck in the academic landscape. And then beyond that, for an eating disorder, you really need a multidisciplinary care team, at the very least, a therapist, a dietitian, and a medical provider. And prior to a quip, these folks were incredibly inaccessible. If you could find somebody, they were almost all out of network, not covered by insurance, incredibly pricey out of pocket. And then beyond that, they didn't talk to one another, right? The family member or the patient was really playing that role of the care coordinator, which made focusing on treatment really hard. So that's what a QIP is designed to do, really disseminate access to the best of our existing evidence-based treatments and build these multidisciplinary care teams for families that are all coordinated on the same page, working together so that families can really focus on the hard work of recovery.
SPEAKER_00You brought up earlier you fit the stereotype of what a patient with an eating disorder may look like, white upper middle class. What does the data show? Are there populations that are underdiagnosed? I'm thinking of non-white populations. I'm just curious what the data looks like.
SPEAKER_01The reality is with eating disorders, everybody is underdiagnosed. So even those, again, who fit the stereotype, like me, or are underdiagnosed. But then that certainly gets hugely exacerbated in populations that don't fit the stereotype. And so a couple to point out one, boys struggle too, because 40% of people who struggle with eating disorders are boys and men. And it's already an illness that is so hard to reach out about. And so if you think this is a girl's illness, that prevents a lot of people and a lot of families from getting their boys' help. When we know that they are for, again, 40% of all sufferers are boys and men. Another population is people in average weight or higher weight bodies. We tend to think of eating disorders as something that only happens when you're emaciated. And the large majority of people with eating disorders are not. They live in normal weight or higher weight bodies. And then food insecurity. We have new research that as food insecurity rises in a population, eating disorders directly rise in proportion. And so these are all populations that are not getting diagnosed and getting the adequate health that they need for their eating disorders.
SPEAKER_00Your point about people with normal body weight is interesting. So, how do you think we balance the public health messaging around the obesity crisis, particularly amongst adolescents? And it's a real public health problem that we have. But if you go too far, if you don't manage that properly, it could turn into an eating disorder. And so, how do you balance both ends of this public health problem that we have? We want to make sure that people are healthy and you could turn the dial the wrong way or message something the wrong way around obesity, and particularly for young people where they're still figuring out lots of things about their body image and mental health.
SPEAKER_01It's incredibly challenging. And I talk to a lot of obesity specialists or weight management specialists who see plenty of eating disorders in their office, and they see when this message is taken too far, and a lot of kids start to struggle with eating disorders. With you can have anorexia in a higher weight body. And these cases are particularly challenging because they have been told for so much of their life, they've been given this message of you need to lose weight, your body is not okay. It really goes back to at a high level taking the focus off of weight. I will sometimes see parents with two kids who have different body shapes and sizes. One is in a smaller body and one is in the larger body, and see how they treat those kids differently, right? The one in the smaller body, they say it's fine to have dessert. And the one in the larger body, they're constantly trying to encourage them to eat fruits and vegetables and run around outside. And that's precisely the opposite of what you want to do. Regardless of your weight, we want to be encouraging healthy behaviors amongst our kids. So it's great to introduce variety and many colors and share the importance of foods that are going to fuel your body to have energy for the day. It's great to be encouraging physical activity because it's great, it makes us feel good and it makes us have energy for the day, but really not tying any of that to a weight-based outcome. And we also know that trying to make people lose weight is not super effective in the long term. And so really encouraging again these healthy behaviors for the entire family, divorcing that from any weight content.
SPEAKER_00I totally agree. And your example around multiple kids and making sure the messaging is the same and the behaviors are the same from a parenting standpoint totally resonates. So I appreciate you bringing that up. What is your take on GLPs and the introduction of them and how that plays into the equation? Because that's changing eating behaviors medically. And I'm curious where that goes as the cost of those go down and as people have more access to those drugs, there's obviously tremendous benefit, but I could see a world where, if misused, could turn into challenges.
