May 22nd, 2009 by Nancy Brown, Ph.D. in Better Health Network
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Many of us are conscious of the fact that not only has our culture extended adolescence to about age 22, now “adultescence” seems to be becoming the norm. This phenomenon is experienced by parents whose adult children return home after college, for whatever reason – some financial, others just not sure what else to do – creating a large number of “failure to launch” scenarios for parents who should be retiring and worrying about their own parents, without adult children to worry about, too!
Paralleling this process seems to be what my daughter, a rising senior in high school, describes as her own “I won’t grow up” crisis. She drives, she works, she makes decisions, she has friends and a boyfriend, she is excited about her summer plans, applying for college as well as going to college, and perceives her life as supported, magical and pretty darn perfect. So, why on earth should she look forward to being a grown-up?
What is the motivation? What do adults in our society have that teens and young adults who go to college do not – well let me see – marriages, bills, worry, stress, chores, a full time job, a house, cars to purchase and maintain, kids, colleagues, bosses, pets, neighborhood issues – and so on.
Newsflash folks, by giving our teens the rights and privileges associated with adulthood at younger and younger ages, we have effectively removed their motivation to grow up and leave home! Parenting has become a lifelong profession as we uberly competent and supportive parents have created a generation of young adults who do not need to become responsible for their own lives, and we have made it exceedingly difficult to answer the question – why should I grow up?
Beats me, is all I can say!
This post, Teenage Personal Responsibility: What Is The Motivation To Grow Up?, was originally published on
Healthine.com by Nancy Brown, Ph.D..
May 7th, 2009 by Stacy Stryer, M.D. in Uncategorized
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I was thumbing through the newspaper today while my teen was eating breakfast before school. Watching her measure out a serving size of cereal “just for the fun of it” makes me a tad bit nervous, considering she doesn’t have an ounce of fat on her. I quickly searched for the health section – it gives me an idea of what my patients will ask about during the work day (such as the “swine” flu), and it can also be a good starting point for blog ideas.
The front page of the health section Tuesday had a picture and quote from a beautiful teen who had died of bulimia several years ago. She looked familiar. My eyes scanned down to the name below the quote, and upon recognizing the name, my eyes immediately welled with tears. She had been my patient years ago, and I didn’t know she died. She was a great, sweet, smart teen who was well aware of her bulimia and the possible consequences. And she died.
At the very least, eating disorders can ruin their own lives and those of their families. And they kill. Although statistics vary based on the study, about 0.5% to 1% of teens and women in the United States have anorexia nervosa, an illness that involves significant weight loss and food refusal. About 1% to 3% of young American women have bulimia, a condition that includes regular binging and purging. Over 1 million males have an eating disorder and the numbers are climbing. Eating disorders are difficult to treat, especially once a pattern has been established and it has become a “way of life.” The earlier they are recognized, the more likely treatment will be successful.
These days, children have unrealistic expectations of what they should look like and how much they should weigh. Think about it. Their role models have changed dramatically over the past several decades. Girls and teens are exposed to ultra-thin, beautiful women wherever they turn – on TV, in magazines, music videos, and movies. And if that weren’t enough, moms, aunts, sisters and other teens and adults they know talk about food all the time – about eating too much, counting their calories, watching their weight, feeling “fat.” It’s no wonder that almost one-half of first through third grade girls want to be thinner and that over 80% of 10 year olds are afraid of being fat!
Our country’s obsession with food and it’s trickling down effect is readily apparent when we look at the results of the Youth Risk Behavior Survey for middle schoolers, a survey conducted in 10 states in 2005 (see end of blog) . By 6th grade, almost half of the students surveyed were trying to lose weight (even though only 14 to 18% were actually overweight), 5 to 7% vomited or took laxatives due to weight concerns, and 10 to 20% didn’t eat for at least 24 hours because they wanted to lose or didn’t want to gain weight! And we can’t forget that boys develop eating disorders, too. They tend to be diagnosed later than girls, possibly because we aren’t expecting to see males develop these illnesses.
