A couple of pounds of extra body fat are not a health risk for most people. But being seriously overweight or obese can cause someone to have a number of health problems, both physical and emotional.
The links below provide information on some common health concerns that go with being overweight. You'll also find tips on what teens can do to manage weight in a healthy way.
To read about some of the common physical problems that can affect overweight people, check out these articles:
Being overweight also can impact how people feel about themselves. Check out these articles for insight into the emotional issues that can affect some overweight teens and how to deal with them:
Weight loss is a tricky topic. Lots of people are unhappy with their present weight, but most aren't sure how to change it — and many would be better off staying where they are. You may want to look like the models or actors in magazines and on TV, but those goals might not be healthy or realistic for you. Besides, no magical diet or pill will make you look like someone else.
So what should you do about weight control?
Being healthy is really about being at a weight that is right for you. The best way to find out if you are at a healthy weight or if you need to lose or gain weight is to talk to a doctor or dietitian, who can compare your weight with healthy norms to help you set realistic goals. If it turns out that you can benefit from weight loss, then you can follow a few of the simple suggestions listed below to get started.
Weight management is about long-term success. People who lose weight quickly by crash dieting or other extreme measures usually gain back all (and often more) of the pounds they lost because they haven't permanently changed their habits.
Tips for Success
Therefore, the best weight-management strategies are those that you can maintain for a lifetime. That's a long time, so we'll try to keep these suggestions as easy as possible!
Make it a family affair. Ask your mom or dad to lend help and support and to make dietary or lifestyle changes that will benefit the whole family, if possible. Teens who have the support of their families tend to have better results with their weight-management programs. But remember, you should all work together in a friendly and helpful way — making weight loss into a competition is a recipe for disaster!
Watch your drinks. It's amazing how many extra calories can be lurking in the sodas, juices, and other drinks that you take in every day. Simply cutting out a can of soda or one sports drink can save you 150 calories or more each day. Drink water or other sugar-free drinks to quench your thirst and stay away from sugary juices and sodas. Switching from whole to nonfat or low-fat milk is also a good idea.
Start small. Small changes are a lot easier to stick with than drastic ones. Try reducing the size of the portions you eat and giving up regular soda for a week. Once you have that down, start gradually introducing healthier foods and exercise into your life.
Stop eating when you're full. Lots of people eat when they're bored, lonely, or stressed, or keep eating long after they're full out of habit. Try to pay attention as you eat and stop when you're full. Slowing down can help because it takes about 20 minutes for your brain to recognize how much is in your stomach. Sometimes taking a break before going for seconds can keep you from eating another serving.
Avoid eating when you feel upset or bored — try to find something else to do instead (a walk around the block or a trip to the gym are good alternatives). Many people find it's helpful to keep a diary of what they eat and when. Reviewing the diary later can help them identify the emotions they have when they overeat or whether they have unhealthy habits. Your doctor or a registered dietitian can give you pointers on how to do this.
Eat less more often. Many people find that eating a couple of small snacks throughout the day helps them to make healthy choices at meals. Stick a couple of healthy snacks (carrot sticks, whole-grain pretzels, or a piece of fruit) in your backpack so that you can have one or two snacks during the day. Adding healthy snacks to your three squares and eating smaller portions when you sit down to dinner can help you to cut calories without feeling deprived.
Five a day keep the pounds away. Ditch the junk food and dig out the fruits and veggies! Five servings of fruits and veggies aren't just a good idea to help you lose weight — they'll help keep your heart and the rest of your body healthy. Other suggestions for eating well: replace white bread with whole wheat, trade your sugary sodas for water and low-fat milk, and make sure you eat a healthy breakfast. Having low-sugar, whole-grain cereal and low-fat milk with a piece of fruit is a much better idea than inhaling a donut as you run to the bus stop or eating no breakfast at all! A registered dietitian can give you lots of other snack and menu ideas.
More Tips
Avoid fad diets. It's never a good idea to trade meals for shakes or to give up a food group in the hope that you'll lose weight — we all need a variety of foods to stay healthy. Stay away from fad diets because you're still growing and need to make sure you get proper nutrients. Avoid diet pills (even the over-the-counter or herbal variety). They can be dangerous to your health; besides, there's no evidence that they help keep weight off over the long term.
Don't banish certain foods. Don't tell yourself you'll never again eat your absolutely favorite peanut butter chocolate ice cream or a bag of chips from the vending machine at school. Making these foods forbidden is sure to make you want them even more. Also, don't go fat free: You need to have some fat in your diet to stay healthy, so giving up all fatty foods all the time isn't a good idea. The key to long-term success is making healthy choices most of the time. If you want a piece of cake at a party, go for it! But munch on the carrots rather than the chips to balance it out.
Get moving. You may find that you don't need to cut calories as much as you need to get off your behind. Don't get stuck in the rut of thinking you have to play a team sport or take an aerobics class to get exercise. Try a variety of activities from hiking to cycling to dancing until you find ones you like.
Not a jock? Find other ways to fit activity into your day: walk to school, jog up and down the stairs a couple of times before your morning shower, turn off the tube and help your parents in the garden, or take a stroll past your crush's house — anything that gets you moving. Your goal should be to work up to 60 minutes of exercise every day. But everyone has to begin somewhere. It's fine to start out by simply taking a few turns around the block after school and building up your levels of fitness gradually.
Build muscle. Muscle burns more calories than fat. So adding strength training to your exercise routine can help you reach your weight loss goals as well as give you a toned bod. And weights are not the only way to go: Try resistance bands, pilates, or push-ups to get strong. A good, well-balanced fitness routine includes aerobic workouts, strength training, and flexibility exercises.
Forgive yourself. So you were going to have one cracker with spray cheese on it and the next thing you know the can's pumping air and the box is empty? Drink some water, brush your teeth, and move on. Everyone who's ever tried to lose weight has found it challenging. When you slip up, the best idea is to get right back on track and don't look back. Avoid telling yourself that you'll get back on track tomorrow or next week or after New Year's. Start now.
Try to remember that losing weight isn't going to make you a better person — and it won't magically change your life. It's a good idea to maintain a healthy weight because it's just that: healthy.
The U.S. government's food guide pyramid is all about creating a personalized plan to help you make healthy choices, get the most nutrition out of your calories, balance food and physical activity, and stay within your calorie needs.
A Guide to Healthy Living
The pyramid shows food groups as a series of differently sized
orange for grains
green for vegetables
red for fruit
yellow for oils
blue for milk, yogurt, and cheese (milk group)
purple for meats, poultry, fish, dried beans, eggs, and nuts (meat & beans group)
The stripes are different widths to show how much of a person's daily food intake should be made up of that food group. So the orange band is much wider than the yellow one because people need to eat a lot more grains than oils.
How much we eat is tied to how much we exercise. Teens need to eat a variety of foods to get the nutrients that help the body grow. But teens who are very active need additional food so they can fuel their activity levels in addition to their growth. And those who are less active need to eat less food to avoid gaining weight.
Pyramid Basics
The Food Guide Pyramid helps people remember the following key points:
Combine exercise with eating well. The figure climbing stairs at the side of the pyramid reminds us that exercise is an important part of any healthy lifestyle. Regular physical activity benefits every part of our bodies, including the mind. Experts now know that exercise fights off a range of possible health problems like heart disease, diabetes, and even depression. Teens should get at least 60 minutes of moderate to vigorous exercise every day.
Eat a variety of foods. The different color bands in the pyramid send the message that it's important to eat lots of different foods. Not only does eating a variety of foods provide a good balance of nutrients, it also keeps our taste buds entertained!
