Everything about Teens

Anorexic Teens  Anorexic teens refers to teenagers who suffer from anorexia nervosa, which is one of the most common teen eating disorders. In this article we will review anorexic teen statistics, warning signs, causes, factors, symptoms, effects and treatment of teen anorexia. Anorexia Nervosa is a serious and potentially life-threatening eating disorder, which is characterized by self-starvation and excessive weight loss. Teenage girls are more likely to have anorexia than any other group. Teen anorexia, or anorexia nervosa, is one of the most common eating disorders among teens. Anorexia means that a troubled teen is starving her or himself. Teens with anorexia are obsessed with their body image. Anorexic troubled teens hardly eat anything, and have a distorted view of themselves so that they always think they are fat even if they become dangerously thin. Teen anorexia can cause serious health problems or death, so troubled teens with anorexia need to get medical treatment to recover from their eating disorder. Eating disorders such as anorexia are most common among teens, though eating disorders can begin earlier or later in life. About 1 percent of teens have an eating disorder. Teen anorexia is most common among teen girls, but about 10 percent of troubled teens with anorexia are boys, and teen boys with eating disorders often go undiagnosed and untreated. Between 5 and 20 percent of teens with anorexia will die because of the disorder. Some signs that a teen has anorexia include: Losing weight even after he or she is underweight Fear of being fat, and belief that he or she is fat even if he or she is underweight Denial that he or she is underweight Obsession with what he or she eats, especially obsessively counting calories, weighing food, or developing strict eating rituals Eating hardly anything at all and saying he or she is never hungry Excessive exercising to lose weight For teen guys, an obsession with looking athletic Staying away from social activities, especially those involving food Some of these symptoms, such as social withdrawal, losing too much weight, or lack of appetite can also indicate other health problems in troubled teens, including depression, bulimia, or other illnesses. Teens with these symptoms need to be diagnosed by a medical professional. The causes of anorexia are unknown, but some factors seem to make teens more prone to anorexia, such as: Feeling out of control, and wanting to control their bodies Fear of the changes that occur during puberty, such as natural and healthy weight gain Role models such as celebrities who are excessively thin Mental illnesses such as depression, anxiety, or obsessive compulsive disorder Family members who are overly concerned with weight Genetics ? Involvement in sports that stress ideal weights, such as gymnastics, ice-skating, ballet, track, and wrestling Peer pressure from someone they know who is anorexic Anorexia can do serious harm to a teen's body, sometimes ending in death. Some effects of anorexia are: Malnutrition and starvation Lack of energy Susceptibility to injury, especially due to brittle bones Damage to the heart, liver, and kidneys Lowered blood pressure, pulse, and breathing rate Muscle weakness Anemia (lack of red blood cells) Swollen joints Light-headedness and poor concentration Poor performance in sports or school Loss of hair Broken fingernails Dry hair and skin Growth of soft hair all over the body Guilt Depression and withdrawal In teen girls, loss of menstrual cycle Death Teens with anorexia need medical treatment without delay so they can recover from their eating disorder. If you, your teen, or a friend may have anorexia, find help immediately. Teens with anorexia should be treated by doctors, mental health professionals, and dieticians. Individual therapy is necessary to help the teen learn better eating habits and a better attitude about food and body image, and family therapy can help the troubled teen to have a supportive environment during her or his recovery. Anorexic Teens Sources: Eating Disorder Recovery Center - www.addictions.net & www.edrecover.com  Nemours Foundation, TeensHealth, Eating Disorders: Anorexia and Bulimia [online] National Eating Disorders Association, Anorexia Nervosa [online] TEEN BULIMIA What is Bulimia According to the United States Department of Health and Human Services' Substance Abuse & Mental Health Services Administration (SAMHSA) (1), bulimia is an eating disorder that mostly affects young women between the ages of 12 and 25 of normal or near normal weight. Characteristics of bulimia include episodic binge eating followed by feelings of guilt and self-condemnation. Teens suffering from bulimia often show signs of the eating disorder by eating a large amount of food in a small time frame and immediately purging themselves of the food ingested by causing themselves to vomit. Other ways the bulimic uses to rid the body of food eaten during a binge include laxatives, diuretics (water pills), and fasting. Often called the "binge/purge" cycle, this behavior is brought about by an extreme fear of gaining weight. Treatment of Bulimia Treatment for teens suffering from bulimia has been advancing in recent years. In 2002, the American Psychological Association reported on a study conducted in 2000 about two types of psychotherapy that have met success in the treatment of bulimia (2). One type focuses on the symptoms of bulimia while the other aims to address issues the bulimic may have with relationships. Cognitive behavioral therapy helps the bulimic address the symptoms of bulimia and focuses on the negative thoughts associated with their weight and appearance. This therapy also helps guide the bulimic to make positive diet changes. Interpersonal psychotherapy aims to improve the worth of the bulimic's current relationships and to improve any negative aspects of those relationships by dealing with issues directly. This therapy also helps the bulimic to form a wider social network. A study reported in the August 2000 American Journal of Psychiatry (Vol. 157, No. 8) reported that bulimics who responded well to either of these types of therapy did so within the first six to eight sessions. The report further states that randomly selected patients who did not respond to the two types of therapy did respond to antidepressant medication such as Prozac. Studies suggest that bulimia is manifested in women between the ages of 18 and 24. Psychologist Daniel Le Grange, Ph.D., however, believes that by exploring bulimic patients' histories more thoroughly, the cycle of bingeing and purging often begins as early as 15 or 16. How to Prevent Bulimia According to the Public Broadcasting System's Perfect Illusions website (3), there are steps parents, teachers, coaches and others who work with teens can take to help avoid bulimia. A few of these include: Modifying and adapting expectations you have of your teen. Examining your own perceptions and attitudes towards food, body image, physical appearance and exercise. Do not give off the message that you cannot do activities such as dance, swim, or wear certain types of clothing because of the way you look or how much you weigh. Encourage eating in response to physical hunger. Encourage eating a variety of foods. Help teens to appreciate their bodies and encourage them to engage in physical activity. Do not use food as a reward or punishment. Do not criticize your own weight or the way you look by avoiding the use of such phrases as "I'm too fat" or "I've got to lose weight." Love, accept, and acknowledge the teen's value verbally. TEEN OBESITY Teen Obesity Statistics Teen obesity has grown to epidemic proportions in the United States. The US Department of Health and Human Services recently published teen obesity statistics regarding this dangerous trend. According to the report, 14% of adolescents in the United States are overweight. This figure has nearly tripled in the last 20 years. This means that 14% of our teens are at risk for heart disease, high cholesterol, and high blood pressure. Type 2 Diabetes has also increased dramatically in teens as a direct result of teen obesity. Additionally, teens who are dealing with teen obesity have a very high probability of being obese as adults further increasing their risk of other serious health problems. Reading these teen obesity statistics may be a little frightening but may also be viewed as "something to worry about tomorrow" because teen obesity statistics are dwarfed by other problems teens face today. Teens dealing with teen obesity also deal with social discrimination which can be devastating. Overweight or obese teens often have low self esteem which keeps them from joining in many activities with other teens. Obese teens may also suffer from depression which can lead to a viscous circle of staying at home watching TV and snacking, gaining more weight, feeling worse about themselves, and spending more time in front of the TV. Obese teens may feel this is a problem they are powerless to change. IT ISN'T. What Causes Teen Obesity? The cause of teen obesity is generally lack of physical activity combined with unhealthy eating habits. We have become a very sedentary society. We spend hours sitting in front of computers, video games, or televisions. One survey showed 43% of adolescents watched more than two hours of television per day. Daily physical education has been eliminated from a lot of schools. More children are "latchkey" children who, while waiting for parents to come home from work, sit and watch TV or play video games. In a January report to the Centers for Disease Control and Prevention (CDC), Dr. William Dietz, Director of the Division of Nutrition and Physical Activity concluded "of all the ways of tackling this problem, TV reduction appears to be the most effective measure in reducing weight gain in this population The other side of the equation, our diet, too often consist of greasy fast food, sugary snacks, and large portion sizes at restaurants. Going on a strict diet is not the answer. It is important to change the way the whole family eats. Whole fruits, whole vegetables and whole grains should make up a large part of the diet. Parents need to know the value of choosing whole grain breads rather than white. The August 2002 issue of The American Journal of Clinical Nutrition contains a report showing a strong correlation between the amounts of whole grain consumed over a four year period, and healthier weight, healthier waist-to-hip ratio, and decreased risk for diabetes. This was true no matter how much refined grain was eaten, and no matter how much fiber. Recent reports from public health organizations have concluded that if children are given appealing places to play, it increases their participation and as a result their health was markedly improved and reduces teen obesity by increasing weight loss. Activities to do to help reduce teen obesity: Play basketball Play tennis Play volley ball Play racket ball Go to a skate park Go swimming Play any ball sports These can all make a big difference in teen obesity. Additionally there are classes in dance, gymnastics, karate, etc. There are youth baseball, football and soccer teams to join. The idea is to choose something fun and get moving, dancing, jumping, climbing, walking, skating?. So, grab an apple and go have fun! SELF IMAGE Self image is the mental picture that you have of yourself. The teen years represent one of the pivotal times for the development of self image. It is at this time that many teenagers develop the personalities that they will have the rest of their lives. And this picture they have of themselves can influence the kinds of friends they have, the choices they make and their performance at school and work. In order to have a successful and fulfilling life, a teen needs to develop a positive self image. Negative self image can lead to damaging behaviors In recent years, studies (including one at the University of Illinois at Urbana-Champaign) have shown a correlation between negative self image and damaging behaviors. Without the confidence to stand up for oneself, teenagers may look for acceptance by having unprotected sex, doing drugs or abusing alcohol. When teenagers do not think they are valued by their parents, or if they feel they are being ignored, they may act out in ways that  can hurt them for the rest of their lives. Another problem stemming from negative self image can be suicidal tendencies. If a teen feels worthless, unwanted and depressed, he or she may decide to take his or her own life. This can be a very painful experience for everyone involved • especially family and friends. Developing a positive self image In order to help your teenager develop a positive self image, it is important to make sure that he or she feels worthwhile and knows that you care. In fact, even if your teenager is exhibiting inappropriate behaviors, it is important