Compulsive Exercise

Rachel and her cheerleading team practice three to five times a week. Rachel feels a lot of pressure to keep her weight down - as head cheerleader, she wants to set an example to the team. So she adds extra daily workouts to her regimen. But lately, Rachel has been feeling worn out, and she has a hard time just making it through a regular team practice.

You may think you can't get too much of a good thing, but in the case of exercise, a healthy activity can sometimes turn into an unhealthy compulsion. Rachel is a good example of how an overemphasis on physical fitness or weight control can become unhealthy. Read on to find out more about compulsive exercise and its effects.

Too Much of a Good Thing?

We all know the benefits of exercise, and it seems that everywhere we turn, we hear that we should exercise more. The right kind of exercise does many great things for your body and soul: It can strengthen your heart and muscles, lower your body fat, and reduce your risk of many diseases.

Many teens who play sports have higher self-esteem than their less active pals, and exercise can even help keep the blues at bay because of the endorphin rush it can cause. Endorphins are chemicals that naturally relieve pain and lift mood. These chemicals are released in your body during and after a workout and they go a long way in helping to control stress.

So how can something with so many benefits have the potential to cause harm?

Lots of people start working out because it's fun or it makes them feel good, but exercise can become a compulsive habit when it is done for the wrong reasons.

Some people start exercising with weight loss as their main goal. Although exercise is part of a safe and healthy way to control weight, many people may have unrealistic expectations. We are bombarded with images from advertisers of the ideal body: young and thin for women; strong and muscular for men. To try to reach these unreasonable ideals, people may turn to diets, and for some, this may develop into eating disorders such as anorexia and bulimia. And some people who grow frustrated with the results from diets alone may overexercise to speed up weight loss.

Some athletes may also think that repeated exercise will help them to win an important game. Like Rachel, they add extra workouts to those regularly scheduled with their teams without consulting their coaches or trainers. The pressure to succeed may also lead these people to exercise more than is healthy. The body needs activity but it also needs rest. Overexercising can lead to injuries like fractures and muscle strains.

Are You a Healthy Exerciser?

Fitness experts recommend that teens do at least 60 minutes of moderate to vigorous physical activity every day. Most young people exercise much less than this recommended amount (which can be a problem for different reasons), but some - such as athletes - do more.

Experts say that repeatedly exercising beyond the requirements for good health is an indicator of compulsive behavior. Some people need more than the average amount of exercise, of course - such as athletes in training for a big event. But several workouts a day, every day, when a person is not in training is a sign that the person is probably overdoing it.

People who are exercise dependent also go to extremes to fit activity into their lives. If you put workouts ahead of friends, homework, and other responsibilities, you may be developing a dependence on exercise.

If you are concerned about your own exercise habits or a friend's, ask yourself the following questions. Do you:

• force yourself to exercise, even if you don't feel well?
• prefer to exercise rather than being with friends?
• become very upset if you miss a workout?
• base the amount you exercise on how much you eat?
• have trouble sitting still because you think you're not burning calories?
• worry that you'll gain weight if you skip exercising for a day?

If the answer to any of these questions is yes, you or your friend may have a problem. What should you do?

How to Get Help

The first thing you should do if you suspect that you are a compulsive exerciser is get help. Talk to your parents, doctor, a teacher or counselor, a coach, or another trusted adult. Compulsive exercise, especially when it is combined with an eating disorder, can cause serious and permanent health problems, and in extreme cases, death.

Because compulsive exercise is closely related to eating disorders, help can be found at community agencies specifically set up to deal with anorexia, bulimia, and other eating problems. Your school's health or physical education department may also have support programs and nutrition advice available. Ask your teacher, coach, or counselor to recommend local organizations that may be able to help.

You should also schedule a checkup with a doctor. Because our bodies go through so many important developments during the teen years, guys and girls who have compulsive exercise problems need to see a doctor to make sure they are developing normally. This is especially true if the person also has an eating disorder. Female athlete triad, a condition that affects girls who overexercise and restrict their eating because of their sports, can cause a girl to stop having her period. Medical help is necessary to resolve the physical problems associated with overexercising before they cause long-term damage to the body.