Eat foods in moderation. The colored bands that show each food group are wider at the bottom of the pyramid than they are at the top. That's a reminder to people that they can eat lots of some foods in each group but that other foods in this group should be limited. Foods at the bottom of each section include those with little or no solid fats and little or no added sugars or sweeteners. So in the fruit food group, people should eat whole, fresh apples more often than apple pie. Likewise, when it comes to the grains food group, a person should choose more whole-grain products, such as whole-wheat pasta instead of regular pasta. Another example is in the milk group, where people should get most of their dairy intake from fat-free or low-fat milk, yogurt, and cheese instead of whole milk, pudding, or ice cream.
Practical Advice on Eating Right and Exercise
Americans are getting heavier and less healthy — kids and teens as well as adults. A lot of this is because we're becoming a nation of couch potatoes. We're spending more time in front of computer screens and TVs than meeting up with friends and playing sports. We're sitting in cars instead of walking or biking to our destinations.
In addition to using the pyramid as a way to remind people to eat right and exercise, the government designed a website, called MyPyramid, to give specific food and exercise guidelines.
At this site, you can get personalized recommendations about which foods to eat and how much — including estimates of the number of calories needed to stay at a healthy weight for your age, gender, and activity level. To create your personal profile, visit the MyPyramid site.
You've probably heard countless times how exercise is "good for you." But did you know that it can actually help you feel good, too? Getting the right amount of exercise can rev up your energy levels and even help improve your mood.
Rewards and Benefits
Experts recommend that teens get 60 minutes or more of moderate to vigorous physical activity each day. Here are some of the reasons:
Exercise benefits every part of the body, including the mind. Exercising causes the body to produce endorphins, chemicals that can help a person to feel more peaceful and happy. Exercise can help some people sleep better. It can also help some people who have mild depression and low self-esteem. Plus, exercise can give people a real sense of accomplishment and pride at having achieved a certain goal — like beating an old time in the 100-meter dash.
Exercising can help you look better. People who exercise burn more calories and look more toned than those who don't. In fact, exercise is one of the most important parts of keeping your body at a healthy weight.
Exercise helps people lose weight and lower the risk of some diseases. Exercising to maintain a healthy weight decreases a person's risk of developing certain diseases, including type 2 diabetes and high blood pressure. These diseases, which used to be found mostly in adults, are becoming more common in teens.
Exercise can help a person age well. This may not seem important now, but your body will thank you later. Women are especially prone to a condition called osteoporosis (a weakening of the bones) as they get older. Studies have found that weight-bearing exercise, like jumping, running or brisk walking, can help girls (and guys!) keep their bones strong.
The three components to a well-balanced exercise routine are: aerobic exercise, strength training, and flexibility training.
Aerobic Exercise
Like other muscles, the heart enjoys a good workout. You can provide it with one in the form of aerobic exercise. Aerobic exercise is any type of exercise that gets the heart pumping and quickens your breathing. When you give your heart this kind of workout regularly, it will get stronger and more efficient in delivering oxygen (in the form of oxygen-carrying blood cells) to all parts of your body.
If you play team sports, you're probably meeting the recommendation for 60 minutes or more of moderate to vigorous activity on practice days. Some team sports that give you a great aerobic workout are swimming, basketball, soccer, lacrosse, hockey, and rowing.
But if you don't play team sports, don't worry — there are plenty of ways to get aerobic exercise on your own or with friends. These include biking, running, swimming, dancing, in-line skating, tennis, cross-country skiing, hiking, and walking quickly. In fact, the types of exercise that you do on your own are easier to continue when you leave high school and go on to work or college, making it easier to stay fit later in life as well.
Strength Training
The heart isn't the only muscle to benefit from regular exercise. Most of the other muscles in your body enjoy exercise, too. When you use your muscles and they become stronger, it allows you to be active for longer periods of time without getting worn out.
Strong muscles are also a plus because they actually help protect you when you exercise by supporting your joints and helping to prevent injuries. Muscle also burns more energy when a person's at rest than fat does, so building your muscles will help you burn more calories and maintain a healthy weight.
Different types of exercise strengthen different muscle groups, for example:
For arms, try rowing or cross-country skiing. Pull-ups and push-ups, those old gym class standbys, are also good for building arm muscles.
For strong legs, try running, biking, rowing, or skating. Squats and leg raises also work the legs.
For shapely abs, you can't beat rowing, yoga or pilates, and crunches.
Flexibility Training
Strengthening the heart and other muscles isn't the only important goal of exercise. Exercise also helps the body stay flexible, meaning that your muscles and joints stretch and bend easily. People who are flexible can worry less about strained muscles and sprains.
Being flexible may also help improve a person's sports performance. Some activities, like dance or martial arts, obviously require great flexibility, but increased flexibility can also help people perform better at other sports, such as soccer or lacrosse.
Sports and activities that encourage flexibility are easy to find. Martial arts like karate also help a person stay flexible. Ballet, gymnastics, pilates, and yoga are other good choices. Stretching after your workout will also help you improve your flexibility.
What's Right for Me?
One of the biggest reasons people drop an exercise program is lack of interest: If what you're doing isn't fun, it's hard to keep it up. The good news is that there are tons of different sports and activities that you can try out to see which one inspires you.
When picking the right type of exercise, it can help to consider your workout personality. For example, do you like to work out alone and on your own schedule? If so, solo sports like biking or snowboarding may be for you. Or do you like the shared motivation and companionship that comes from being part of a team?
You also need to plan around practical considerations, such as whether your chosen activity is affordable and available to you. (Activities like horseback riding may be harder for people who live in cities, for example.) You'll also want to think about how much time you can set aside for your sport.
It's a good idea to talk to someone who understands the exercise, like a coach or fitness expert at a gym. He or she can get you started on a program that's right for you and your level of fitness.
Another thing to consider is whether any health conditions may affect how — and how much — you exercise. Doctors know that most people benefit from regular exercise, even those with disabilities or conditions like asthma. But if you have a health problem or other considerations (like being overweight or very out of shape), talk to your doctor before beginning an exercise plan. That way you can get information on which exercise programs are best and which to avoid.
Too Much of a Good Thing
As with all good things, it's possible to overdo exercise. Although exercising is a great way to maintain a healthy weight, exercising too much to lose weight isn't healthy. The body needs enough calories to function properly. This is especially true for teens, who are still growing.
Exercising too much in an effort to burn calories and lose weight (also called compulsive exercise) can be a sign of an eating disorder. If you ever get the feeling that your exercise is in charge of you rather than the other way around, talk with your doctor, a parent, or another adult you trust.
It's also possible to overtrain — something high school athletes need to watch out for. If you participate in one sport, experts recommend that you limit that activity to a maximum of 5 days a week, with at least 2–3 months off per year. You can still train more than that as long as it's cross-training in a different sport (such as swimming or biking if you play football).
Participating in more than one activity or sport can help athletes use different skills and avoid injury. Also, never exercise through pain. And, if you have an injury, make sure you give yourself enough time to heal. Your body — and your performance — will thank you.
Considering the benefits to the heart, muscles, joints, and mind, it's easy to see why exercise is wise. And the great thing about exercise is that it's never too late to start. Even small things can count as exercise when you're starting out — like taking a short bike ride, walking the dog, or raking leaves.
If you're already getting regular exercise now, try to keep it up after you graduate from high school. Staying fit is often one of the biggest challenges for people as they get busy with college and careers.
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Garrett had a hard time waking up for school during his sophomore year. At first he thought it was because he'd been going to bed late over summer vacation and then sleeping in the next day. He assumed he'd adjust to his school schedule after a couple of weeks. But as the school year progressed, Garrett found himself lying awake in bed until 2 or 3 in the morning, even though he got up at 6:30 AM every day. He began falling asleep in class and his grades started to suffer.