that you show unconditional love and offer your help and support. Additionally, there are a number of things you can support that can help your teenager feel useful and involved. One of the most important things you can do is encourage your teenager in accomplishments. These accomplishments can be at school, work, home or with extracurricular activities. Having something that your teen does well • or is at least improving at • can help him or her feel a sense of accomplishment that can help them develop a positive self image. Setting goals and achieving them, as well as being involved, can help teenagers feel connected to others and as though they are doing something worthwhile. You can help your teenager by encouraging his or her efforts, and by supporting their decisions to do their best. You should praise improvement and encourage your teenager to excel. Attend ceremonies and events so that you can show your support for your teenager on a regular basis. Constructive correction is also important. Helping your teenager’s self image does mean you ignore all the negative things. You should be helping your teen improve, and correcting behavior. But you should do so in a constructive and gentle manner. And, while you are pointing out areas that need improvement, you should also take the time to make sure that you praise your teenager for what he or she is doing well. A positive self image can provide a teenager with confidence and with the good feelings that make it possible for him or her to do his or her best, and to say no when confronted with the temptation of dangerous or damaging behaviors. How a teenager feels about himself or herself can play a large roll in later success in life. In fact, teen self esteem can influence decisions that are made now - decisions that can impact health, mental state and achievement in later years. It is important to help your teenager feel that he or she is of worth. This will inspire the confidence that helps teenagers excel at what they do, and give the courage to say no to dangerous substances and situations. Helping your teenager build good self esteem Positive self esteem is when a teen knows that he or she is loved, cared for and is worthwhile. Self esteem is understanding that others think well of us. Teenagers need to feel that their friends, teachers and parents respect and love them. There are some things that parents can do help teens develop a healthy self esteem: Avoid too much negativity. Focus on what your teenager has done right. It is alright to correct your teen when he or she is wrong, but do so in a gentle manner, and accompany your critique with praise for some other activity that he or she is doing well at. Make sure you recognize the good while you are helping to manage the bad. Focus on improvement, rather than on perfection. No one is going to be perfect. Let your teenager know that you notice when he or she makes improvements in their activities and behaviors. Focus on the journey, rather than what you wish was the end product. Encourage achievement. Help your teenager set and achieve goals. They should be challenging goals, but also goals that your teen can accomplish. Being able to overcome challenges and reach a goal can give your teenager a good sense of accomplishment and worth. Understand that your teenager may want different things than you. You may want your teenager to be a doctor, but he or she may want to be a journalist. Understand that your teen may have different goals in life. Try to support your teenager in his or her decisions. As long as your teen is not engaging in risky, damaging or illegal behavior, try to be supportive and encouraging. Listen to your teen. Invite your teenager to share his or her ideas and opinions. Listen respectfully, and encourage critical thinking. Be a model of civil discussion and teach your teenager how to disagree without arguing. Encourage exercise. Physical activity helps increase one’s self esteem. Encourage your teenager to get regular exercise, either through activities at home or by participating in organized sports. Encourage extracurricular activities. Your teenager does need to be involved in everything, but one or to extra activities can really help improve self esteem. It gives your teen something to improve at and accomplish. Make sure that you attend recitals and exhibitions and sporting events that your teenager participates in to show your support. TEEN STRESS Having a teenager can be difficult. And it can be hard to know how to properly nurture and care for your teen. However, if you make the effort to show love and kindness - and support and interest - you can help your teenager develop the healthy self esteem that leads him or her to live a successful and fulfilling life. All of us, both young and old experience stress at certain times in our life. It's how much stress we encounter and how we deal with the stress that can determine whether or not it's a problem. Stress, otherwise known in more medical terms as the "flight or fight" response, increases our heartbeats, speeds our metabolism and heightens our awareness. A little bit of this stress can be good for us, keeping us in tune with our surroundings. If these stressors last for long periods of time, they can keep us in a constant state of tension. They begin to wear on us physically, mentally and emotionally. Causes of teen stress It really depends on each individual what they consider to be stressful. What may be stressful for one teen, may not bother another teen at all. For this reason, it is well advised to keep in tune with your individual child's feelings about different things. Stressors can come from both internal and external sources, some of which are listed below. Family problems (divorce, death in family, new sibling, financial problems) Moving to a new school Difficulty in school (learning difficulties, too much homework, tests) Friends (lack of friends, shyness, fights with friends, acceptance/rejection, peer pressure, boyfriend/girlfriend problems) Overload (too many extra-curricular activities combined with school work, jobs, etc) Illness Physical changes in body Lack of sleep Deciding one's future (college planning, job planning) Overachieving (trying to be perfect in many areas) High expectations (setting goals too high can come from both parents and the individual themselves) Warning signs of teen stress Signs of teen stress can come in many forms. Every teen will experience some signs at different times, but when they last for longer periods of time it can tend to create further problems. Signs of stress can be physical, mental or emotional. Physical signs of teen stress Headaches Stomach aches Muscle aches Nervousness Eating disorders (over eating, under eating) Sleeping disorders (insomnia, nightmares) Mental signs of teen stress Forgetfulness Unorganized Lack of concentration Drop in grades Emotional signs of teen stress Anger quickly Sadness Impatience Frustration Easily Agitated Violent Solutions for teen stress management Now that we are aware of the causes and signs of teen stress, what can we do as parents to help alleviate it? Most stress can be dissipated by some simple everyday methods. If stress has overrun their lives it's best to seek further professional help for them. Talking - Talk to your child about what's bothering them. Talking and working out one's problems with somebody else will help reduce built up tension. Encourage them to talk to their friends or other adults as well. Take time out to relax - Have them find some activities that they enjoy doing such as reading a book or listening to music. Exercise and eat healthy - Exercise (non-competitive) can help reduce built up muscle tension among other things. Eating properly along with good exercise can keep their bodies healthy and prepared to deal with the stress. Avoid too much caffeine as this increases anxiety. Be prepared/organized - Don't allow them to wait until the last minute to do assignments or study for a test. Feeling prepared and ready for things can reduce lots of built up stress. Have them create a daily schedule to follow to keep them more organized. Learn relaxation techniques - Breathing exercises, meditation and muscle relaxation are great techniques for alleviating physical and mental tension. The teenage years are an especially stressful period of our lives. So much is changing around us which we are forced to deal with all at once. Whether intentional or not, we as parents might be putting too much pressure on our children as well. Regardless of the cause, it's important to get down to the root of the problem before it gets out of control. If left untreated, stress can lead to further problems down the road which may be harder to deal with. Teens may turn to drug or alcohol abuse to alleviate their stress. They can become depressed or suffer other types of anxiety disorders. As parents, we can and should help them before it gets out of hand. CYBER BULLYING It is probably safe to say that at some point in our early or late childhood, we have all had an encounter with a school bully in one form or another. Whether it was a friend, a sibling, a classmate or even ourselves being bullied, it is a memory we would rather not remember. Maybe we were a bully ourselves or knew someone that was. According to the Journal of the American Medical Association, 29.9% of American students were involved in some way with school bullying. Results showed that 10% of children reported being bullied, 13% reported being a school bully, and 6% reported being both bullied and being the bully. Findings also show that boys were more likely to be the bully and the one doing the bullying. One of the growing trends in the online world is cyber bullying. As children, preteens and teenagers become more active online and through social media Web sites and channels, it is no surprise that bullying is emerging. Bullying has been going on in “real world” playgrounds for decades, and now it is moving to the playgrounds of the virtual world. However, even though cyber bullying takes place online in a world that isn’t “real”, the consequences - emotional and physical - can be real. Emotionally, cyber bullying can be scarring, since it involves threats and humiliation. In the physical realm, cyber bullying has in some cases moved into the “real world”, with the harassment continuing offline. There have been reports of beatings, murders and suicides in connection with cyber bullying. It is important to note that cyber bullying occurs between minors. Harassment by an adult toward a teenager online is a different matter, usually predation. Cyber bullying is not limited to the Internet. It includes the use of any digital technology (including cell phone texting) by a minor or group of minors to embarrass, torment, threaten, harass, or target another minor. This can leave scars, since online “friends” - as well as offline friends - can see the abuse. Children, preteens and teenagers are already sensitive about their identities, and cyber bullying can be as real a blow as bullying that takes place in the physical world. Cyber bullying stats Parents should be aware that cyber bullying has increased over time, and that it becomes more prevalent as children move into their teenage years. The i-SAFE survey offers statistics that illustrate how prevalent cyber bullying has become amongst those in the 4th through 8th grades: 58 percent of kids report that someone has been hurtful or mean to them online. 21 percent of kids claim that they have received threatening messages, either by email, through social media accounts or text messaging. 35 percent of kids say that they have received threats online. 42 percent of kids classify mean behavior towards them online as bullying. 