Make a Positive Change

Changes in activity of any kind - eating or sleeping, for example - can often be a sign that something else is wrong in your life. Girls and guys who exercise compulsively may have a distorted body image and low self-esteem. They may see themselves as overweight or out of shape even when they are actually a healthy weight.

Compulsive exercisers need to get professional help for the reasons described above. But there are also some things that you can do to help you take charge again:

• Work on changing your daily self-talk. When you look in the mirror, make sure you find at least one good thing to say about yourself. Be more aware of your positive attributes.
• When you exercise, focus on the positive, mood-boosting qualities.
• Give yourself a break. Listen to your body and give yourself a day of rest after a hard workout.
• Control your weight by exercising and eating moderate portions of healthy foods. Don't try to change your body into an unrealistically lean shape. Talk with your doctor, dietitian, coach, athletic trainer, or other adult about what a healthy body weight is for you and how to develop healthy eating and exercise habits.

Exercise and sports are supposed to be fun and keep you healthy. Working out in moderation will do both.

Binge Eating Disorder

Walker's room is his oasis. It's where he listens to music, does his homework, and talks online with his friends. For the most part, it looks like a typical teen bedroom — except for what's under the bed. That's where Walker keeps his secret stash of snacks and tosses the empty candy wrappers, chip bags, and cookie boxes.

Walker has just polished off a whole package of cookies and a large bag of chips — and he hasn't even finished his homework yet. He's searching for more chips to eat while he does his math. He hates that he's overweight, but he can't seem to stop bingeing. In the back of his mind, he knows that in an hour or so he's going to feel guilty and disgusted with himself, but right now it feels like he just can't stop eating.

Understanding Binge Eating

If you gorged yourself on chocolate during Halloween or ate so much of your grandma's pumpkin pie at Thanksgiving that you had to wear elastic-waist pants afterwards, you know what it feels like to overeat. It's perfectly normal to overeat from time to time — most people do.

Teens are notorious for being hungry a lot. That's because the body demands extra nutrients to support the major growth of muscle and bone that's happening. So if you go through phases where you feel like eating more sometimes, that's usually why and it's absolutely natural.

But binge eating is different from normal appetite increases or overeating from time to time. People with a binge eating problem consume unusually large amounts of food on a regular basis. They often eat quickly, and they don't stop eating when they become full.

Binge eating involves more than just eating a lot. With binge eating, a person feels out of control and powerless to stop eating while he or she is doing it. That's why binge eating is also called compulsive overeating.

People with a binge eating problem may overeat when they feel stressed, upset, hurt, or angry. Many find it comforting and soothing to eat, but after a binge they are likely to feel guilty and sad about the out-of-control eating. Binge eating is often a mixed-up way of dealing with or avoiding difficult emotions.

How Is Binge Eating Different From Other Eating Disorders?

Anorexia nervosa, bulimia nervosa, and binge eating are all considered eating disorders because they involve unhealthy patterns of eating.

Both binge eating and bulimia involve eating excessive amounts of food, feeling out of control while eating, and feeling guilty or ashamed afterward. But bulimia nervosa (sometimes called binge-purge syndrome) is different from binge eating disorder because people with bulimia vomit or use laxatives to try to keep themselves from gaining weight after eating. They may also try to burn off the extra calories by exercising compulsively as a way of making up for overeating. People with binge eating disorder do not have these "purge" characteristics.

Unlike bulimia and binge eating, which involve out-of-control overeating, people with anorexia are preoccupied with thinness and starve themselves to feel more in control. People with anorexia have a distorted body image and believe they're fat — even though they actually may be dangerously thin. Like people with bulimia, some people with anorexia may also exercise compulsively to lose weight.

All three of these eating disorders involve unhealthy eating patterns that begin gradually and build to the point where a person feels unable to control them. All eating disorders can lead to serious health consequences, and all involve emotional distress.

Why Do Some People Binge Eat?