Most teens don't get enough sleep, but that's usually because they're overloaded and tend to skimp on sleep. But sleep problems can keep some teens, like Garrett, awake at night even when they want to sleep.
Over time, those nights of missed sleep (whether they're caused by a sleep disorder or simply not scheduling enough time for the necessary ZZZs) can build into a sleep deficit. People with a sleep deficit are unable to concentrate, study, and work effectively. They can also experience emotional problems, like depression.
What Happens During Sleep?
You don't notice it, of course, but while you're asleep, your brain is still active. As people sleep, their brains pass through five stages of sleep. Together, stages 1, 2, 3, 4, and REM (rapid eye movement) sleep make up a sleep cycle. One complete sleep cycle lasts about 90 to 100 minutes. So during an average night's sleep, a person will experience about four or five cycles of sleep.
Stages 1 and 2 are periods of light sleep from which a person can easily be awakened. During these stages, eye movements slow down and eventually stop, heart and breathing rates slow down, and body temperature decreases. Stages 3 and 4 are deep sleep stages. It's more difficult to awaken someone during these stages, and when awakened, a person will often feel groggy and disoriented for a few minutes. Stages 3 and 4 are the most refreshing of the sleep stages — it is this type of sleep that we crave when we are very tired.
The final stage of the sleep cycle is known as REM sleep because of the rapid eye movements that occur during this stage. During REM sleep, other physical changes take place — breathing becomes rapid, the heart beats faster, and the limb muscles don't move. This is the stage of sleep when a person has the most vivid dreams.
Why Do Teens Have Trouble Sleeping?
Research shows that teens need 8½ to more than 9 hours of sleep a night. You don't need to be a math whiz to figure out that if you wake up for school at 6:00 AM, you'd have to go to bed at 9:00 PM to reach the 9-hour mark. Studies have found that many teens, like Garrett, have trouble falling asleep that early, though. It's not because they don't want to sleep. It's because their brains naturally work on later schedules and aren't ready for bed.
During adolescence, the body's circadian rhythm (sort of like an internal biological clock) is reset, telling a teen to fall asleep later at night and wake up later in the morning. This change in the circadian rhythm seems to be due to the fact that the brain hormone melatonin is produced later at night in teens than it is for kids and adults, making it harder for teens to fall asleep. Sometimes this delay in the sleep–wake cycle is so severe that it affects a person's daily functioning. In those cases it's called delayed sleep phase syndrome.
Changes in the body clock aren't the only reason teens lose sleep, though. Lots of people have insomnia — trouble falling or staying asleep. The most common cause of insomnia is stress. But all sorts of things can lead to insomnia, including physical discomfort (the stuffy nose of a cold or the pain of a headache, for example), emotional troubles (like family problems or relationship difficulties), and even an uncomfortable sleeping environment (a room that's too hot, cold, or noisy).
It's common for everyone to have insomnia from time to time. But if insomnia lasts for a month or longer with no relief, then doctors consider it chronic. Chronic insomnia can be caused by a number of different problems, including medical conditions, mental-health problems, medication side effects, or substance abuse. People with chronic insomnia can often get help for their condition from a doctor, therapist, or other counselor.
For some people, insomnia can be made worse by worrying about the insomnia itself. A brief period of insomnia can build into something longer lasting when a person becomes anxious about not sleeping or worried about feeling tired the next day. Doctors call this psychophysiologic insomnia.
Other conditions can disrupt sleep too. Some of these are listed on the following pages.
Periodic Limb Movement Disorder and Restless Legs Syndrome
People with these conditions find their sleep is disrupted by leg (or, less frequently, arm) movements, leaving them tired or irritable from lack of sleep. In the case of periodic limb movement disorder (PLMD), these movements are involuntary twitches or jerks: They're called involuntary because the person isn't consciously controlling them and is often unaware of the movement. People with restless legs syndrome (RLS) actually feel physical sensations in their limbs, such as tingling, itching, cramping, or burning. The only way they can relieve these feelings is by moving their legs or arms to get rid of the discomfort.
Doctors can treat PLMD and RLS. For some people, treating an iron deficiency can make them go away; other people may need to take other types of medication.
Obstructive Sleep Apnea
This sleep disorder causes a person to stop breathing temporarily during sleep. One common cause of obstructive sleep apnea is enlarged tonsils or adenoids (tissues located in the passage that connects the nose and throat). Being overweight or obese can also lead a person to develop obstructive sleep apnea.
People with obstructive sleep apnea may snore, have difficulty breathing, and even sweat heavily during sleep. Because it disrupts sleep, someone with sleep apnea may feel extremely sleepy or irritable during the day. People who show signs of obstructive sleep apnea, such as loud snoring or excessive daytime sleepiness, should be evaluated by a doctor.
Reflux
Some people have gastroesophageal reflux disease (GERD), which causes stomach acid to move backward up into the esophagus, producing the uncomfortable, burning sensation known as heartburn. GERD symptoms can be worse when someone is lying down. Even if someone doesn't notice the feelings of heartburn during sleep, the discomfort it causes can still interfere with the sleep cycle.
Nightmares
Most teens have nightmares on occasion. But frequent nightmares can disrupt sleep patterns by waking someone during the night. Some things can trigger more frequent nightmares, including certain medications, drugs, or alcohol. Ironically, sleep deprivation can also be a cause. The most common triggers for more frequent nightmares are emotional, such as stress or anxiety. If nightmares are interfering with your sleep, it's a good idea to talk to a doctor, therapist, or other counselor.
Narcolepsy
People with narcolepsy are often very sleepy during the day and have sleep "attacks" that may make them suddenly fall asleep, lose muscle control, or see vivid dreamlike images while dozing off or waking up. Someone's nighttime sleep may be disrupted, with frequent awakenings throughout the night. Narcolepsy can be disturbing because people fall asleep without warning, making it hazardous to do things like drive. A person's schooling, work, or social life can be affected by the unusual sleep patterns.
Narcolepsy is not that commonly diagnosed in teens, although many cases go unrecognized. People usually first begin to have symptoms between the ages of 10 and 25, but may not be properly diagnosed until 10–15 years later. Doctors usually treat narcolepsy with medications and lifestyle changes.
Sleepwalking
It's rare for teens to walk in their sleep; most sleepwalkers are children. Sleepwalking may run in families. It tends to happen most often when a person is sick, has a fever, is not getting enough sleep, or is feeling stress.
Because most sleepwalkers don't sleepwalk often, it's not usually a serious problem. Sleepwalkers tend to go back to bed on their own and don't usually remember sleepwalking. (Sleepwalking often happens during the deeper sleep that takes place during stages 3 and 4 of the sleep cycle.) Sometimes, though, a sleepwalker will need help moving around obstacles and getting back to bed. It's also true that waking sleepwalkers can startle them (but it isn't harmful), so try to guide a sleepwalker back to bed gently.
What Should I Do?
If you think you're getting enough rest at night and you're still feeling tired during the day, it's a good idea to visit your doctor. Excessive tiredness can be caused by all sorts of health problems, not just difficulties with sleep.
If your doctor suspects a sleep problem, he or she will look at your overall health and sleep habits. In addition to doing a physical examination, the doctor will take your medical history by asking you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. The doctor may also do tests to find out whether any conditions — such as obstructive sleep apnea — might be interfering with your sleep.
Different sleep problems are treated differently. Some can be treated with medications, whereas others can be helped by special techniques such as light therapy (where someone sits in front of a lightbox for a certain amount of time each day) or other practices that can help reset a person's body clock.
Doctors also encourage teens to make lifestyle changes that promote good sleeping habits. You probably know that caffeine can keep you awake, but many teens don't realize that playing video games or watching TV before sleeping can do the same thing.