53 percent of kids admit that they have said something mean to someone else online. It is assumed that these numbers also apply to those in 9th through 12th grade, since these students have more access to the Internet. Also disturbing is the fact that 58 percent of those who are faced with cyber bullying do not tell a parent or other trusted adult when these incidents occur online. Kids are seeing these problems, but they don’t know what to do about it. Protecting against cyber bullying It is important to do what you can to protect your children against cyber bullying. If the incident is school related, there is some recourse there. Criminal law with regard to cyber bullying is still being worked out. However, if it occurs regularly, it is often possible to address the situation - provided you know who is at the other end. Encourage your children to take the following actions if they are faced with a cyber bully: Tell someone about it. Find a trusted adult - parents, teachers, etc. - and report the incident. Continue to report it if the problem continues. Take a screen shot of the cyber bulling. It is possible to print out the current screen, or to take a picture of it for storage. This could be important when it comes time to track down a cyber bully or prove a case. Save messages from cyber bullies. Do not delete these messages. You want to make sure that they are easy to find and access should you need them as evidence of wrong doing. It is also possible to save text messages from cyber bullies on your cell phone. Do not open messages from known cyber bullies. If you receive a message from someone you know is a cyber bully, you should not open it. Do not delete it (save for just in case), but you do not have to read the message, either. Block cyber bullies who attack you during chats and other social media. Inform the police if you are threatened physically. Do not agree to see someone you met online in person. If you do, do so in a public place, and bring a trusted adult with you. Do not give out any personal information - phone number, address or anything else that can identify you. It is possible to use a fake screen name and avatar (picture) to make identification even more difficult. Be a good online citizen yourself. Do not get caught up in cyber bullying. SCHOOL BULLYING What is school bullying? School bullying comes in several forms and includes things that we may tend to overlook. It involves someone or a group of individuals consistently and intentionally harming another by the following means. Hitting or threatening (physical) Teasing and name calling (verbal) Spreading rumors, hurting someone's reputation or leaving someone out (social isolation) Boys tend to fall into the first category more often. Girls will more likely do the verbal and mental bullying. Signs of being bullied Some signs of your child being bullied are more obvious than others. The physical signs are easier to see, but mental turmoil is more likely to be kept hidden. Staying alert and aware of your child's behavior at all times can make all the difference. Not wanting to go to school (ex. Faking illness) Grades beginning to fall Depression, mood changes, low self-esteem Complaints of headaches, stomach-aches and other pains Sleeping problems Changing normal routines to/from school to avoid situations Unexplained damage to self (ex. Bruises) or clothing Missing and/or damaged belongings Eating problems Attempted suicide What to do if your teen is being bullied at school Talk to your child - Try to get your child to open up as much as possible about what has been going on. The more information you have, the better prepared you are to address this situation with the correct authorities. Talk to the school - Many schools have no bullying tolerance rules. Unless the school knows about the bullying, they cannot be enforced. Many times teachers/principals are unaware of specific situations, so it's necessary to share any information you may have. Ask your school if they have a no bullying rule. If not, request that they get together to create one. Avoid situations - If bullying takes place in specific situations, have them change their routines to avoid the bullying. It also helps if the victim remains supervised as much as possible. Bullying is more likely to occur while the child is alone. Signs of being a school bully What if your child is the one doing the bullying at school? It can be just as devastating to this child's future as well. Statistics show that children who are bully's tend to exhibit other negative behaviors as well (stealing, vandalism, drug use, etc). Some possible signs are as follows: Aggression Likes to be in power Lack of empathy towards others Low self-control What to do if your teen is a school bully No one likes to think that their child may be a bully, but if you are faced with that situation there are some things you can do. Talk to your child - Find out if there are things going on in your child's life that may be prompting this behavior. Seek help - Arrange a meeting with your child's doctor or mental health professional. They are the people best prepared to deal with this type of situation. Children will usually open up more to someone other than a parent. It is ultimately our responsibility as parents, teachers, friends and peers to look out for anyone that may be suffering. Keeping our eyes open and informing the necessary authorities is beneficial to all involved. Sources: 1. Tonja R. Nansel; Mary Overpeck; Ramani S. Pilla; W. June Ruan; Bruce Simons-Morton; Peter Scheidt Bullying Behaviors Among US Youth: Prevalence and Association With Psychosocial Adjustment JAMA, Apr 2001; 285: 2094 - 2100 2. safeyouth.org 3. keepkidshealthy.com 4. stopbullyingnow.com 5. teen-matters.com 6. kidshealth.org 7. http://www.familyfirstaid.org/bullying.html TEEN ANXIETY Your Teens Are at Risk Teenage years are ones of high stress, difficult decisions, and soaring emotions. The life of a teenager seems oftentimes like a soap opera, with the extreme highs and lows, dramatic outbursts, and the unexplained "silent treatments". Anxiety can result from a broken nail, a lower grade on a test than anticipated, or other seemingly trivial issues. In a world of cell phones, palm pilots, portable television, and other high-powered technology, children learn from a very young age that faster is better. The culture in America promotes a feeling of always having to get ahead, and this reflects on teenagers especially, who are still impressionable children trying to be adults. They are looking to the media, as well as their surroundings, to find their identity and who and what they are expected to be. So What is Teen Anxiety in "Layman's" Terms? Anxiety can manifest itself in different ways. It depends on the person and what they are going through in their lives. A basic definition would be to say that anxiety is a painful or apprehensive uneasiness of mind. But prolonged anxiety is a completely different ballpark. It is an overwhelming feeling of dissatisfaction and restlessness, where nothing ever seems to be right. Symptoms of Teen Anxiety Anxiety in teenagers can cause complications such as overeating, smoking, even depression and drug use. Medical experts have diagnosed countless numbers of teenagers with anxiety-related disorders, including, but not limited to, depression, bipolar/manic depression, schizophrenia , and addiction. So, how, then, do you know when anxiety becomes a problem for your child? Some signs of severe teen anxiety are as follows: Anger Depression Fatigue Extreme mood swings Substance abuse Secretive behavior Changes in sleeping and eating habits Bad hygiene or meticulous attention to Compulsive or obsessive behavior Teenagers face circumstances that may or may not be to their liking every day. But the ability to handle these situations, for a teen that suffers from anxiety, can seem overwhelming and even impossible. The resilience most teens have is not as present in a teen that has an anxiety disorder. What one teen looks at as a means to an end, the other teen sees only as the end. What Can You Do to Prevent Anxiety in Your Teen? The key to success in all relationships seems to be the same. Listen. Teenagers don't want to talk about their problems to a parent who lectures them and criticizes every move. Teens need someone who they can vent their frustrations to and release that inner tension which is ever-present in any teenager, but much more so in an anxiety sufferer. Teenagers need to know that whatever they say will be accepted. They need to know that they can trust you, and that they are loved and cared for. Find activities to help get rid of the restlessness, and don't discourage a teenager from becoming independent and finding his or her own outlets. You also need to pay close attention to the warning signs, and if your teen is suffering, call your family doctor or local mental health professional for help, because no one can do it alone. I Think My Teen Has A Problem With Anxiety Oftentimes, the battle seems endless. But it is possible for a teen to combat anxiety. There are a variety of methods, such as: Therapy A healthy parental relationship Hotlines Medication Understanding, but above all? Support Doctors seem to be prescribing anti-anxiety medications to teenager more than ever. 80% of teens today are on some kind of anti-anxiety meds. Sometimes medication is necessary, but only in the most severe cases. It is always better to approach anxiety without using any drugs if possible, because medication does change one's brain chemistry, especially in teens, where the drugs are stronger, and the teen is more susceptible. Sources: thestressoflife.com Merriam-Webster Dictionary Dr. Tawny Moon ABUSIVE TEEN RELATIONSHIPS Abuse in teenage relationships, also called teen dating violence, is becoming more common, and more accepted among teens, according to a recent survey by the National Center on Domestic and Sexual Violence (NCDSV). The Center for Disease Control (CDC) reports that nearly one in ten teens in grades 7 to 12, male and female, has been physically abused by a boy or girlfriend. Abused teens are more likely to drink heavily, use drugs, engage in risky sexual behavior, develop eating disorders, and attempt suicide. Abuse or dating violence can be physical, verbal, or sexual, and is often used to control the other person. Some warning signs to talk to your teen about to see if they are in an abusive teen relationship or a victim of teen dating violence include: * Jealous or controlling behavior, including over friends, appearance, and eating habits * Sexual pressure * Pressure to use drugs or alcohol * Name-calling or swearing * A partner losing his or her temper, blaming the other for his or her behavior * A partner insulting or embarrassing the other in front of others * Any form of physical violence * A partner threatening to hurt others or him or herself Abusive teen relationships and teen dating violence have become alarmingly common among both genders; in a study conducted by the CDC, nearly equal numbers of teenage boys and girls reported being abused by their partner. Abusive teen relationships and teen dating violence are not limited by ethnic group or income level. According to the NCDSV: * 20 percent of teens have been threatened by their partners, or had partners threaten to hurt themselves if the relationship ended. * 33 percent of teens, and 50 percent of teen girls, say they have felt pressured to have sex in a serious relationship. * 30 percent have worried about their safety in a relationship, and 20 percent have been hit, slapped, or pushed. * 64 percent have been with a jealous or controlling partner. * 55 percent have compromised their standards to keep their partner. * 25 percent have been put down or called names by their partner. Abuse will continue over time, and usually becomes more serious, leading to death in 1,300 cases each year, according to the CDC. Abusive teen relationships and teen dating violence have long lasting mental and emotional effects on its victims and the people who care about them. Unfortunately, those who are abused as teenagers are more likely to be in abusive relationships as adults. Because of the seriousness of this problem, it is important to watch for the warning signs of an abusive teen relationship or teen dating violence, including: * Unexplained injuries * Changes in appearance * Withdrawal from friends and family * Giving up activities that were once enjoyed * Changes in behavior or mood - acting depressed, anxious, or secretive, or acting out * Alcohol or drug use * Apologizing for or justifying a partner's behavior - especially his or her temper * Acting afraid of a partner, or worrying about making him or her angry * One partner is possessive and makes all the decisions * One partner insults, criticizes or embarrasses the other If you are in an abusive teen relationship or a victim of teen dating violence, talk to a trusted adult to get help. The Teen Action Campaign suggests  that if your child or friend is in an abusive teen relationship, talk to them. Be supportive and make it clear that it is not their fault they are being abused. Do not judge them or push them to do anything they are not comfortable with, and be patient. Encourage your teen to stay out of contact with the abuser. If you know the abuser, do not attack him or her as a person, but it make it clear that his or her behavior is not acceptable and encourage him or her to talk to a counselor and develop healthy behaviors. Do not hesitant to turn to good sources for help, including trusted school counselors, religious leaders, doctors, community support groups, the police, or the National Domestic Violence Hotline at 1-800-799-SAFE. Sources: 1. Center for Disease Control: National Center for Injury Prevention and Control, and "Morbidity and Mortality Weekly Report," May 19, 2006 2. Teen Action Campaign 3. National Center on Domestic and Sexual Violence 4. National Youth Violence Prevention Resource Center 5. Substance Abuse and Mental Health Services Administration 6. Girl's Health.gov TEEN DEPRESSION  Stress from the pressure to have good grades, be a star athlete, or from peers can result in adolescent or teenage depression. If your teen experiences some of the following warning signs - please see a therapist in your area. We also provide information on residential treatment centers that have on site therapists to deal with teen depression. Recognizing Adolescent / Teenage Depression: These symptoms may indicate depression, particularly when they last for more than two weeks: Poor performance in school Withdrawal from friends and activities Sadness and hopelessness Lack of enthusiasm, energy or motivation Anger and rage Overreaction to criticism Feelings of being unable to satisfy ideals Poor self-esteem or guilt Indecision, lack of concentration or forgetfulness Restlessness and agitation Changes in eating or sleeping patterns Substance abuse  Problems with authority Suicidal thoughts or actions Get help for youth with adolescent depression - fill out the contact form today! Or visit childhood depression for info on a depressed child. Related Article: Teen Suicide : Statistics and Prevention >> Teen Suicide Statistics Every year nearly 5,000 American teenagers and young adults kill themselves. That makes suicide the third-leading cause of death among those 15 to 24 years old, says the U.S. Centers for Disease Control. Only accidents and homicides kill more. It's important that parents understand what may lead teens to suicide, learn the warning signs, and know what they can do to help. Some Basics Facts About Teen Suicide * More young people die by their own hand than from cancer, heart disease and AIDS combined. * Girls attempt suicide at a rate double that of boys. * But four times as many boys as girls die by suicide. * Boys tend to use more lethal methods, like hanging, jumping from heights, or guns.  