Most experts believe that it takes a combination of things to develop an eating disorder — including a person's genes, emotions, and behaviors (such as eating patterns) learned during childhood.

Some people may be more prone to overeating because of biological reasons. For example, the hypothalamus (the part of the brain that controls appetite) may fail to send proper messages about hunger and fullness. And serotonin, a normal brain chemical that affects mood and some compulsive behaviors, may also play a role in binge eating.

In most cases, the unhealthy overeating habits that develop into binge eating start during childhood, sometimes as a result of eating habits learned in the family. It's normal to associate food with nurturing and love. But some families may overuse food as a way to soothe or comfort. When this is the case, kids may grow up with a habit of overeating to soothe themselves when they're feeling pressured because they may not have learned healthier ways to deal with stress. Some kids may grow up believing that unhappy or upsetting feelings should be suppressed and may use food to quiet these emotions.

Both guys and girls can have eating disorders. Anorexia and bulimia appear to be more common among girls. But binge eating seems to be just as likely to affect guys as girls.

It's hard to know just how many teens may have a binge eating problem. Because people often feel guilty or embarrassed about the out-of-control eating, many don't talk about it or seek help.

What Are the Signs a Person Has a Binge Eating Problem?

Someone with a binge eating problem might:

• eat much more rapidly than normal
• eat until uncomfortably full
• eat large amounts of food even when not hungry
• eat alone because of embarrassment
• feel disgusted, depressed, or guilty after a binge eating episode
• gain weight excessively

A person who binge eats usually does so more than twice a week over a period of 6 months or more, and often feels upset, embarrassed, ashamed, or angry about the out-of-control eating.

Getting Help

For many people with binge eating problems, it can seem hard to reach out for help because of the embarrassment they may feel and the stigma that society places on overeating and being overweight. Many people don't get treatment for binge eating until they're adults and trying to lose weight. But getting professional help as a teen can reduce some of the long-term health problems.

People with eating disorders need professional help because problems like binge eating can be caused by brain chemistry and other things that are beyond someone's control. Doctors, counselors, and nutrition experts often work together to help those with eating disorders manage their eating, weight, and feelings.

Nutrition specialists or dietitians can help them learn about healthy eating behaviors, nutritional needs, portion sizes, metabolism, and exercise. They can also help design an eating plan that's specially designed for someone's needs and help the person stick with it and make progress.

Unlike a problem with drugs or alcohol where part of the treatment is avoiding the substance altogether, people still have to eat. This can make it harder for someone with a binge eating problem to overcome it because the temptation to overeat is always there. So part of dealing with a binge eating disorder is learning how to have a healthy relationship with food.

Psychologists and other therapists can help people learn healthy ways of coping with emotions, thoughts, stress, and other things that might contribute to a person's eating problem.

Sometimes certain family members can help by talking with the person and his or her therapist about shared eating patterns, feelings (and beliefs about how feelings should be expressed), and family relationships. Doing this can help someone examine how certain eating patterns may have been influenced by family — and to stop the patterns that aren't healthy.

Depending on what's behind someone's binge eating, doctors may prescribe medications along with therapy and nutrition advice.

People with binge eating disorder may find it helpful to surround themselves with supportive family members and friends. It's best to avoid people who make negative comments about eating or weight because they can add to someone's feelings of self-criticism, making matters worse.

Another thing that can help build self-confidence and take a person's mind off eating is trying a new extracurricular activity or hobby. Finding a way to express feelings, such as through music, art, dance, or writing, can also help someone deal with difficult emotions in a healthy way.

As with any eating disorder, there is no quick fix for binge eating. Treatment can take several months or longer while someone learns a healthier approach to food. But with the right guidance, commitment, and practice, it is possible to overcome old habits and replace them with healthier behaviors.

A Guide to Eating for Sports

There's a lot more to eating for sports than chowing down on carbs or chugging sports drinks. The good news is that eating to reach your peak performance level likely doesn't require a special diet or supplements. It's all about working the right foods into your fitness plan in the right amounts. Here are some basics.