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5 Ideas for Better Sleep
Most teens need about 8½ to more than 9 hours of sleep each night. But about 1 in 4 teens has trouble sleeping. Lack of sleep can affect everything from our emotions to how well we focus on tasks like driving. It can affect sports performance, increase our chances of getting sick, and may be linked to weight gain in some people.
How can we get the sleep we need? Here are some ideas:
Be active during the day. You've probably noticed how much running around little kids do — and how soundly they sleep. Take a tip from a toddler and get at least 60 minutes of exercise a day. Physical activity can decrease stress and help people feel more relaxed. Just don't work out too close to bedtime because exercise can wake you up before it slows you down.
Avoid alcohol and drugs. Lots of people think that alcohol or drugs will make them relaxed and drowsy, but that's not the case. Drugs and alcohol disrupt sleep, increasing a person's chance of waking up in the middle of the night.
Say goodnight to electronics. Experts recommend using the bedroom for sleep only. If you can't make your bedroom a tech-free zone, at least shut everything down an hour or more before lights out. Nothing says, "Wake up, something's going on!" like the buzz of a text or the ping of an IM.
Keep a sleep routine. Going to bed at the same time every night helps the body expect sleep. Creating a set bedtime routine can enhance this relaxation effect. So unwind every night by reading, listening to music, spending time with a pet, writing in a journal, playing Sudoku, or doing anything else that relaxes you.
Expect a good night's sleep. Stress can trigger insomnia, so the more you agonize about not sleeping, the greater the risk you'll lie awake staring at the ceiling. Instead of worrying that you won't sleep, remind yourself that you can. Say, "Tonight, I will sleep well" several times during the day. It can also help to practice breathing exercises or gentle yoga poses before bed.
Everyone has a sleepless night once in a while. But if you regularly have trouble sleeping and you think it's affecting your mood or performance, talk to your doctor.
Sometimes having your period can be a pain — literally. Most girls have to deal with PMS, cramps, or headaches around the time of their periods. These problems are usually normal and nothing to worry about. Here are the facts on which period problems are common and normal — and which ones might indicate there's something else going on.
What Is PMS?
Premenstrual syndrome (PMS) is the term for the physical and emotional symptoms that many girls and women get right before their periods begin each month. If you have PMS, you might experience:
acne
bloating
fatigue
backaches
sore breasts
headaches
constipation
diarrhea
food cravings
depression or feeling blue
irritability
difficulty concentrating
difficulty handling stress
PMS is usually at its worst during the 1 to 2 weeks before a girl's period starts, and it usually disappears when her period begins.
Why Do Some Girls Get PMS?
Doctors have not pinpointed the exact cause of PMS, but many believe it is linked to changing hormone levels. Following a girl’s period, the amounts of estrogen and progesterone (female hormones) in a girl's body increase. Then about 1 week before her period starts, levels of both of these hormones begin to fall. The thinking is that these changing hormone levels can lead to PMS symptoms.
It isn't clear why some girls develop PMS and others don't. It's possible that those who develop PMS are simply more sensitive to the changes in hormone levels. There are other theories as well. For example, some believe that what you eat can affect how you feel, especially during the couple of weeks before a girl's period.
Luckily, there are several things you can do to ease PMS symptoms. Eating a balanced diet with lots of fresh fruits and vegetables and cutting back on processed foods like chips and crackers can help. You might also want to reduce your salt intake (salt can make you retain water and become more bloated) and, believe it or not, drink more water. Say no to caffeine (it can make you jumpy and anxious) and yes to certain vitamins: B-complex vitamins, calcium, magnesium, and vitamin E are thought to be helpful. Also, daily exercise and stress-relief techniques like meditation can help some girls.
When it comes to medicine, over-the-counter pain medicines like ibuprofen can relieve achy heads and backs. But for really serious PMS pain, see your doctor. He or she might be able to prescribe a different medicine or birth control pills to help with many of your PMS symptoms.
Why Do Some Girls Get Cramps?
Lots of girls have abdominal cramps during the first few days of their periods. Cramps are most likely caused by prostaglandins (pronounced: pross-tuh-glan-dinz), chemicals your body produces that make the muscles of the uterus contract. The good news is that cramps usually only last a few days. But if you're in pain, medicine like ibuprofen may help.
Exercise may also make you feel better, possibly because it releases endorphins, chemicals in the body that literally make you feel good. Soaking in a warm bath or putting a warm compress on your stomach won't make your cramps disappear but may help your muscles relax a little. If you have severe cramps that keep you home from school or from doing stuff with your friends, visit your doctor for advice.
Why Isn't My Period Regular?
It can take up to 3 years from the time a girl starts menstruating for her body to develop a regular cycle. Even then, what's regular varies from person to person. Girls' cycles can range from 21 to 45 days.
Changing hormone levels might make your period short one month (such as 2 or 3 days) and more drawn out (such as 7 days) the next. You might skip a few months, get two periods almost right after each other, have a really heavy period, or one so light you almost don't notice it. (If you're sexually active and you skip a period, though, you should visit your doctor or a women's clinic to make sure you're not pregnant.)
All this irregularity can make planning for your period a real hassle. Try to keep track of when your last period started, and guess that about 4 weeks from that day you could be due for another. If you're worried about wearing that cute dress and suddenly starting your period at school, just make sure you pack protection. Carry a pad or tampon in your backpack, and wear a pantiliner to handle the first wave.
When it comes to periods, every girl's body has a unique (and unpredictable) timeline for getting on track. If your period still has not settled into a relatively predictable pattern after 3 years, or if you have four or five regular periods and then skip your periods for a couple of months, make an appointment with your doctor to check for possible problems.
Why Haven't I Started My Period Yet?
Everybody goes through puberty at different speeds. Some girls begin menstruating as early as age 8 or 9; others don't get going until they're 15 or 16. It all depends on your hormones — and your family. Want to guess when you'll get your period? Ask when your mom and grandmothers (from both sides of your family) started theirs. When you start puberty is partly linked to genetics. So although there's no guarantee that you'll follow in their footsteps, your relatives could give you a pretty good clue about your own period.
One thing that can delay puberty — and your period — is excessive exercising, usually distance running, ballet, or gymnastics, combined with a poor diet. For exercise to be excessive, it means more than just playing soccer for a couple of hours a few times a week or working out once in a while with an exercise tape. To exercise so much that you delay your period, you would have to train vigorously for several hours a day, most days of the week, and not get enough calories, vitamins, and minerals.
Unless compulsive exercise has postponed your period, there's nothing you can do on your own to hurry things along. If you haven't started to menstruate by the time you're 16, consult your doctor. He or she will probably do a pelvic exam and take a blood test to determine the hormone levels in your body. Then the doctor might prescribe hormones to jump-start your cycle.
Menstrual Problems
Even if it seems strange to you, most of the stuff that goes along with a girl's period is completely normal. But there are a few conditions that can be more serious. If you suspect you have any of these conditions, see your doctor for advice.
No Periods
Amenorrhea is the term doctors use for absence of periods. Girls who haven't started their periods by the time they are 16 may have primary amenorrhea, usually caused by a hormone imbalance or developmental problem.
There's also a condition called secondary amenorrhea, when someone who had normal periods stops menstruating for at least 3 months. Low levels of gonadotropin-releasing (pronounced: go-nad-uh-troe-pin) hormone (GnRH), which controls ovulation and the menstrual cycle, frequently bring on amenorrhea. Stress, anorexia, weight loss or gain, stopping birth control pills, thyroid conditions, and ovarian cysts are examples of things that can throw your hormones out of whack. To get everything back on course, your doctor may use hormone therapy. If a medical condition is affecting your monthly cycles, then treatment of the condition will help to resolve the problem. As mentioned earlier, lots of strenuous exercise combined with a poor diet can also cause amenorrhea. Cutting back on exercise and eating a balanced diet with more calories will help correct the problem, but be sure to talk with your doctor as well.