What can we do? Society must take some responsibility for the large number of teens and adults with eating disorders. Genetics appears to play a role also. While these factors are out of our control, others are not. First of all, we can build our children’s self-esteem and confidence with regards to their academic and moral aptitude, rather than their outer appearance. We can make sure that we don’t discuss weight and eating around our children and that we act as good role models by eating well and maintaining a normal weight. We can limit TV, movies, and fashion magazines in our home and spend time together as a family. We can try to make our expectations for our children realistic and feasible. We can watch our children and teens closely for signs of an eating disorder, particularly if they are involved in sports, such as ballet, gymnastics, and wrestling, which focus on specific body types. And, if we are concerned about them, we can immediately make an appointment for them to be seen by their pediatrician and therapist to be weighed and to discuss any concerns. I can assure you it won’t be a wasted visit, even if your child turns out to have a healthy weight and eating habits. Don’t ignore signs of an eating disorder, as one of my patients did in the past. Upon hearing that her daughter weighed a mere 70% of her ideal body weight, her mom said that she was fine and that she, too, had gone through a similar “phase” when she was a teen. Eating disorders are real, and they kill.
Specific Results of the YRBS for Middle School Students
Across states, the percentage of students who were overweight ranged as follows:
• 6th grade: 14.4% to 18.7% (median: 18.6%)
• 7th grade: 10.0% to 15.8% (median: 14.0%)
• 8th grade: 8.0% to 14.9% (median: 13.0%)
Across states, the percentage of students who described themselves as slightly or very overweight ranged as follows:
• 6th grade: 19.6% to 26.7%
• 7th grade: 24.7% to 29.7%
• 8th grade: 24.2% to 29.7%
Trying to Lose Weight
Across states, the percentage of students who were trying to lose weight ranged as follows:
• 6th grade: 40.7% to 48.4% (median: 46.8%)
• 7th grade: 42.7% to 51.9% (median: 44.2%)
• 8th grade: 41.6% to 49.6% (median: 45.9%)
Ate Less Food to Lose Weight or to Keep From Gaining Weight
Across states, the percentage of students who ever ate less food, fewer calories, or foods low in fat to lose weight or to keep from gaining weight ranged as follows:
• 6th grade: 35.0% to 47.9% (median: 41.4%)
• 7th grade: 39.1% to 47.5% (median: 41.6%)
• 8th grade: 41.1% to 47.5% (median: 46.6%)
Went Without Eating for 24 Hours or More to Lose Weight or to Keep From Gaining Weight
Across states, the percentage of students who ever went without eating for at least 24 hours to lose weight or to keep from gaining weight ranged as follows:
• 6th grade: 10.0% to 19.2% (median: 15.6%)
• 7th grade: 13.9% to 18.3% (median: 16.6%)
• 8th grade: 18.1% to 21.6% (median: 19.5%)
Vomited or Took Laxatives to Lose Weight or to Keep From Gaining Weight
Across states, the percentage of students who ever vomited or took laxatives to lose weight or to keep from gaining weight ranged as follows:
• 6th grade: 4.8% to 7.5% (median: 6.3%)
• 7th grade: 4.0% to 6.2% (median: 4.7%)
• 8th grade: 6.4% to 8.2% (median: 7.3%)
April 16th, 2009 by Stacy Stryer, M.D. in Health Tips
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By Stacy Beller Stryer, M.D.
Those middle school years …
As a parent, we often think these are years to be feared. Years that we wish we could just blink away. We hear horror stories from our friends and look at book titles, such as “Parenting 911,” and “The Roller Coaster Years,” with trepidation. If only we could run away … just for awhile.
But, if we did run away we would be missing out on some of the most rewarding and exciting times we will have with our children. Sure, I am not going to deny that middle-school age children(referred to as “middlers” by authors Charlene Giannetti and Margaret Sagarese) are emotional, moody and, at times, unreliable. But, as someone once told me, almost every negative attribute can be turned into a positive one. I guess that means that maybe, instead of being emotional and unreliable, our middlers are actually passionate and spontaneous.
Developmentally, they are expanding their horizons in many ways. This is when they develop abstract reasoning, a complex sense of humor (beyond the potty jokes), and the knowledge that there is an entire world out there for them to conquer. This is when they begin to develop strong interests, likes and dislikes, and when they begin to take greater risks – in a positive way.