TEEN SUICIDE High Risk Groups for Teen Suicide Teens commit suicide for many reasons, but some common circumstances have been identified. According to the National Alliance on Mental Illness, the overwhelming majority of those who kill themselves, including teens, have a have a psychological or substance-related disorder at the time of death. These disorders make it harder to deal with stressful situations teenagers may face, like failing a test, breaking up with a boyfriend or girlfriend, the death of a loved one or seeing parents divorce. Some mental disorders, like depression, can be difficult to recognize in young people, says Dr. Richard O'Conner, a psychotherapist and author of the book Active Treatment of Depression. Symptoms can easily be mistaken for common teenage behavior like anger, sullenness or acting out. Also among teens at higher risk of suicide are those who exhibit one or more of these characteristics. * Perform poorly in school * Have access to guns * Experience violence at home * Previously attempted suicide * Have a family history of depression or suicide * Suffered physical or sexual abuse * Are struggling to cope with issues of sexual orientation * Have a friend who committed suicide. Warning Signs of Teen Suicide According to the National Mental Health Association, four of five teens who kill themselves have given a clear warning of their intentions. Parents and friends should recognize these behaviors commonly associated with suicide. * An obsession with death * Withdrawing from regular friends and activities * Verbal clues: "I'm going away" or "I won't see you again" * Feelings of worthlessness or guilt * Suicidal thoughts or fantasies * Giving away possessions or putting affairs in order * Talking to friends about suicide * A dramatic change in appearance or personality * A severe decline in school performance or social interaction * Marked change in eating or sleeping habits. Above all, any suicide threats or talk of death - even writings or drawings indicating a desire to die - must be taken seriously, no matter how harmless they may seem or whether the teen dismisses them as "a joke." What Parents Should (and Shouldn't) Do to Help Prevent Teen Suicide Be alert to your teen's behavior and feelings. If he or she seems depressed or withdrawn, watch your child carefully. Those thinking about suicide often feel helpless or alone. You can help by communicating openly. Demonstrate your willingness to listen. If your child is hesitant to talk to you about how he or she is feeling, suggest someone else he or she can confide in. It may be another relative, a member of the clergy, a counselor at school, or your physician ? anyone your child is comfortable talking with. Do's * Keep the lines of communication open. * Express your love and support. * Ask questions: "You've been talking about death a lot lately. Are you having thoughts about suicide?" * Make hotline numbers available to your teen, like 1-800-SUICIDE. (1-800-784-2433) * Get help from a mental health professional. Don'ts * Don't lecture. * Don't say "But you have so much to live for," nor try to list the reasons. * Don't minimize your child's feelings. * Don't be afraid to talk with your teenager about suicide. * Don't assume anyone who talks of suicide won't really kill himself. * If the threat of suicide is immediate, don't leave your child alone. * Don't assume someone who is receiving treatment and "feeling better" won't commit suicide. TEEN DATE RAPE Rape is a serious crime that the victim can report to the police. A victim of rape is never at fault, and should seek medical help immediately. Teen date rape is a widespread crime. In 2002, about 9 percent of teens - 12 percent of teen females and 6 percent of teen males - reported that they had been raped, and many rapes remain unreported. A rapist sometimes uses physical force, fear, drugs or alcohol, or other methods to force a teen to have sex. Any sexual intercourse - vaginal, anal, or oral - is rape if the teen did not want it. Date rape also occurs if a teen agrees to one type of sexual contact, but is forced to perform other sexual acts. Rape is not always avoidable, but there are some things teens can do to reduce the risk of being a date rape victim: * Stay in control; don't drink or use drugs and don't get in a car with someone you don't know well. * Try not to do things alone; go to parties and other activities with friends, and consider sticking to group dates. * Always carry a cell phone or phone card and some extra money in case you need to get out of a bad situation. * Learn how to defend yourself. * Decide what your limits are, and remember that a person who pressures you to change your standards doesn't care about you and should be avoided. * If someone is trying to force you into doing something you don't want, loudly tell him or her "no" and get away. Making noise can attract help and scare your attacker. * Trust your instincts; if you don't feel comfortable with a person or situation, get away. Date rape drugs are often used to rape teens. Date rape drugs usually have no smell, taste, or color and can be added to a teen's drink without the teen knowing. They cause the teen to become helpless - unable to move, see, or get away. To avoid being the victim of date rape drugs, teens should not drink alcohol, and should only drink from containers they opened themselves and have always been in control of - including while they were in the bathroom. If you know or think that you have been raped, get away from the area without touching anything, and go to an emergency room or police station immediately - before showering, washing, urinating, or changing clothes. Nurses or doctors will treat you, and make a record of your injuries and check you for evidence that can be used against your attacker. Even if you choose not to press charges you should seek medical attention so you can be treated for injuries and checked for sexually transmitted diseases, which can be spread even if your attacker used a condom or forced you into oral or anal intercourse. Date rape causes emotional harm, including feelings of guilt, depression, anger, distrust, and worthlessness, and trouble sleeping or having normal sexual relations later in life. Rape victims should seek counseling to help them heal from the emotional damage of rape, and consider joining a support group for rape victims. Free counseling is available to rape victims in most areas. Remember that it is not your fault if you were raped. If someone you know is a victim of teen date rape, listen and offer comfort. Help the person get medical care and counseling, and reinforce the idea that the rape was not the victim's fault. Resources: Local police, emergency room professionals, and phonebooks can direct you to local help for rape victims, or call: National Sexual Assault Hotline, 1-800-656-HOPE (4673) 24-hour National Domestic Violence Hotline, 1-800-799-SAFE (7233) or 1-800-787-3224 (TDD) Teen Date Rape Sources: * The Cleveland Clinic, Rape and Date Rape GirlsHealth.gov, Safety - How to be Safety Savvy, What is Rape and Date Rape? [online] * U.S. Department of Health and Human Services, womenshealth.gov, sexual assault [online] * U.S. Department of Health and Human Services, womenshealth.gov, date rape drugs [online] * Center for Disease Control, Sexual Violence: Fact Sheet [online] DATE RAPE DRUGS Date rape drugs are several drugs that generally have no flavor, taste, or smell when added to drinks, and make their victims drowsy, confused, or otherwise unable to defend themselves. Using drugs to make a teen have sex is a type of rape, and is a serious crime. Teens and their parents should educate themselves about date rape drugs and how teens can stay safe. One in three teen or adult females will be sexually assaulted in her lifetime, and teen and adult males can also be sexually assaulted. Since the 1990's the number of teens assaulted through the means of date rape drugs has been increasing. Also, about 1 percent of teens admit to using date rape drugs for other illegal purposes, such as getting high. Date rape drugs are easily added to drinks to incapacitate teen victims. There are several types of date rape drugs, including Rohypnol, GHB, and Ketamine. Rohypnol is also known as rophies, roofies, roach, and rope, and is similar to newer drugs called Xanax, Klonopin, and Rivotril. Rohypnol usually comes in the form of a pill that dissolves in liquids. Some Rohypnol turns blue when it dissolves, but many Rohypnol pills have no color. GHB, or gamma hydroxybutyrate, is commonly known as liquid ecstasy, soap, easy lay, vita-G, and Georgia home boy. GHB comes in several forms, including a colorless, odorless liquid, a white powder, or a pill. GHB is made by some people in home labs, so it can contain any number of dangerous chemicals. Ketamine is a white powder and is used in the U.S. as an anesthetic. These date rape drugs have similar effects on teen victims, which can include: * Loss of memory * Lower blood pressure and heart rate * Sleepiness * Muscle relaxation or loss of muscle control * Drunk or dream-like feelings * Nausea and vomiting * Problems talking, including slurred speech * Loss of consciousness * Confusion * Problems seeing * Dizziness * Breathing problems * Hallucinations and other distorted perceptions * Seizures or convulsions * Coma * Death, especially if mixed with alcohol or other drugs Alcohol is also considered a date rape drug because it makes it harder to think clearly and resist attack. Here are some things teen girls and guys can do to protect themselves against date rape drugs: * Keep your drink with you at all times, even when you go to the bathroom. * Don't drink from punch bowls. * Don't accept drinks from others. * Only drink from containers you opened yourself. * Don't drink things that taste or look funny. * Don't drink alcohol or use drugs. * Go to parties with friends and watch out for each other. * Be clear about your standards and limits, and avoid people who pressure you to change them. * Stay away from people and situations that make you feel uncomfortable. * Don't go off alone with anyone you don't know well. Remember that even if someone has been drinking it is not his or her fault if he or she is raped or assaulted. If you think that you have been drugged or raped, go to the hospital or police station right away to get medical help, even if you do not want to press charges against your attacker or know who your attacker is. Do not clean up, change your clothes, or urinate (pee) before getting help. Find someone you can talk to; you may feel guilty, afraid, ashamed, or shocked, but it is important to talk to someone you can trust about what happened to you. Call a crisis center or hotline to talk with a counselor. The number for the National Domestic Violence Hotline is 800-799-SAFE or 800-787-3224 (TDD). If you know a teen who has been the victim of date rape drugs, be supportive, encourage the teen to get medical help and counseling, and reinforce  the idea that the victim is not at fault for what happened to her or him. Teens and Date Rape Drugs