Heavy Periods
Menorrhagia (pronounced: men-uh-ray-jee-uh) is the term doctors use for extremely heavy, prolonged periods. Menorrhagia is more than just 1 or 2 days of a heavier-than-average flow. Girls who have menorrhagia soak through at least a pad an hour for several hours in a row or have periods that are more than 7 days long. (Clotting during your period is not necessarily a sign of menorrhagia, though — lots of girls, with both heavy and light periods, pass clots when they menstruate.)
The most frequent cause of menorrhagia is an imbalance between the amounts of estrogen and progesterone in the body. Because of this imbalance, the endometrium (pronounced: en-doh-mee-tree-um, the lining of the uterus) keeps building up. Then when the body gets rid of the endometrium during a period, the bleeding is very heavy.
Many girls have hormone imbalances during puberty, so it's not uncommon to experience menorrhagia during the teen years. Other cases of heavy bleeding may be caused by thyroid conditions, blood diseases, or inflammation or infections in the vagina or cervix. To help figure out the cause of abnormal bleeding, a doctor can do a pelvic exam, a Pap smear, and blood tests. If you do have menorrhagia, it can be treated with hormones, medicine, or removal of any growths in the uterus that may be the cause of excessive bleeding.
Extremely Painful Periods
Dysmenorrhea (pronounced: dis-men-uh-ree-uh) is the medical term for very painful periods. Primary dysmenorrhea — painful periods that are not caused by a disease or other condition — is more common in teens than secondary dysmenorrhea (painful periods caused by a disease or condition).
The culprit in primary dysmenorrhea is prostaglandin, the same naturally occurring chemical that causes cramps. In large amounts, prostaglandin can cause nausea, vomiting, headaches, backaches, diarrhea, and severe cramps when you have your period. Fortunately, these symptoms usually only last for a day or two. Doctors usually prescribe anti-inflammatory medicines to treat primary dysmenorrhea. As with cramps, exercise, hot water bottles, and birth control pills might also bring some relief.
Some of the more common conditions that can cause secondary dysmenorrhea include:
endometriosis, a condition in which tissue normally found only in the uterus starts to grow outside the uterus
fibroids or growths on the inside wall of the uterus
All of these conditions require that a doctor diagnose the problem and then treat you appropriately.
What to Do if You Suspect a Problem
When you have questions about your period or anything else related to your development, talk to your doctor. This is particularly true if you notice a change in your menstrual cycle. Though most period problems turn out to be nothing to worry about, it's always good to be safe.
See your doctor if:
You have not started your period by the time you are 16. This may indicate that you have a problem that requires medical attention.
You stop getting your period or it becomes really irregular after it has been regular for a while (like 6 months or more). This can be a sign that you may have a hormone imbalance or a problem with nutrition, which can harm your body if left untreated.
You have very heavy or long periods, especially if you have a short cycle and get your period frequently. In rare cases, lots of blood loss can cause anemia (iron deficiency) and leave you feeling really weak and tired.
Your periods are really painful. You might have endometriosis or benign growths that should be removed. Or if you're sexually active, you might have PID.
Chances are that your painful or irregular periods are nothing to worry about. But if there is something going on, the quicker you get it taken care of, the sooner you'll be on your way to feeling great again.
Once you get your period, you'll need to use something to soak up the menstrual blood. There are lots of choices out there, and it may take some experimenting before you find the product that works best for you.
Here's an overview of what's available.
Pads
Super, slender, overnight, with or without wings, deodorant, maxi, mini . . . pads may seem a bit confusing at first because there are so many different kinds. But the good news is that with all these choices, there's bound to be one that works for you.
Pads are rectangles of absorbent material that attach to the insides of a girl's underwear. They're sometimes also called sanitary pads or sanitary napkins. Some pads have extra material on the sides (called "wings") that fold over the edges of your underwear to better hold the pad in place and prevent leakage.
Some girls have periods with heavier bleeding, and others have lighter periods with less bleeding. Pads come in several different thicknesses and absorbencies for heavier or lighter menstrual periods or for day or nighttime use. That way, girls who have a lighter flow don't need to feel like they're wearing a pad that's bigger than they need — and girls with a heavy flow don't need to worry that they'll leak through their pad.
Some pads come with a deodorant or deodorizing substance in them, although these can cause irritation in the genital area for some girls.
Most pads that you buy in stores have a sticky strip along the bottom. You peel off the strip that covers the adhesive, press the pad into the crotch of your underwear (wrapping the wings around and sticking them under the crotch if the pad you're using has wings). This type of pad is disposable. Once you've removed the pad, wrap it in toilet paper and put it in the trash can (or if you're at school or out somewhere, in the special disposal box that's found in most stalls). Don't try to flush a pad down the toilet — even the lightest kind of pad may back up the toilet and make a huge (embarrassing!) mess.
It's also possible to buy reusable pads that can be washed after each wearing — these are usually available in natural health stores or online. These kinds of pads clip onto a girl's underwear (or have a special holder that clips on). Some women choose to use these pads because they think they are better for the environment or because they save money. It's all a matter of personal preference.
No matter what kind of pad you choose, it's best to change pads every 3 or 4 hours, even when your flow isn't very heavy. Regular changing prevents buildup of bacteria and eliminates odor. Naturally, if your period is heavy, you should change pads more often because they may get saturated more quickly.
Tampons
Unlike a pad, which catches menstrual blood after it leaves the body, a tampon absorbs blood from inside the vagina. A tampon is also made of absorbent material, but it's compressed into a tiny tubular shape. Like pads, tampons come in different sizes and absorbencies for heavier and lighter periods (words like "super" or "ultra" on the packaging usually mean that a tampon is designed for girls whose flow is heavier).
Tampons can also come with or without deodorant. Again, using these is a matter of personal preference. There's no real need for deodorant in a tampon, since regular changing usually gets rid of any odor. For some girls, the deodorant in tampons can irritate the vagina.
It's easy to use a tampon, but you do need to learn how. After washing your hands, follow the directions that come with the tampons carefully and be sure to relax. Some tampons come with an applicator — a plastic or cardboard tube that guides the tampon into the vagina. Other tampons are inserted with the fingers.
Some girls find that using a slender size, applicator-style tampon makes it easier to insert tampons at first. (An applicator with a rounded top can be especially helpful for beginners.) The first time you use a tampon, try to do so on a heavier flow day so the tampon slips in easier.
Some girls worry that tampons can get lost inside their bodies, but tampons can't just randomly wander around inside us. The vagina holds a tampon in place and the opening of the cervix (located at the top of the vagina) is just too tiny for a tampon to get through. There's only one place a tampon can go — and that's out the way it came in.
Tampons usually have a string attached to one end that stays outside a girl's body and can be used to remove the tampon at any time. Occasionally, a girl may forget to remove a tampon or may insert a new one when the old one is still in place. If a tampon is left in too long, it won't get lost. But a girl may get a discharge and odor, and she could develop an infection. That's why it's important to change tampons often.
A tampon needs to be changed every 4 to 6 hours or when it's saturated with blood. Because you can't see a tampon as you can with a pad, you'll need to remember when it's time to change or you may get spotting or leakage on your underwear or clothing. Pull gently on the string that is attached to the end of the tampon until the tampon comes out, wrap it in toilet paper, and throw it in the trash. Don't flush a tampon down the toilet — even when the box says a tampon is flushable, some tampons can still cause problems in some plumbing systems.
If it's time to change your tampon and you can't find the string, don't worry! The tampon is still there. You'll need to reach in with your fingers to find the string. It may take a minute to do because the string might be a bit hard to grab.