Personally, I love being with my middler (8th grade) and my almost middler (5th grade) girls. They are interesting, exciting, and a blast to be with. When my 8th grader becomes passionate about something, particularly some social injustice, she can talk a mile a minute. My 5th grader can be very intense when she practices viola or writes original music for her instrument. She often performs for me while I am preparing dinner. Both are becoming much more adventurous – last month we went to an Asian supermarket and bought several canned fruits we had never heard of so we could have taste tests.
I have been thinking about these middle years recently, not only because my children are this age, but also because I have been preparing for a lecture on this topic for parents at a local school. Although I have been counseling patients for years, I have recently read several additional books on the topic in preparation for the talk. They have been helpful, although my basic parenting principles remain unchanged. They seem to be important for children and teens of all ages. I think (“Parenting, according to Dr. Stacy”) that the six key elements of being a good parent of any age child include:
1. Open communication
2. Respect and consistent discipline
3. Compassion
4. Sensitivity
5. Awareness
6. Being a role model
Although the principles remain the same over time, the way we express them varies, depending on the child’s age. For middlers, there should be a strong emphasis on sensitivity and awareness. Children in this age range tend to be very emotional and sensitive, and we need to understand and respect this. For example, they may not want to be kissed or hugged in public anymore. Or, they may need some private time after school or in the evening. We should allow them to retreat to their rooms for a certain time period before bombarding them with questions or making other demands. Respecting their needs ultimately improves communication. We should also be particularly aware of sudden or extreme changes in our middlers’ behavior, as depression, eating disorders and other problems can appear during these years.
Adapting these six basic parenting skills will certainly not ensure a problem-free middle school experience for you or your child, but it will make it much more likely that he or she will come to you in times of need and will strengthen the relationship that you have with each other. Consequently, your middler will be less likely to engage in high risk behaviors or succumb to peer pressure which occurs during these years.
March 26th, 2009 by Stacy Stryer, M.D. in News, Opinion
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The number of teens giving birth in the United States has increased for the second year in a row, after a decline for 14 consecutive years. According to a reported recently released by the Centers for Disease Control, the birth rate increased from 41.9 births per 1000 teens in 2006 to 42.5 births in 2007. Not only does becoming pregnant and giving birth as a teen increase the risk of serious medical problems for the newborn, including low birth weight and an increased risk of death, but it also makes it more likely that a mom will have many socioeconomic difficulties, including a greater chance she will end up on welfare, not receive a high school degree, and live below the poverty level (which translates to difficulties for newborns as they get older).
Obviously, teens who become pregnant did not use a condom during intercourse, or at least not correctly. Therefore, these teens are also at risk of developing sexually transmitted diseases, such as Chlamydia, gonorrhea, and AIDS. Unfortunately, some of these infections, such as HIV, can pass through the placenta, and infect the unborn fetus. Given the fact that the risk of developing HIV and AIDS in adults is increasing in some areas of the United States, it also makes it more likely that an infected female will become pregnant. A report recently published stated that the rate of HIV is greater than 3% in Washington DC, which is considered an epidemic.
Although researchers don’t know why the number of babies born to teens has increased for the second year in a row, they speculate that increases may be due to increased risk taking, more relaxed and changing attitudes, portraying sex as OK or even a positive experience on TV, increased risk taking by teens, changing attitudes, and having teen role models who become pregnant (Miley Cirus, Jamie Lynn Spears, Bristol Palin).
How are we going to improve these statistics? We must ensure that sex, STDs, teen pregnancy and contraception is not only taught at school but also discussed in our own home – over and over. Our teens must not only learn our values, but also how to keep themselves healthy. It is fine to teach abstinence at home, but parents should also teach about condoms as a way to protect their teens. Often, we are the last to know that they have become sexually active. (Regular communication and discussion with our teens may give us the privilege of finding out sooner!)
It is also important to teach our teens how to deal with a certain situation before it happens, such as what to do when someone of the opposite sex makes an advance. If your child hasn’t been taught what to do in situations such as a teen making a physical advance, friends trying to increase poor behavior via peer pressure, watching drinks carefully , and others, she will probably be more likely to freeze up when such a situation arises and allow it to get out of hand. My rule of them it to talk about these tough subjects about 2 years before your teens may be in such a situation. This gives them time to think about it and formulate a plan of how to say “no” or how to stay safe. We need to see a reversal of the teen birth rate – in order to do this, we need the community, schools and parents all to work toward a common goal of educating and protecting our teens.