Sources: * National Institute on Drug Abuse, "NIDA InfoFacts: Rohypnol and GHB" [online] * Nemours Foundation, TeensHealth, "Date Rape" [online] * U.S. Department of Health and Human Services, womenshealth.gov, "Date Rape Drugs" [online] TEEN PREGNANCY STATISTICS The United States has the highest rates of teen pregnancy and births in the western industrialized world. Teen pregnancy costs the United States at least $7 billion annually. A review of teenage pregnancy statistics in the United States might well bring to mind a version of the old "good news ? bad news" routine. The good news is U.S. teen pregnancy rates have fallen to their lowest levels in decades. The bad news is American teen girls aged 15-19 still become pregnant at a rate far higher than their counterparts in any other industrialized country. According to the Planned Parenthood Federation of America, the following are among the consequences endured by teenage mothers, their children, and society. Teen mothers are less likely to graduate from high school. Teen mothers are more likely than women who delay child bearing to live in poverty and to require public assistance. Children of teen mothers are more likely to be born at low birth weight, to have health and developmental problems, and to be abused and/or neglected. The cost of teen pregnancy amounts to an estimated $7 billion annually in lost tax revenues, public assistance, health care, and other costs. But despite those risks, the U.S. Department of Health and Human Services reports some 900,000 pregnancies occur each year among teen girls 15-19. In 2001, the latest year for which pregnancy statistics are available, 84 of every 1,000 teen girls in the U.S. became pregnant, says the National Campaign to Prevent Teen Pregnancy. That's down from a high of 117 pregnancies per 1,000 teen girls aged 15-19 in 1991, a decline of more than 28 percent. That falling U.S. teen pregnancy rate may sound very good, until it's compared to the rates of teen pregnancy in other countries. Planned Parenthood points out that American teens become pregnant at a rate 12 times higher than that of women in the Netherlands, where only about 6.9 per 1,000 aged 15-19 get pregnant each year. As you might expect, the vast majority of teen pregnancies - about 4 out of 5 - are unintended, according to the Alan Guttmacher Institute, a non-profit organization devoted to the study of reproductive health issues. Here are some more facts about teenage pregnancy. About 25 percent of teen girls who give birth have another baby within two years. Between 11 and 12 percent of all U.S. births are to teenage mothers. Almost one-third of sexually experienced teenage girls (31 percent) have been pregnant at least once. About one in eight sexually experienced teen boys (13 percent) have caused a pregnancy. Some 46 percent of girls who first had sex before age 15 have been pregnant, compared with 25 percent who first had sex at age 15 or older. About 37 percent of teen girls who have had three or more sex partners have been pregnant, while 25 percent of those with one or two sex partners have been pregnant. Not surprisingly, 43 percent of girls who did not use contraception the first time they had sex have been pregnant, compared to 27 percent of those who did use contraception the first time they had sex. If you're a parent wondering just what percentage of American teens have had sex, it depends on who you ask. The U.S. Centers for Disease Control says just under 50 percent of all high school students have had sex at least once. A slightly higher percentage of high school boys have had sex than high school girls, but both groups are just below 50 percent. Surveying a similar population, the Alan Guttmacher Institute reports that 80 percent of Americans teens have had sex at least once by the time they reach their twentieth birthday. Ironically, the success of the past 15 years in bringing down U.S. teen pregnancy rates may now serve to divert resources from that same effort, says the National Campaign to Prevent Teen Pregnancy. That progress - a decline of more than 28 percent in U.S. teen pregnancy rates between 1991 and 2001 - may have inadvertently convinced policy makers that allocating resources to prevent teen pregnancy is no longer a priority. The organization points out that a quick review of the data makes it clear that a major prevention effort is still needed. TEEN SELF-INJURIOUS BEHAVIOR Self-injury is a negative way of dealing with strong emotions, and can include cutting, scratching, burning, mutilating or hitting oneself, or anything else that causes bodily harm. According to CNN.com, one in five teens say they have purposely injured themselves at some time. Some teens see self-injury as trendy, but to parents and others it can be frightening and frustrating. It is most common in the adolescent and teenage years and affects people from both sexes and all backgrounds, though the National Mental Health Association and S.A.F.E. Alternatives report that those who seek help for self-injury are more likely to be teenage girls from middle or upper class backgrounds. Teen self-injury, self-mutilation or cutting can be overcome, but the problems causing a teen to self-injure or self-mutilate, such as cutting, need to be resolved and the teen must learn healthier ways to deal with emotions. Some of the reasons teens give for self-injuring or self mutilating include: * Not knowing how to deal with stress * An unresolved history of abuse * Low self esteem * Feelings of loneliness or fear * A need to feel in control * Mental health problems such as depression, anxiety, or obsessive-compulsive disorder * Wanting to get the attention of people who can help them * Peer pressure/curiosity Teen self-injury or self-mutilation is dangerous, especially cutting, leaving physical and emotional scars and sometimes leading to serious injury or death. Though teen self-injury or self-mutilation is not a suicide attempt, some teens who self-injure or self-mutilate also attempt suicide, and many engage in other risky behaviors such as drinking and drug use, or suffer from eating disorders associated with troubled teens. Because teens who self-injure or self-mutilate often do not know how to ask for help, it is important to watch for some of these signs that a teen may be harming him or  herself, or is at risk for doing so: * Unexplained injuries, such as cuts, scratches, burns, bruises, etc. * Making excuses for injuries or scars if they are discovered * Acting embarrassed or ashamed about injuries * Wearing long sleeves even in hot weather * Secretiveness or withdrawal * Having trouble dealing with emotions * Spending time with people who self-injure, especially on the internet * A history of eating disorders * Having trouble functioning at work, school, and in relationships * Low self esteem Self-injury and self-mutilation is often addictive, and can become increasingly serious. It is possible for a teen to stop, but it usually requires help. If you think your teen or someone you know is self-injuring or self-mutilating such as cutting themselves, here are some things you can do: * Talk to your teen calmly and directly; do not lecture, judge, or get angry * Do not try to force your teen to stop?he or she needs to make that change on his or her own * Be supportive by listening and letting your teen know that he or she is not a bad person and can find better ways to deal with his or her emotions * Seek help from a doctor or counselor who is comfortable helping your teen work through the healing process * Encourage your teen to find positive activities to relax or deal with emotions, such as playing an instrument, journal writing, sports, dancing, reading, exercise, etc. * Encourage your teen to avoid people, music, and internet sites that glorify self-injury, and to seek friends who share his or her positive interests * Educate yourself about self-injury and do not hesitate to talk to someone yourself if you are feeling angry, guilty, depressed, or overwhelmed Resources: If your teen or someone you know is feeling suicidal or has a serious injury, call 911 or go to the emergency room immediately. For more information about teen self-injury such as cutting and how to get help, go to the web site of The Center for Young Women's Health at http://www.youngwomenshealth.org/si.html, or call S.A.F.E. Alternatives (Self Abuse Finally Ends) at 1-800-DONTCUT (800-366-8288). Sources: 1. The Center for Young Women's Health: Children's Hospital Boston [online] 2. S.A.F.E. Alternatives (Self Abuse Finally Ends) [online] 3. National Mental Health Association [online] 4. CNN.com [online] 5. WebMD/CBS news, "Cutting: Parents' Nightmare" [online] TeensHealth: Cutting (Nemours Foundation) [online] 6. Focus Adolescent Services: Self-Injury [online] 7. Teen Health Centre [online] YOUTH VIOLENCE Youth violence is violence between adolescents or teens, including fighting, threatening, and bullying. Teen violence is becoming a more serious problem, involving more troubled teens and leading to more teen deaths. In many cases, there are things parents can do to help troubled teens avoid youth violence. Victims and perpetrators of teen violence are more often male than female, but all teenagers can be at risk. Teen violence ending in homicide is the second leading cause of death among adolescents and teenagers. An average of fifteen young people are killed every day, usually with firearms, and 750,000 young people are treated in emergency rooms for violence-related injuries each year. A recent CDC study of high school students found that 33 percent had been in a physical fight in the last year and 17 percent reported that they had taken a weapon to school in the previous 30 days. 15 to 25 percent of youth experience bullying each year. Some factors that increase the chances that a troubled teen will be involved in teen violence are: Involvement in gangs or fighting Low parental involvement Discipline that is inconsistent, lax, or too harsh Use of drugs or alcohol by teen or parents A history of violence in the home Emotional problems/lack of self-control Injuring animals or people Lack of involvement in positive extracurricular activities Exposure to media violence Lack of economic opportunities in community/low income Poor performance in school, especially due to learning disorders These risk factors are not what causes teen violence, but they often put teens in situations where they are more likely to be victims or offenders. Teens who are the victims of youth violence may have physical symptoms of violence such as injuries or torn clothing, or may become depressed, anxious, or withdrawn. Parents should talk to their teens if they see any of these symptoms. Some things that parents can do to protect their children from violence include: Talk to your teen, and listen - show caring and concern Know where teens go, what they do, and who they're with Include teens in family activities, and be home during at least one of these times: when your teen wakes up, when he or she comes home from school, at dinner time, or when your teen goes to bed Be consistent and firm - but not harsh - in your discipline Discourage involvement with gangs, including wearing gang-related clothing and making or drawing gang signs - talk to local police to find out more about gangs in your area If applicable, help your teen or other family members get help for drug or alcohol problems Encourage positive activities, such as extracurricular school or church involvement Teach the importance of a good education Monitor and control your teen's exposure to violence in the media, including television, movies, video games, music, etc. Get involved in your community and your child's school; talk to school administrators about violence or bullying that occurs at school. Set a good example of non-violent ways to resolve conflicts If your teen has been the victim of teen violence or bullying, seek counseling for him or her. School counselors or local health clinics may offer free counseling. If you think your troubled teen is involved in teen violence, it is important to talk to him or her. To help a violent teen: Get him or her counseling from a qualified professional; if there are issues of violence or abuse in your family, get family counseling as well. Remove guns and other weapons from your home Limit access to violent media or influences Talk to local police and school counselors for additional ideas on preventing teen violence. Youth Violence Sources: Center for Disease Control, National Center for Injury Prevention and Control, "Youth Violence, Facts" [online] National Youth Violence Prevention Resource Center [online] U.S. Department of Health and Human Services, Stop Bullying Now! [online] U.S. Department of Justice, Bureau of Justice Statistics, "Homicide trends in the U.S." [online] Center for Disease Control, "Morbidity and Mortality Weekly Report," June 18, 1993 [online]

