What steps can parents take to keep their teens and pre-teens healthy?

“The most important steps parents can take are to keep the lines of communication open, and to empower teenagers through responsible decision-making and the establishment of trust,” said pediatric specialist Lori B. Feldman-Winter, M.D., M.P.H., Head of the Division of Adolescent Medicine at Cooper University Hospital.

By way of good example, and by encouraging rapport in the home, parents can provide their children with the skills they need to handle the physical, emotional and psychological changes they face during adolescence.

“Maintaining healthy habits shifts from parental control to adolescent control, and parents can model healthy habits by engaging in regular physical activity and establishing healthy eating habits,” Dr. Feldman-Winter said. “The most prevalent health problem affecting adolescents is obesity, followed by trauma due to accidental or intentional injuries, as well as other health concerns that arise from high-risk behaviors.”

For both teens and pre-teens, obesity can trigger health problems, such as diabetes. For pre-teens, emotional issues related to the onset of puberty can occur, particularly among those who go through puberty earlier than their peers. Older teens are at risk for injuries from playing sports and from high-risk behaviors, such as alcohol and/or substance abuse. The late-teen years also are the most common period for mood disorders to become apparent, including anxiety and depression. For adolescent females, problems with menstruation and hormonal imbalances can occur.

“The most important consideration when thinking about the medical needs of adolescents and the way to keep them healthy is their psycho-social history,” Dr. Feldman-Winter said. “Most serious health problems in the adolescent arise from behaviors that lead to accidents and injury. Other risk behaviors may increase the likelihood that the adolescent will become infected, such as with sexually transmitted infections. Since behavior is at the root of many health problems encountered by adolescents, we in Cooper’s Division of Adolescent Medicine spend a lot of time taking detailed history while respecting the autonomy and privacy of our adolescent patients,” Dr. Feldman-Winter said.

With adolescence being a time of substantial physical and behavioral change, parents can be assured that physicians specializing in adolescent medicine can provide insights on, as well early diagnosis and treatment of, health and wellness issues specific to teens and pre-teens.

Related Links

• Health eTalk Web Chat: Keeping Your Adolescent Healthy
• Adolescent Medicine at Cooper

Why this national obsession with thinness? Lori Feldman-Winter, M.D., an Adolescent Medicine expert from the Children’s Regional Hospital at Cooper, agrees with the common theory that exposure to unusually thin images on television and in magazines may contribute to girls’ distorted body images, especially in the face of a growing trend toward obesity. In addition, Dr. Winter suggests that family dynamics also play a role in girls’ self-perception and their ideas about healthy body weight and a healthy diet.

“Today’s families have become very fragmented,” explains Dr. Winter. “The family dinner table is virtually non-existent in some households as evenings often consist of kids being shuttled to games, practices, lessons, etc. This makes it difficult for parents to demonstrate good eating habits and monitor what their kids are eating.” Dr. Feldman-Winter adds that moms’ and dads’ own obsessions with dieting and their weight can have a significant influence on how their children perceive healthy body types, and she stresses that parents need to “walk the walk” when it comes to healthy eating.

Poor body image can lead to many unhealthy, dangerous behaviors, especially for girls. Conseulo Cagande, M.D., an adolescent and adult psychiatrist at Cooper University Hospital, stresses the importance of developing a healthy body image for adolescent girls.

“Girls’ fixation with the appearance of their bodies can contribute to a variety of issues. These include poor eating patterns, an unhealthy pre-occupation with food and self, extreme dieting, lower self-esteem and depression, drug and alcohol abuse, and general physical and mental ill health,” says Dr. Cagande.

In extreme cases, Dr. Cagande explains, these unhealthy behaviors can eventually lead to eating disorders, including anorexia nervosa and bulimia nervosa. “These two medical disorders are serious illnesses in which certain maladaptive patterns of eating take on a life of their own. If left untreated, anorexia nervosa and bulimia can be life threatening,” she warns. Recognition of developing patterns associated with eating disorders along with early treatment can result in much better outcomes.

It’s estimated that up to four percent of females suffer from anorexia nervosa in their lifetimes, according to the National Institutes of Health. People with this disorder view themselves as overweight even though they are very thin. Eating becomes an obsession and unusual eating habits develop, such as avoiding foods and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. People with anorexia may repeatedly weigh themselves and may develop other tactics to control their weight, such as intense and compulsive exercise. Many also purge themselves by vomiting or abusing laxatives, enemas and diuretics.

Bulimia nervosa is slightly more common than anorexia. Like people with anorexia, individuals with bulimia may fear gaining weight, have an obsession with losing weight, and feel intensely dissatisfied with their bodies. The difference may be that because purging usually follows binge-eating episodes, people with bulimia typically weigh within the normal range for their age and height. People with bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet relieved when they purge.

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