SPEAKER_01We are monitoring the situation very closely. The research is being written right now, and we are going to know a lot more in the next several years. Anytime that you have more intentional weight loss and more people going into what we call negative caloric deficit, taking in less calories than your body needs, you are going to have more eating disorders. So I certainly think that we will see some negative ramifications of these eating disorders. I was just chatting with the uh head of the National Alliance for Eating Disorders, one of the large nonprofits in the space. And they have a helpline that people can call in to get help for suspected eating disorders. She was telling me that one in three callers over the last several months have mentioned being on a GLP one and that exacerbating eating disorder thinking and behaviors. And so it's something that we're really closely following. At the same time, there is some emerging anecdotal data that for people with binge eating disorder, it can be helpful and can help them sometimes quiet their food noise. And so the jury is still out. I think we are gathering and equipped, trying to be at the cutting edge of really gathering the research on where this can be a useful tool for people with eating disorders and where we need to be really cautious about using it in the broader population.
SPEAKER_00As you look to the future, what is your hope as it relates to how eating disorders are treated, let's say five years from now?
SPEAKER_01I hope more and more people have access. Like we have treated over 15,000 patients since we opened our doors. It makes us one of, if not the largest eating disorder treatment provider in the country, which I'm so proud of and also horrified about, given that there are five million Americans today, right now, who need our help. So I hope that we've expanded reach pretty dramatically. And then frankly, I also get excited about our ability not just to disseminate the best of the existing evidence-based treatments, but really to make existing evidence-based treatments better. Our best treatments still leave a lot of room to be desired. They don't result in full recovery for everybody. They've been studied on a pretty homogeneous population that doesn't reflect the true diversity of everyone who struggles. And so I get super excited about our ability at equip to, again, not only disseminate what works to more people, but actually to make our existing treatments better for a greater diversity of the population.
SPEAKER_00Christina, you're doing incredible work. Thanks for coming on the podcast. All right, next we've got our interview with Dana Klein from a company called George. So George is built off of decades of experience that Dana and her team have. Dana has a really interesting background. She is strong in public service and community partnerships. She actually works with early stage companies in the Florida market. She works with the country of North Macedonia and is an honorary consul there. She's got a really unique background. But most importantly, she's got a deep passion for mental health and young children. The game that she's building is helping kids as young as kindergartners figure out how they can self-cope, self-manage some of the challenges they face in elementary school, hoping that results in better outcomes for them as they become teenagers, young adults, and adults. So tell us about George.
SPEAKER_03George is a mental health app for kids 7 to 12 with the five top mental health issues: anxiety, depression, OCD, ADHD, and autism issues. We coupled AI with evidence-based therapies, CBT, ACT, and positive psychology. And we put in formal-friendly characters that engage children in games, conversation, exercises, and more to help them identify, articulate, and cope with triggers in a productive manner. So we teach them real emotional intelligence and resilience. And we have real-time monitoring for the parents and real-time monitoring for any clinician, healthcare provider, social services, anybody else who's in the loop. So it's a human in the loop technology connecting all the dots to the child, very child-centric.
SPEAKER_00What's the age range for George?
SPEAKER_03So it's 7 to 12. And the reason why we chose that age group, there's a couple of reasons. The first one is that we want to get them before they're teenagers when it's much more difficult. And by doing so, we become preventative in nature's teach them great skill sets to continue on through their life. The other reason is because that age group is a very crucial time in childhood development and is grossly underserved in mental health. So seven to twelve, younger if they're literate, older if they need to run it.
SPEAKER_00What's an example of a type of skill that George teaches an eight year old?
SPEAKER_03A big part of the problem is that kids react and they might have a delayed process. So Maybe they something happened today and it takes them two days to actually process. They're acting out. Nobody knows why. Everybody's at a loss. And it just gets worse. So part of that is articulation. We use conversation with George. We also use storytelling. So pulling the child out to create a rhythm of process that they can carry on through their lives.
SPEAKER_00And this is for any child, right? They don't have to be a child that is having a mental health issue or crisis.
SPEAKER_03Absolutely. And in fact, other illnesses as well. So let's say you have a family where one child is affected, the other children maybe want to be included or feel they maybe they have another issue. And so everybody can be under the same subscription for not a penny more and with the paraportal. And then if they have other disabilities such as terminal illnesses, or maybe they have cerebral palsy, this is something that addresses their emotional side. And we all need help with our emotional side. So it's safe for any child. We are compliant and we have safety measures across the board.
SPEAKER_00Love that. What are you excited about for the future?