Childhood Obesity

Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. The prevalence of obesity among adolescents aged 12 to 19 years increased from 5.0% to 18.1%.Obesity is the result of caloric imbalance (too few calories expended for the amount of calories consumed) and is mediated by genetic, behavioral, and environmental factors. Childhood obesity has both immediate and long-term health impacts:

• Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease.
• Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.
• Obese youth are more likely than youth of normal weight to become overweight or obese adults, and therefore more at risk for associated adult health problems, including heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis.

Healthy lifestyle habits, including healthy eating and physical activity, can lower the risk of becoming obese and developing related diseases.
Prevalence
In the past 30 years, the occurrence of overweight in children has doubled and it is now estimated that one in five children in the US is overweight. Increases in the prevalence of overweight are also being seen in younger children, including preschoolers. Prevalence of overweight is especially higher among certain populations such as Hispanic, African American and Native Americans where some studies indicate prevalence of >85th percentile of 35-40%. Also, while more children are becoming overweight, the heaviest children are getting even heavier. As a result, childhood overweight is regarded as the most common prevalent nutritional disorder of US children and adolescents, and one of the most common problems seen by pediatricians.

Consequences of Childhood Overweight
Both the short term and long term effects of overweight on health are of concern because of the negative psychological and health consequences in childhood.
Potential Negative Psychological Outcomes:

• Depressive symptoms
• Poor Body Image
• Low Self-Concept
• Risk for Eating Disorders

Negative Health Consequences:

• Insulin Resistance
• Type 2 Diabetes
• Hypertension
• High Total and LDL Cholesterol and triglyceride levels in the blood
• Low HDL Cholesterol levels in the blood
• Sleep Apnea
• Early puberty
• Orthopedic problems such as Blount's disease and slipped capital femoral epiphysis
• Non-alcoholic steatohepatitis (fatty infiltration and inflammation of the liver)

Further, obese children are more likely to be obese as adults, hence they are at increased risk for a number of diseases including: stroke, cardiovascular disease, hypertension, diabetes, and some cancers.