A tampon needs to be changed every 4 to 6 hours or when it's saturated with blood. Because you can't see a tampon as you can with a pad, you'll need to remember when it's time to change or you may get spotting or leakage on your underwear or clothing. Pull gently on the string that is attached to the end of the tampon until the tampon comes out, wrap it in toilet paper, and throw it in the trash. Don't flush a tampon down the toilet — even when the box says a tampon is flushable, some tampons can still cause problems in some plumbing systems.
If it's time to change your tampon and you can't find the string, don't worry! The tampon is still there. You'll need to reach in with your fingers to find the string. It may take a minute to do because the string might be a bit hard to grab.
Tampon or Pad?
When deciding what type of protection to use, it's really up to you. Some girls like tampons because they're easy to store in a purse or pocket. Tampons and cups are also helpful for girls who participate in sports like swimming, since you can't wear a pad in the water.
Some girls prefer pads because they're easy to use and it's easier to remember when to change them since you can see them getting soaked with blood.
Many girls switch back and forth: Sometimes they use tampons and sometimes they use pads, depending on the situation, where they're going to be, and their menstrual flow. Some girls use pads at night and tampons during the day. And some girls with heavy periods use tampons together with pads or pantiliners for added protection against leakage.
If you have any concerns or questions about your period, talk to your doctor.
Some girls worry that if they use tampons, they will no longer be virgins. The truth is, a virgin is someone who has never had sexual intercourse. Inserting a tampon is definitely not the same as having sex!
So why do girls ask this question so often? Girls who are virgins usually have a hymen, a very thin piece of skin-like tissue that stretches partly across the opening of the vagina. A lot of people mistakenly think that a girl is only a virgin if her hymen has not been broken. Most of the time a girl's hymen breaks after having sex for the first time.
But a girl's hymen can tear in ways that have nothing to do with having sex. For example, it is possible that inserting a tampon might tear the hymen (although that usually doesn't happen). So even if a tampon does break a girl's hymen, she is still a virgin until she has had sexual intercourse.
Menstruation (a period) is a major stage of puberty in girls; it's one of the many physical signs that a girl is turning into a woman. And like a lot of the other changes associated with puberty, menstruation can be confusing. Some girls can't wait to start their periods, whereas others may feel afraid or anxious. Many girls (and guys!) don't have a complete understanding of a woman's reproductive system or what actually happens during the menstrual cycle, making the process seem even more mysterious.
The Female Reproductive System
Baby girls are born with ovaries, fallopian tubes, and a uterus. The two ovaries are oval-shaped and sit on either side of the uterus (womb) in the lowest part of the abdomen called the pelvis. They contain thousands of eggs, or ova. The two fallopian tubes are long and thin. Each fallopian tube stretches from an ovary to the uterus, a pear-shaped organ that sits in the middle of the pelvis. The muscles in a female's uterus are powerful and are able to expand to allow the uterus to accommodate a growing fetus and then help push the baby out during labor.
As a girl matures and enters puberty, the pituitary gland releases hormones that stimulate the ovaries to produce other hormones called estrogen and progesterone. These hormones have many effects on a girl's body, including physical maturation, growth, and emotions.
About once a month, a tiny egg leaves one of the ovaries — a process called ovulation — and travels down one of the fallopian tubes toward the uterus. In the days before ovulation, the hormone estrogen stimulates the uterus to build up its lining with extra blood and tissue, making the walls of the uterus thick and cushioned. This happens to prepare the uterus for pregnancy: If the egg is fertilized by a sperm cell, it travels to the uterus and attaches to the cushiony wall of the uterus, where it slowly develops into a baby.
If the egg isn't fertilized, though — which is the case during most of a woman's monthly cycles — it doesn't attach to the wall of the uterus. When this happens, the uterus sheds the extra tissue lining. The blood, tissue, and unfertilized egg leave the uterus, going through the vagina on the way out of the body. This is a menstrual period. This cycle happens almost every month for several more decades (except, of course, when a female is pregnant) until a woman reaches menopause and no longer releases eggs from her ovaries.
How Often Does a Girl Get Her Period?
Just as some girls begin puberty earlier or later than others, the same applies to periods. Some girls may start menstruating as early as age 10, but others may not get their first period until they are 15 years old.
The amount of time between a girl's periods is called her menstrual cycle (the cycle is counted from the start of one period to the start of the next). Some girls will find that their menstrual cycle lasts 28 days, whereas others might have a 24-day cycle, a 30-day cycle, or even longer. Following menarche, menstrual cycles last 21–45 days. After a couple of years, cycles shorten to an adult length of 21–34 days.
Irregular periods are common in girls who are just beginning to menstruate. It may take the body a while to sort out all the changes going on, so a girl may have a 28-day cycle for 2 months, then miss a month, for example. Usually, after a year or two, the menstrual cycle will become more regular. Some women continue to have irregular periods into adulthood, though.
As a girl gets older and her periods settle down — or she gets more used to her own unique cycle — she will probably find that she can predict when her period will come. In the meantime, it's a good idea to keep track of your menstrual cycle with a calendar.
How Long and How Much?
The amount of time that a girl has her period also can vary. Some girls have periods that last just 2 or 3 days. Other girls may have periods that last 7 days or longer. The menstrual flow — meaning how much blood comes out of the vagina — can vary widely from girl to girl, too.
Some girls may be concerned that they're losing too much blood. It can be a shock to see all that blood, but it's unlikely that a girl will lose too much, unless she has a medical condition like von Willebrand disease. Though it may look like a lot, the average amount of blood is only about 2 tablespoons (30 milliliters) for an entire period. Most teens will change pads 3 to 6 times a day, with more frequent changes when their period is heaviest, usually at the start of the period.
Especially when menstrual periods are new, you may be worried about your blood flow or whether your period is normal in other ways. Talk to a doctor or nurse if:
your period lasts longer than a week
you have to change your pad very often (soaking more than one pad every 1–2 hours)
you go longer than 3 months between periods
you have bleeding in between periods
you have an unusual amount of pain before or during your period
your periods were regular then became irregular
Cramps
Some girls may notice physical or emotional changes around the time of their periods. Menstrual cramps are pretty common — in fact, more than half of all women who menstruate say they have cramps during the first few days of their periods. Doctors think that cramps are caused by prostaglandin, a chemical that causes the muscles of the uterus to contract.
Depending on the girl, menstrual cramps can be dull and achy or sharp and intense, and they can sometimes be felt in the back as well as the abdomen. These cramps often become less uncomfortable and sometimes even disappear completely as a girl gets older.
Many girls and women find that over-the-counter pain medications (like acetaminophen or ibuprofen) can relieve cramps, as can taking a warm bath or applying a warm heating pad to the lower abdomen. Exercising regularly throughout the monthly cycle may help lessen cramps, too. If these things don't help, ask your doctor for advice.
PMS and Pimples
Some girls and women find that they feel sad or easily irritated during the few days or week before their periods. Others may get angry more quickly than normal or cry more than usual. Some girls crave certain foods. These types of emotional changes may be the result of premenstrual syndrome (PMS).
PMS is related to changes in the body's hormones. As hormone levels rise and fall during a woman's menstrual cycle, they can affect the way she feels, both emotionally and physically. Some girls, in addition to feeling more intense emotions than they usually do, notice physical changes along with their periods — some feel bloated or puffy because of water retention, others notice swollen and sore breasts, and some get headaches.
PMS usually goes away soon after a period begins, but it can come back month after month. Eating right, getting enough sleep, and exercising may help relieve some of the symptoms of PMS. Talk to your doctor if you are concerned about your premenstrual symptoms.
It's also not uncommon for girls to have an acne flare-up during certain times of their cycle; again, this is due to hormones. Fortunately, the pimples associated with periods tend to become less of a problem as girls get older.