SPEAKER_03We are built for the masses. So what makes us really different is that we automate 30 plus years of experience in child psychology developed by Dr. Metcalf out of Australia, where they do a great deal of mental health work. She's a researcher and a scientist. And so this what she did was she automated what she does in her practice. And then so it's not just AI across the board. So then we use the AI for a very specific personal journey. So we can relate to each child individually. So our mission is that no child is left behind. This allows us to do this. We also use what's known as White Hat technology, which is separate from Black Hat, which is used in social media to look for vulnerabilities and keep the child addicted. We do just the opposite. We use White Hat, which is used for a very specific purpose. And then we have a timed user experience. So children get on up to 10 minutes at a time and get back off into real life, although they can use it multiple times throughout the day. We don't leave any children behind. Every child can be included. And then at the end of the day, we want every child to go off into their own journey.
SPEAKER_00We were just talking about the importance of incorporating children in the design of some of these software solutions. How have you used children and their input to help design George and the app itself?
SPEAKER_03George was designed by over a thousand children, putting in their two cents every corner. This whole app was built with intention across the board. So it's built for children by children, and they have their own journey, a little bit like Minecraft. We're multicultural, multilingual, male-female. So we always meet the child where they're at. And that's another thing that makes us very different. It's all child-based. Instead of connecting a child to a system, the system actually connects to the child.
SPEAKER_00Dana, thank you for joining us and telling us about George. Excited for all the things that George can do to help kids help navigate growth and wellness and resilience. So they turn into healthy, productive teenagers, adolescents, and young adults. My last guest is Sophia. She is a marriage and family therapist in LA. She works with teens and young adults who are navigating anxiety, trauma, neurodivergence, perfectionism, substance abuse, relationship challenges. She's got a master's in clinical psychology from Pepperdine. What's really interesting about her is she really knows how to work with this population. And I wanted to talk to her about some of the challenges she's seeing at the intersection of social media and mental health. And so I hope you'll enjoy this interview with Sophia. What are your thoughts on that?
SPEAKER_02I definitely feel like there needs to be more restrictions, especially with how detrimental we've seen, like that they have they know so much that I didn't know that much at my age about everything that's happening around the world. And it's caused mental health challenges for all ages, not just adolescents. But when your brain is developing and you hear all these things that you're not really supposed to, then it can be very overwhelming. But then it really is hard for them to make that next step. And I think with social media, there's another level of the self-esteem. There's this pressure to build this persona online that is not necessarily themselves. And then how can you be confident in who you actually are if you feel like this person that you've created is almost better than who you were born like to be? And I think that complete couldn't be more false. Like I think who you are uniquely as yourself and the experiences that you have and the impact you have on other people as your authentic self is the biggest or the most important thing. But social media definitely needs to have more restrictions. I would like to read more about what the restrictions necessarily are. Like, do you know what I know it's the age, but is there anything after the age that they're still restricting, or is it just the age itself? When Facebook first started, that's what it was for college students and up. Yeah, there were workarounds, and of course, like everyone was like wanting to get on it, but it still created this level of like safety almost because when social media started, I think that people actually were maybe having those conversations a little bit more. And then over time, a lot of things when they want to look at like maybe the dollar amount more and want they're like, oh, this can make can get so much bigger. Those conversations start getting lesser and lesser until they almost disappear. And the fact that it's coming back again is really great. Also saying the like restrictions also with AI and everything, too. I think that needs to be something that is really hard to have. But with mental health, especially with adolescents, a lot of them are talking to this. It's like a robot, essentially. And that is something that I'm hoping is goes like after the social media, then there's something that is has more even parent controls and stuff that allows for more safety, too.
SPEAKER_00All right, thank you for joining us for your dose of optimism. Make sure to check out our show notes to get more information about our guests and the work they're doing. Visit our podcast page on the Kids X website to join our podcast community and to learn more about pediatric innovation. Thank you to our sponsors and to our presenting partner, Kids X. Please subscribe wherever you get your podcasts. And remember, it takes a village to make sure our kids grow into healthy adults. So volunteer at your local library, help out at the community center, and if you're so inspired, donate to your local children's hospital. Alright, see you next time. The content, views, opinions, and information presented on this podcast do not reflect the views of Children's Hospital Los Angeles or of the sponsors of the podcast.