Contributors to Childhood Overweight

• Food Choices - diets higher in calories (including fats and simple sugars) and lower in fruits and vegetables are linked with overweight
• Physical Activity vs. Sedentary Activity - less physical activity and more time spent participating in activities such as watching tv results in less energy expenditure
• Parental Obesity - children of obese parents are more likely to be overweight themselves. There is an inherited component to childhood overweight that makes it easier for some children to become overweight than others. There are a number of single gene mutations ("genetic alterations") that are capable of causing severe childhood overweight, though these are rare. Even children with genetic risk for overweight will still only become overweight if they consume more calories than they use. Parental obesity may also reflect a family environment that promotes excess eating and insufficient activity.
• Eating Patterns - skipping meals or failure to maintain a regular eating schedule can result in increased intakes when food is eaten.
• Parenting Style - some researchers believe that excess parental control over children's eating might lead to poor self regulation of kid's energy intake.
• Diabetes during pregnancy - overweight and type 2 diabetes occur with greater frequency in the offspring of diabetic mothers (who are also more likely to be obese)
• Low Birth Weight - Low birth weight (<2500 a="a" epidemiological="epidemiological" factor="factor" font="font" for="for" g="g" in="in" is="is" overweight="overweight" risk="risk" several="several" studies.="studies.">
• Excessive weight gain during pregnancy - Several studies have shown that excessive maternal weight gain during pregancy is associated with increased birth weight and overweight later in life.
• Formula Feeding - Breast feeding is generally recommended over formula feeding. Although the exact mechanism in unknown, several long-term studies suggest that breast feeding may prevent excess weight gain as children grow.
• Parental Eating and Physical Activity Habits - Parents with poor nutritional habits and who lead sedentary lifestyles role model these behaviors for their children, thereby creating an "obesigenic" home environment.
• Demographic Factors. Certain demographic factors are associated with an increased risk of being overweight in childhood. For example, there is evidence that African-American and Hispanic children 6 to 11 years years old are more likely to be overweight than are non-Hispanic white children of the same age. Asian and Pacific Islander children of the same age were slightly less likely to be overweight.

Measuring Childhood Overweight
Childhood overweight is identified through the measurement of Body Mass Index or BMI. BMI can also be calculated using kilograms (kg) and meters (m), as well as pounds (lbs) and inches (in):

Once BMI is calculated, it can then be used to determine if a child is overweight or not, by comparing the BMI with the CDC growth charts (http://www.cdc.gov/growthcharts/) for children of the same age and sex. Children who have a BMI at or above the 95%, percentile for age and sex are considered overweight. Children with a BMI that falls between the 85%-95% are classified as at risk for overweight. To plot body mass index-for-age percentiles for boys, click here. To plot body mass index-for-age percentiles for girls, click here.
Parents whose children fall in the "at risk for overweight" category should discuss this with their pediatrician or family physician and should carefully monitor their child's growth. Parents whose children fall in the "overweight" category should make an appointment with their pediatrician or family physician to discuss whether treatment is warranted. Screening for other health risk factors (such as blood pressure or lipid profile) may be recommended by your physician. The BMI is just an initial tool in a series of examinations required to determine if your child is overweight. At no time should a child be diagnosed and labeled overweight by a parent, teacher, or other lay (non-medical) individual. Discussions concerning the child's weight should occur only after reviewing his or her condition with a medical professional.

Tips for Parents & Caregivers to Help Establish Healthy Eating Patterns with Kids

• Parents should choose what children can eat, (what foods and drinks are in the home, what foods and drinks are served at meals and snacks, what restaurants they go to, etc) but among those foods, parents should allow kids to choose whether they eat at all and how much to eat.
• Fruits and vegetables, as compared to high calorie snack foods (often high fat and high sugar), should be readily available in the home.
• Serve and eat a variety of foods from each food group.
• Use small portions - child portions are usually very small, particularly compared to adult portions. More food can always be added.
• Bake, broil, roast or grill meats instead of frying them.
• Limit use of high calorie, high fat and high sugar sauces and spreads.
• Use low-fat or nonfat and lower calorie dairy products for milk, yogurt and ice cream.
• Support participation in play, sports and other physical activity at school, church or community leagues.
• Be active as a family - Go on a walk, bike ride, swim or hike together. Limit TV time.
• Avoid eating while watching TV. TV viewers may eat too much, too fast, and are influenced by the foods and drinks that are advertised.
• Replace high-sugared drinks, espically sodas, with water and/or low fat milk.
• Limit fruit juice intake to two servings or less per day (one serving = ¾ cup) - Many parents allow their children unlimited intake of fruit juice (100%) because of the accompanying vitamins and minerals. However, children who drink too much fruit juice may be consuming excess calories.
• Encourage free play in young children and provide environments that allow children to play indoors and outdoors.
• Role model through actions healthy dietary practices, nutritional snacks, and lifestyle activities. Avoid badgering children, restrictive feeding, labeling foods as "good" or "bad," and using food as a reward.

Tips for Pediatricians & Other Health Care Professionals to Facilitate the Prevention of Childhood Overweight (from the American Academy of Pediatrics Policy Statement, August 2003).

Health Supervision Recommendations:

• Identify and track patients at risk by virtue of family history, birth weight, or socioeconomic, ethnic, cultural, or environmental factors.
• Calculate and plot BMI once a year in all children and adolescents.
• Use change in BMI to identify rate of excessive weight gain relative to linear growth.
• Encourage, support, and protect breastfeeding.
• Encourage parents and caregivers to promote healthy eating patterns by offering nutritious snacks, such as vegetables and fruits, low-fat dairy foods, and whole grains; encouraging children's autonomy in self-regulation of food intake and setting appropriate limits on choices; and modeling healthy food choices.
• Routinely promote physical activity, including unstructured play at home, in school, in child care settings, and throughout the community.
• Recommend limitation of television and video time to a maximum of 2 hours per day.
• Recognize and monitor changes in obesity-associated risk factors for adult chronic disease, such as hypertension, dyslipidemia, hyperinsulinemia, impaired glucose tolerance, and symptoms of obstructive sleep apnea syndrome.

Advocacy Recommendations:

• Help parents, teachers, coaches, and others who influence youth to discuss health habits, not body habitus, as part of their efforts to control overweight.
• Enlist policy makers from local, state, and national organizations and schools to support a healthful lifestyle for all children, including proper diet and adequate opportunity for regular physical activity.
• Encourage organizations that are responsible for health care and health care financing to provide coverage for effective obesity prevention and treatment strategies.
• Encourage public and private sources to direct funding toward research into effective strategies to prevent overweight and to maximize limited family and community resources to achieve healthful outcomes for youth.
• Support and advocate for social marketing intended to promote healthful food choices and increased physical activity.

References:

American Academy of Pediatrics. Prevention of Pediatric Overweight and Obesity: American Academy of Pediatrics Policy Statement; Organizational Principles to Guide and Define the Child Health System and/or Improve the Health of All Children; Committee on Nutrition. Pediatrics. 2003;112:424-430
Banis HT, Varni JW, Wallander JL, Korsch BM, Jay SM, Adler R, Garcia-Temple E, & Negrete V. Psychological and social adjustment of obese children and their families. Child: Care, Health, and Development. 1998;14,157-173.
Barker M. Birthweight and body fat distribution in adolescent girls. Arch Dis Child 1997; 77(5): 381-383.
Barlow SE, & Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. Pediatrics, 1998; 102(3): URL:http://www.pediatrics.org/cgi/content/full/102/3/e29.
Bouchard C and Perusse L. Heredity and body fat. Annual Review of Nutrition, 1988;8:259-77.
Dietz WH. Childhood Weight affects adult morbidity and morality. J Nutr, 1998;128 (2):411S-414S.
Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public health crisis, common sense cure. Lancet 2002, 360:473-82.
Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH. Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. Arch Pediatr Adolesc Med. 1996;150(4):356-62.
Satter E. How to Get Your Kid to Eat...But Not Too Much. Bull Publishing Company, 1987.
Haas JS. Lee LB. Kaplan CP. Sonneborn D. Phillips KA. Liang SY. The association of race, socioeconomic status, and health insurance status with the prevalence of overweight among children and adolescents. American Journal of Public Health. 93(12):2105-10, 2003
Johnson SL, Birch LL. Parents' and children's adiposity and eating style. Pediatrics, 1994;94:653-661.
Kinnunen TI, Luoto R, Gissler M, Hemminki E. Pregancy weight gain from 1960s to 2000 n Finland. Int J Obes 2003; 27:1572-77.
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, et al. CDC growth charts: United States. Advance data from vital and health statistics; no 314. Hyattsville, Maryland: National Center for Health Statistics. 2000.
Malina RM, Katmarzyk PT, Beunen G. Birth weight and its relationship to size attained and relative fat distribution at 7 to 12 years of age. Obesity Research 1996; 4(4): 385-390.
Obarzanek E, Schreiber GB, Crawford PB, Goldman SR, Barrier PM, Frederick MM, & Lakatos E. Energy intake and physical activity in relation to indexes of body fat: The NHLBI Growth and Health Study. Am J Clin Nutr, 1994;60:15-22.
Sallis JF. Epidemiology of physical activity and fitness and adolescents. Critical Reviews in Food Science and Nutrition, 1993;33:403-408.
Shapiro C, Sutija VG, Bush J. Effect of maternal weight gain on infant birth weight. J Perinat Med 2000; 28:428-31.
Troiano RP and Flegal KM. Overweight children and adolescents: Descroption, epidemiology, and demographics. Pediatrics, 1998;101(3):497-504.