Pads, Tampons, and Liners
Once you begin menstruating, you'll need to use something to absorb the blood. Most girls use a pad or a tampon. But some use menstrual cups, which a girl inserts into her vagina to catch and hold the blood (instead of absorbing it, like a tampon).
There are so many products out there that it may take some experimenting before you find the one that works best for you. Some girls use only pads (particularly when they first start menstruating), some use only tampons, and some switch around — tampons during the day and pads at night, for example.
Girls who worry about leakage from a tampon often use a pantiliner, too, and some girls use liners alone on very light days of their periods.
Periods shouldn't get in the way of exercising, having fun, and enjoying life. Girls who are very active, particularly those who enjoy swimming, often find that tampons are the best option during sports.
If you have questions about pads, tampons, or coping with periods, ask a parent, health teacher, school nurse, or older sister.
When girls begin to go through puberty (usually starting between the ages of 8 and 13), their bodies and minds change in many ways. The hormones in their bodies stimulate new physical development, such as growth and breast development. About 2 to 2½ years after a girl's breasts begin to develop, she usually gets her first menstrual period.
About 6 months or so before getting her first period, a girl might notice an increased amount of clear vaginal discharge. This discharge is common. There's no need for a girl to worry about discharge unless it has a strong odor or causes itchiness.
The start of periods is known as
menarche. Menarche doesn't happen until all the parts of a girl's reproductive system have matured and are working together.
Maybe your day is so packed with things to do that you hardly have time to grab breakfast, let alone make sure you're eating right the rest of the day. Perhaps you're staying up late to get your homework finished and missing out on the sleep you need. The fact is, lots of teens are tired. And with all the demands of school and other activities, it's easy to understand why.
For some people, though, there may be another explanation for why they feel so exhausted: anemia.
To understand anemia, it helps to start with breathing. The oxygen we inhale doesn't just stop in our lungs. It's needed throughout our bodies to fuel the brain and all our other organs and tissues that allow us to function. Oxygen travels to these organs through the bloodstream — specifically in the red blood cells.
Red blood cells, or RBCs, are manufactured in the body's bone marrow and act like boats, ferrying oxygen throughout the rivers of the bloodstream. RBCs contain hemoglobin (pronounced: hee-muh-glow-bin), a protein that holds onto oxygen. To make enough hemoglobin, the body needs to have plenty of iron. We get this iron, along with the other nutrients necessary to make red blood cells, from food.
Anemia occurs when a person has fewer RBCs than normal. This can happen for three main reasons:
Red blood cells are being lost.
The body is producing RBCs slower than it should.
RBCs are being destroyed by the body.
Each of these causes is linked to a different type of anemia.
Blood Loss
When a small amount of blood is lost, the bone marrow is able to replace it without a person becoming anemic. But if a large amount of blood is lost over a short period of time, which can happen if someone has a serious accident or injury, for example, the bone marrow may not be able to replace the red blood cells quickly enough.
Losing a little blood over a long period of time also might lead to anemia. This can happen in girls who have heavy menstrual periods, especially if they don't get enough iron in their diets.
Iron Deficiency Anemia
Iron deficiency anemia is the most common type of anemia in U.S. teens. It occurs when a person's diet is lacking in iron. Iron deficiency — when the body's stores of iron are reduced — is the first step toward anemia. If the body's iron stores aren't replenished at this point, continuing iron deficiency can cause the body's normal hemoglobin production to slow down. When hemoglobin levels and red blood cell production drop below normal, a person is said to have anemia. Someone with anemia may appear pale and may be tired all the time.
There are other nutritional reasons why someone's body may not make enough RBCs. Vitamin B12 and folic acid are also needed to make red blood cells, so it's important to get enough of these nutrients in your diet. If the bone marrow is not working properly because of an infection, chronic illness, or certain medications like chemotherapy, anemia can develop.
Hemolytic Anemia
In a person with hemolytic (pronounced: hee-muh-lih-tik) anemia, the normal lifespan of the red blood cells is shorter than normal. When blood cells die off early, the bone marrow is unable to keep up with production. This can happen for a variety of reasons. A person may have a disorder like sickle cell anemia or sphenocytosis. In other cases, the body's own immune system can cause destruction of RBCs. Antibodies can be formed as a reaction to certain infections or drugs that attack the RBCs by mistake.
Why Do Teens Get Anemia?
Because teens go through rapid growth spurts, they can be at risk for iron deficiency anemia. During a growth spurt, the body has a greater need for all types of nutrients, including iron, which we need to get in the foods we eat.
After puberty, girls are at more risk of iron deficiency anemia than guys are. That's because a girl needs more iron to compensate for the blood lost during her menstrual periods. Pregnancy can also cause a girl to develop anemia. And a teen on a diet to lose weight may be getting even less iron.
Vegetarians are more at risk of iron deficiency anemia than people who eat meat are. Red meat is the richest and best-absorbed source of iron. Although there is some iron in grains, vegetables, and some fruits and beans, there's less of it. And the iron in these food sources is not absorbed by the body as readily as the iron in meat.
What Are the Symptoms?
It's easy for people to overlook the symptoms of anemia because it often happens gradually over time. Looking pale can be a sign of anemia because fewer red blood cells are flowing through the blood vessels. The heart will beat faster in an effort to pump the same amount of blood and oxygen to the body, so the pulse may be faster than normal.
As anemia progresses, a person may feel tired and short of breath, especially when climbing stairs or working out. They may develop headaches. Iron deficiency, which occurs before iron deficiency anemia develops, may affect a person's ability to concentrate, learn, and remember.
Anemia is not contagious, so you cannot catch it from someone who has it.
How Is Anemia Diagnosed?
If you visit a doctor for suspected anemia, he or she will probably give you a physical examination. The doctor will also ask questions about any concerns and symptoms you have, your past health, your family's health (such as whether anyone in your family has anemia), any medications you're taking, any allergies you may have, and other issues. This is called the medical history.
As part of this medical history, your doctor may ask specific questions about the foods you eat. If you're a girl, the doctor may ask questions about your periods, such as how heavy the flow is, when you got your first period, how often you menstruate, and for how many days.
If your doctor suspects you are anemic, he or she will probably take a blood sample and send it to a lab for analysis. This will determine, among other things, the number, size, and shape of your red blood cells, the percentage of your blood that is made up of RBCs, and the amount of hemoglobin present in the blood. With this information, a doctor can determine if a person is anemic and may order additional tests (like measuring iron levels), depending on the suspected cause of the anemia.
How Is Anemia Treated?
The treatment of anemia depends on what's causing it. If the anemia is caused by iron deficiency, your doctor will probably prescribe an iron supplement to be taken several times a day. Your doctor may do a blood test after you have been on the iron supplement. Even if the tests show that the anemia has improved, you may have to continue taking iron for several months to replenish your body's total iron stores.
Because some people become nauseated if they take an iron supplement on an empty stomach, it can help to take it with food. Vitamin C boosts iron absorption, so drink a glass of orange or grapefruit juice when you take your iron. You can increase the chances that the iron you get from food will be absorbed by your body in other ways, too. For example, avoid drinking tea with food because a substance in tea called tannin reduces the body's ability to absorb iron found in the food or iron supplement. Milk can also interfere with iron absorption, so don't pair milk with iron-rich foods if you are concerned about getting enough iron.
Some people need more iron than others: Girls need more than guys, for example. And a girl who has heavy periods has a greater need for iron than a girl who has a light flow.
To make sure you get enough iron, eat a balanced diet every day, starting with a breakfast that includes an iron source, such as an iron-fortified cereal or bread. Lean meat, raisins, spinach, eggs, dried beans, and molasses are also good sources of iron.
