Archive for 2011

How to Get Your Teen to Lose Weight, Part 1: How to Begin?

If you’re concerned that your teen is overweight or obese, how on earth do you bring it up?

Weight can be a really hard topic for parents to bring up with their kids. You don’t want to hurt their self-esteem or make them feel badly about themselves- especially during the teenage years, when confidence is so fragile to begin with. Some parents do comment on their teen’s weight directly, which can cause feelings of resentment, defiance, and guilt. Others try to soften the observances by couching them in a joking manner, which is unlikely to be helpful- see Teasing About Weight Hurts.

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School Avoidance in Teens

Help!  I can’t get my teen to go to school.

The good news and the bad news is that this is not an unusual problem.  At least 5% of children refuse to attend school or remain in class an entire day and some studies show that some form of chronic absenteeism affects 28% of youth some time in their lives.


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Teens and carpooling

Remember when you first got your driver’s license?  Did your friends want to ride with you to school, parties, sports events? I know mine did.  I had no idea how dangerous carpooling as a teen could be until I had the frightening experience of spinning a 360 degree turn on a 4 lane road with my best friend in the front passenger seat.  We’d been talking, I was inexperienced behind the wheel, and was distracted. It scared me enough to reconsider driving with a full car that winter.

We recently had a post on teenage driving and its risks. In Washington state, graduated drivers licensing is in place to help increase experience behind the wheel before allowing full driving rights, and decrease teen accidents. But even with the added experience, teens are still at risk when driving, especially if  their car is packed with friends. Read full post »

Helping Eating Disordered Teens Cope with the Holidays

The winter holidays are a time for family, celebration… and eating more than we do the other ten months of the year. I’m exaggerating (kind of), but there’s no doubt that our holidays are focused around foods. Right now, in the Adolescent Medicine office, there are at least three plates of homemade cookies from three different staff members, plus some salted caramels and walnut fudge.

Most people have no problem with having a few delicious cookies, but for teens with eating disorders, the rich foods flying around can cause severe distress. Teens that restrict their diets may not be able to resist a cookie or two, and then suffer intense guilt and shame. Teens that binge-eat may find themselves overwhelmed with- and binging on- the ready sweets and treats that the holidays present.

You may have a teen with an eating disorder, or you may have a relative or friend who does. These are some tips to help make the holidays easier for these teens and their families. My work was cut out for me with this post; our nurse Gail Allen already came up with a patient education flyer to give to families during the holidays, and I am simply paraphrasing her work! Read full post »

Teenage Stepkids

With the divorce rate in the U.S. around 40-50% (depending on how you slice the statistics), many adults are remarrying or re-committing into families where there are already children. Sometimes a remarriage involves taking on the role of parenting teenage stepchildren. Adolescent stepchildren are different from younger stepchildren; they are dealing with the normal adolescent urge to break away from family and create their own identity, even as you come in and change the makeup of their family.

Ideally, you’re starting to work on this long before you become an “official” stepparent. If you’re going to marry a parent and live with their kids, even part of the time, those kids deserve to get to know you well before you actually join the family. This includes not just fun family outings and trips, but spending time with them during their everyday life doing homework, spending a lazy day in, getting into family arguments, or cleaning out the garage.

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Teens and Birth Control: Emergency Contraception


 Birth control for teens is a topic that can be challenging to discuss. Both parents and teens may be uncomfortable discussing such an intimate topic, but open communication is so important. This post on emergency contraception for teens is the second in a series of 3 posts on teens and birth control.

As I’ve mentioned before, the only way to prevent pregnancy 100% of the time is to not have sex at all.  As parents, having open communication with your teens about expectations and family values is an effective way to help your teen wait to have sex until they are older.

Emergency contraception is a backup method that is not meant as a substitute for longer term contraception. Please see my post on hormone containing methods for more information on more effective long-term contraception. Talk with your teen’s doctor if any of them sound like a method of interest or if you have more questions after reading. Read full post »

HIV-Positive Friends, Roommates, and Fellow Students: Not a Problem

Recently the  Milton Hershey School in Pennsylvania denied admission to a 13-year-old applicant. Despite his many academic and personal achievements, this boy was denied admission for fear that his HIV-positive status would “put their children at risk.”

Is this reminding anyone else of Ryan White?   I was absolutely astonished that in this day and age, a school would even think of refusing a child admission because he was HIV-positive. When Ryan White was diagnosed, even the uppermost government health officials were uncertain about HIV contagion and transmission. Now, more than 25 years later, we know much more about the virus. Denying a child the chance for an education because he is HIV-positive is inexcusable.

Let’s go over how HIV is transmitted. We are actually quite lucky that HIV, compared to other viruses, is so hard to catch. There are three main routes: sexual activity, sharing needles, and mother-to-child transmission.

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Teens and birth control: hormone containing methods

Birth control, also known as contraception, for teens is an important topic to discuss. Whenever the subject of birth control comes up in clinic, I can guarantee someone asks the question about safety.  It’s the same question I would ask if a medical provider discussed any new medication with me.  However, birth control also comes with personal stories: a friend who used one form of contraception and gained 20 pounds, or a mother who had an intrauterine device (IUD) and had horrible complications.  The good news is that birth control has had a makeover during the past decade and there are many options that are extremely effect and safe to use.  Hopefully, this blog can serve as an overview and alleviate some fears. To learn more about how birth control is used for medical reasons other than contraception, see our recent post. Today’s post will be the first in a series of 3 posts on birth control and teens. Read full post »

Home for the Holidays

For many parents, this Thanksgiving will be the first time their teen is coming home from college for the holidays. They’ve been living in dorms or apartments, studying, partying, and reveling in their independence, and now the family gets to reunite. It’s something many parents look forward to, but may worry about as well.

Teens in college have been eating, sleeping, studying, and living independently for at least a couple of months. They’ve lived with few rules. How will they behave when back in their old home? Will there be fights, or will they just be thrilled to have someone do their laundry for them?

Of course, every teen is different. But here are some common things that parents notice when teens are home from college.

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The Birth Control Pill: Not Just For Birth Control

A recent study found that 1 in 3 teenage girls using birth control pills (BCPs) are using them reasons other than birth control- such as preventing acne, easing menstrual cramps, or helping with PMS. Despite their name, birth control pills are  useful for many purposes besides birth control!

There are many brands of BCPs, but they fall into two basic categories: the”combination” BCPs, which contain the female hormones estrogen and progesterone, and the “progesterone-only” BCPs (which obviously contain only progesterone.)

If your teen doesn’t have certain medical issues (more about this below), they would be prescribed combination BCPs. They are better at controlling symptoms that a teen would take a BCP for, and also provide better birth control if it’s needed.

Let’s look at what BCPs can do for your teen:

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