Childhood Overweight

by L. Bellows and J. Roach¹ (05/09)

Quick Facts...

• Overweight children have an increased risk of being overweight as adults.
• Genetics, behavior, and family environment play a role in childhood overweight.
• Childhood overweight increases the risk for certain medical and psychological conditions.
• Encourage overweight children to be active, decrease screen time, and develop healthful eating habits.

The prevalence of overweight children in the United States has increased dramatically in recent years. Recent reports have reached epidemic levels, with approximately 16 percent of children, 2 to 19 years old, classified as overweight.² Colorado fares slightly better with close to 14 percent of children considered overweight; however, the same increasing trend seen nationally is occurring in Colorado as well.³ Excess weight has both immediate and long-term consequences and the current issue demands serious attention.

Definitions

Body Mass Index (BMI) is a measure of weight adjusted for height used to determine weight categories. Due to children’s changing body compositions over time and the different growth rates of boys and girls, BMI for children is age and gender specific. BMI for age is determined using gender-specific growth charts that place a child in a percentile relative to weight and height. Weight categories are determined based on these percentiles and are defined as:

Underweight < 5th percentile
Normal 5th to < 85th percentile
At risk of overweight 85th to <95th br="br" percentile="percentile">Overweight 95th percentile and above

The terms obese and overweight are often used interchangeably, although the terms at risk of overweight and overweight are preferred to reference children whose excess body weight poses medical risks.

Consequences of Childhood Overweight

Overweight children and adolescents are at increased risk for several health complications. During their youth, for example, they are more likely to exhibit risk factors for cardiovascular disease (CVD) including high blood pressure, high cholesterol, dyslipidemia, and type 2 diabetes compared with normal weight individuals.⁴ Additional health complications associated with overweight children include sleep apnea, asthma, and liver damage.⁴⁴⁴ This study also concluded that if overweight begins before 8 years of age, obesity in adulthood is likely to be more severe. Finally, childhood overweight has psychological and emotional consequences. Overweight children are at an increased risk of teasing and bullying, low self-esteem, and poor body image. Further, overweight children and adolescents are more likely to become obese adults. For example, one study found that approximately 80 percent of children who were overweight at 10 to 15 years old were obese at 25. Another study found that 25 percent of obese adults were overweight as children.

Contributors of Childhood Overweight

There is not one single cause of childhood overweight, rather it is a complex interaction of many variables. Contributing factors include genetics, behavior, environment, and certain socio-demographics.
Genetics. Certain genetic characteristics may increase an individual’s susceptibility to excess body weight, however, there are likely to be many genes involved and a strong interaction between genetics and environment that influences the degree of excess body weight.⁵ It has been shown that overweight tends to run in families suggesting a genetic link. In some cases, parental obesity is a stronger predictor of childhood overweight than the child’s weight status alone.⁵
Behavior. Weight gain occurs as a result of energy imbalance, specifically when a child consumes more calories than the child uses. Several behaviors can contribute to weight gain including nutrition, physical activity, and sedentary behaviors.

• Nutrition - An increase in availability and consumption of high-calorie convenience foods and beverages, more meals eaten away from home, fewer family meals, and greater portion sizes all may contribute to childhood overweight. Further, many children’s diets do not meet nutrition guidelines. For example, only 8 percent of children in Colorado ate vegetables three or more times per day as recommended by the U.S. Department of Agriculture.^{3, 6}
• Physical Activity - Decreased opportunities and participation in physical activity is another behavior that contributes to overweight children. Being physically active not only has positive effects on body weight, but also on blood pressure and bone strength.⁷ It also has been shown that physically active children are more likely to remain physically active into adolescence and adulthood.⁷ Children may spend less time being physically active during school as well as at home. School physical education programs have decreased and children are walking to school and doing household chores less frequently.
• Screen Time - While physical activity levels have decreased, sedentary behaviors, such as watching television, playing on the computer and with video games have increased. One study found that time spent watching television, videos, DVDs, and movies averaged slightly over three hours per day among children 8 to 18 years old.⁶ Several studies have found a positive association between time spent watching television and prevalence of overweight in children. Sedentary behavior, and specifically television viewing, may replace time children spend in physical activities, contribute to increased calorie consumption through excessive snacking and eating meals in front of the television, influence children to choose high-calorie, low-nutrient foods through exposure to food advertisements, and decrease children’s metabolic rate.⁶

Environment. There are a variety of environmental factors that can potentially contribute to childhood overweight, including home, childcare settings, school, and the community. The school and community settings are other environments where children learn about eating and physical activity habits. It is becoming increasingly important for all children to have access to healthful food choices and safe physical activity opportunities. Advocating for innovative school nutrition and physical activity programs as well as ensuring that there are well-lit sidewalks, bike paths, and parks in the community can all help to shift towards a more healthful environment for our children.
Socio-Demographics. Certain ethnic minority and socioeconomic populations have increased rates of childhood overweight.⁸ Low-income families face numerous barriers including food insecurity, lack of safe places for physical activity, and lack of consistent access to healthful food choices, especially fruits and vegetables.⁵ Recent reports also indicate racial disparities, with the greatest prevalence among Mexican American boys and African American non-Hispanic girls.² With both sexes combined, roughly 21 percent of both Mexican Americans and African American non-Hispanics are overweight compared to close to 15 percent for white non-Hispanic.²

Promoting Healthy Habits and a Healthy Weight

Lifestyles and behaviors are established early in life; therefore, a focus on healthful behaviors is vital to promoting healthy weight. The primary goals of overcoming childhood overweight should be healthful eating and increased activity. It is important for children to consume enough calories to support normal growth and development without promoting excessive weight gain. The home, childcare setting, school, and community are all integral to a more healthful environment for our children.
Parents, caregivers, teachers, and community members can promote healthy nutrition and physical activity habits and a healthy weight among children by:
Encouraging Healthy Eating Habits

• Serve a wide variety of foods, including fruits, vegetables, whole grains, and low-fat dairy products. Provide children with a variety of foods to ensure they get all the nutrients they need for proper growth and development.
• Know how much food kids need. Keep portion sizes in check to help children maintain their sense of self-regulation –and to know when they are hungry and when they are full.
• Be a good role model for kids by eating together. Eating meals as a family has been shown to increase fruit and vegetable consumption and decrease the amount of junk foods and sugar-sweetened beverages.
• Visit USDA’s MyPyramid website (www.mypyramid.gov) for information and tips for eating healthfully.⁶

Promoting Physical Activity

• Aim for children to accumulate a minimum of 60 minutes of moderate-to-vigorous physical activity each day. Activity bouts can be all at once or in several bouts spread throughout the day.
• Increase opportunities for children to engage in physical activity throughout the day. Incorporating daily recess and physical education into the school day will help ensure that children are getting the recommended 60 minutes of physical activity each day.
• Be a good role model. Engage in activity with children.
• Limit screen and television time to less than two hours per day. Keep televisions and video games out of children’s bedrooms to help them limit the amount of screen time.
• Visit the National Institutes of Health’s WeCan™ (Ways to Enhance Children’s Activity and Nutrition) website (www.wecan.org) for ideas on increasing physical activity, decreasing screen time, and improving food choices among children.⁹

References

²Ogden, C. L., Carroll, M. D., & Flegal, K. M. (2008). High body mass index for age among US children and adolescents, 2003-2006. JAMA, 299(20), 2401-2405.
³Colorado Department of Public Health and Environment, Colorado Physical Activity and Nutrition program. (2006). Overweight, Physical Activity and Nutrition Among Colorado Children and Youth: A Data Resource. Retrieved February 27, 2009 from http://www.cdphe.state.co.us/pp/COPAN/olderadult/childfactsheet04.pdf
⁴Centers for Disease Control and Prevention. (2009). Overweight and Obesity. Consequences. Retrieved February 27, 2009 from http://www.cdc.gov/NCCDPHP/DNPA/obesity/childhood/consequences.htm
⁵American Academy of Pediatrics. (2003). Policy statement. Prevention of pediatric overweight and obesity. Pediatrics, 112(2), 424-430.
⁶United States Department of Agriculture. (2009). MyPyramid: Steps to a Healthier You. Retrieved February 27, 2009 from http://www.mypyramid.gov
⁷Centers for Disease Control and Prevention. (2009). Overweight and Obesity. Contributing Factors. Retrieved February 27, 2009 from http://www.cdc.gov/obesity/childhood/causes.html
⁸Institute of Medicine. (2004). Childhood Obesity in the United States: Facts and Figures. Retrieved February 27, 2009 from http://www.iom.edu/Object.File/Master/22/606/FINALfactsandfigures2.pdf
⁹National Heart, Lung, and Blood Institute. (2009). WeCan! Ways to Enhance Children’s Activity and Nutrition. Retrieved February 27, 2009 from http://www.wecan.org