If someone's anemia is caused by another medical condition, doctors will work to treat the cause. People with some types of anemia will need to see a specialist, called a hematologist, who can provide the right medical care for their needs.
The good news is that for most people anemia is easily treated. And in a few weeks you'll have your energy back!
Eating disorders are so common in America that 1 or 2 out of every 100 students will struggle with one.
Eating disorders are more than just going on a diet to lose weight or trying to make sure you exercise every day. They're extremes in eating behavior — the diet that never ends and gradually gets more restrictive, for example. Or the person who can't go out with friends because he or she thinks it's more important to go running to work off a piece of candy.
The most common types of eating disorder are anorexia nervosa and bulimia nervosa (usually called simply "anorexia" and "bulimia"). But other food-related disorders, like binge eating disorders, body image disorders, and food phobias, are showing up more frequently than they used to.
Anorexia
People with anorexia have an extreme fear of weight gain and a distorted view of their body size and shape. As a result, they can't maintain a normal body weight. Some people with anorexia restrict their food intake by dieting, fasting, or excessive exercise. They hardly eat at all — and the small amount of food they do eat becomes an obsession.
Other people with anorexia do something called binge eating and purging, where they eat a lot of food and then try to get rid of the calories by forcing themselves to vomit, using laxatives, or exercising excessively.
Bulimia
Bulimia is similar to anorexia. With bulimia, a person binge eats (eats a lot of food) and then tries to compensate in extreme ways, such as forced vomiting or excessive exercise, to prevent weight gain. Over time, these steps can be dangerous.
To be diagnosed with bulimia, a person must be binging and purging regularly, at least twice a week for a couple of months. Binge eating is different from going to a party and "pigging out" on pizza, then deciding to go to the gym the next day and eat more healthfully. People with bulimia eat a large amount of food (often junk food) at once, usually in secret. The person typically feels powerless to stop the eating and can only stop once he or she is too full to eat any more. Most people with bulimia then purge by vomiting, but may also use laxatives or excessive exercise.
Although anorexia and bulimia are very similar, people with anorexia are usually very thin and underweight but those with bulimia may be a normal weight or even overweight.
Binge Eating Disorder
This eating disorder is similar to anorexia and bulimia because a person binges regularly on food (more than three times a week). But, unlike the other eating disorders, a person with binge eating disorder does not try to "compensate" by purging the food.
Anorexia, bulimia, and binge eating disorder all involve unhealthy eating patterns that begin gradually and build to the point where a person feels unable to control them.
Anorexia and Bulimia: What to Look For
Sometimes a person with anorexia or bulimia starts out just trying to lose some weight or hoping to get in shape. But the urge to eat less or to purge spirals out of control.
People with anorexia or bulimia frequently have an intense fear of being fat or think that they are fat when they are not. A person with anorexia may weigh food before eating it or compulsively count the calories of everything. When it seems "normal" or "cool" to do things like restrict food intake to an unhealthy level, it's a sign that a person has a problem.
So how do you know if a person is struggling with anorexia or bulimia? You can't tell just by looking at someone. A person who loses a lot of weight may have another health condition or may be losing weight through healthy eating and exercise.
Here are some signs that a person may have anorexia or bulimia:
Anorexia
becomes very thin, frail, or emaciated
obsessed with eating, food, and weight control
weighs herself or himself repeatedly
counts or portions food carefully
only eats certain foods, avoiding foods like dairy, meat, wheat, etc. (of course, lots of people who are allergic to a particular food or are vegetarians avoid certain foods)
exercises excessively
feels fat
withdraws from social activities, especially meals and celebrations involving food
may be depressed, lethargic (lacking in energy), and feel cold a lot
Bulimia
fears weight gain
intensely unhappy with body size, shape, and weight
makes excuses to go to the bathroom immediately after meals
may only eat diet or low-fat foods (except during binges)
regularly buys laxatives, diuretics, or enemas
spends most of his or her time working out or trying to work off calories
withdraws from social activities, especially meals and celebrations involving food
What Causes Eating Disorders?
No one is really sure what causes eating disorders, although there are many theories about why people develop them. Many people who develop an eating disorder are between 13 and 17 years old. This is a time of emotional and physical changes, academic pressures, and a greater degree of peer pressure. Although there is a sense of greater independence during the teen years, teens might feel that they are not in control of their personal freedom and, sometimes, of their bodies. This can be especially true during puberty.
For girls, even though it's completely normal (and necessary) to gain some additional body fat during puberty, some respond to this change by becoming very fearful of their new weight. They might mistakenly feel compelled to get rid of it any way they can.
When you combine the pressure to be like celeb role models with the fact that during puberty our bodies change, it's not hard to see why some teens develop a negative view of themselves.
Many people with eating disorders also can be depressed or anxious, or have other mental health problems such as obsessive-compulsive disorder (OCD). There is also evidence that eating disorders may run in families. Although part of this may be our in genes, it's also because we learn our values and behaviors from our families.
Sports and Eating Disorders
Athletes and dancers are particularly vulnerable to developing eating disorders around the time of puberty, as they may want to stop or suppress growth (both height and weight).
Coaches, family members, and others may encourage teens in certain sports — such as gymnastics, ice-skating, and ballet — to be as thin as possible. Some athletes and runners are also encouraged to weigh less or shed body fat at a time when they are biologically destined to gain it.
Effects of Eating Disorders
Eating disorders are serious medical illnesses. They often go along with other problems such as stress, anxiety, depression, and substance use. People with eating disorders also can have serious physical health problems, such as heart conditions or kidney failure. People who weigh at least 15% less than the normal weight for their height may not have enough body fat to keep their organs and other body parts healthy. In severe cases, eating disorders can lead to severe malnutrition and even death.
With anorexia, the body goes into starvation mode, and the lack of nutrition can affect the body in many ways:
a drop in blood pressure, pulse, and breathing rate
hair loss and fingernail breakage
loss of periods
lanugo hair — a soft hair that can grow all over the skin
lightheadedness and inability to concentrate
anemia
swollen joints
brittle bones
With bulimia, constant vomiting and lack of nutrients can cause these problems:
constant stomach pain
damage to a person's stomach and kidneys
tooth decay (from exposure to stomach acids)
"chipmunk cheeks," when the salivary glands permanently expand from throwing up so often
loss of periods
loss of the mineral potassium (this can contribute to heart problems and even death)
A person with binge eating disorder who gains a lot of weight is at risk of developing diabetes, heart disease, and some of the other diseases associated with being overweight.
The emotional pain of an eating disorder can take its toll, too. When a person becomes obsessed with weight, it's hard to concentrate on much else. Many people with eating disorders become withdrawn and less social. People with eating disorders might not join in on snacks and meals with their friends or families, and they often don't want to break from their intense exercise routine to have fun.
People with eating disorders often spend a lot of mental energy on planning what they eat, how to avoid food, or their next binge, spend a lot of their money on food, hide in the bathroom for a long time after meals, or make excuses for going on long walks (alone) after a meal.
Treatment for Eating Disorders
Fortunately, people with eating disorders can get well and gradually learn to eat normally again. Eating disorders involve both the mind and body. So medical doctors, mental health professionals, and dietitians will often be involved in a person's treatment and recovery.
Therapy or counseling is a critical part of treating eating disorders — in many cases, family therapy is one of the keys to eating healthily again. Parents and other family members are important in helping a person see that his or her normal body shape is perfectly fine and that being excessively thin can be dangerous.
If you want to talk to someone about eating disorders and you don't feel as though you can approach a parent, try talking to a teacher, a neighbor, your doctor, or another trusted adult. Remember that eating disorders are very common among teens. Treatment options depend on each person and their families, but many options are available to help you overcome an eating disorder. Therapy can help you feel in charge again and learn to like your body, just as it is.