Eat Extra for Excellence

Teen athletes have unique nutrition needs. Because athletes work out more than their less-active peers, they generally need extra calories to fuel both their sports performance and their growth. Depending on how active they are, teen athletes may need anywhere from 2,000 to 5,000 total calories per day to meet their energy needs.

So what happens if teen athletes don't eat enough? Their bodies are less likely to achieve peak performance and may even break down rather than build up muscles. Athletes who don't take in enough calories every day won't be as fast and as strong as they could be. And extreme calorie restriction could lead to growth problems and other serious health risks for both girls and guys.

Since teen athletes need extra fuel, it's usually a bad idea for them to diet. Athletes in sports where weight is emphasized — such as wrestling, swimming, dance, or gymnastics — might feel pressure to lose weight, but they need to weigh that choice with the possible negative side effects mentioned above. If a coach, gym teacher, or teammate says that you need to go on a diet, talk to your doctor first or visit a dietitian who specializes in teen athletes. If a health professional you trust agrees that it's safe to diet, he or she can work with you to develop a plan that allows you to perform your best and lose weight.

Eat a Variety of Foods

You may have heard about "carb loading" before a game. But when it comes to powering your game for the long haul, it's a bad idea to focus on only one type of food. Carbohydrates are an important source of fuel, but they're only one of many foods an athlete needs. It also takes vitamins, minerals, protein, and fats to stay in peak playing shape.

Muscular Minerals and Vital Vitamins

Calcium helps build the strong bones that athletes depend on, and iron carries oxygen to muscles. Most teens don't get enough of these minerals, and that's especially true of teen athletes because their needs may be even higher than those of other teens.

To get the iron you need, eat lean red meats (meats with not much fat on them); grains that are fortified with iron; and green, leafy vegetables. Calcium — a must for protecting against stress fractures — is found in dairy foods, such as low-fat milk, yogurt, and cheese.

In addition to calcium and iron, you need a whole bunch of other vitamins and minerals that do everything from help you access energy to keep you from getting sick. Eating a balanced diet, including lots of different fruits and veggies, should provide the vitamins and minerals needed for good health and sports performance.

Protein Power

Athletes need slightly more protein than less-active teens, but most teen athletes get plenty of protein through regular eating. It's a myth that athletes need a huge daily intake of protein to build large, strong muscles. Muscle growth comes from regular training and hard work — not popping a pill. And taking in too much protein can actually harm the body, causing dehydration, calcium loss, and even kidney problems.

Good sources of protein are fish, lean meats and poultry, eggs, dairy, nuts, soy, and peanut butter.

Carb Charge

Carbohydrates provide athletes with an excellent source of fuel. Cutting back on carbs or following low-carb diets isn't a good idea for athletes because restricting carbohydrates can cause a person to feel tired and worn out, which ultimately affects performance.

Nutrition experts advise people to choose whole grains (such as brown rice, oatmeal, sweet potatoes, whole wheat bread, and starchy vegetables like corn and peas) more often than their more processed counterparts like white rice and white bread. That's because whole grains provide both the energy athletes need to perform and the fiber and other nutrients they need to be healthy. Sugary carbs such as candy bars or sodas are less healthy for athletes because they don't contain any of the other nutrients you need. In addition, eating candy bars or other sugary snacks just before practice or competition can give athletes a quick burst of energy and then leave them to "crash" or run out of energy before they've finished working out.

Fat Fuel

Everyone needs a certain amount of fat each day, and this is particularly true for athletes. That's because active muscles quickly burn through carbs and need fats for long-lasting energy. Like carbs, not all fats are created equal. Experts advise athletes to concentrate on healthier fats, such as the unsaturated fat found in most vegetable oils. Choosing when to eat fats is also important for athletes. Fatty foods can slow digestion, so it's a good idea to avoid eating these foods for a few hours before and after exercising.

Shun Supplements

Protein supplements and energy bars don't do a whole lot of good, but they won't really do you much harm either. But other types of supplements can really do some damage.

Anabolic steroids can seriously mess with a person's hormones, causing side effects like testicular shrinkage and baldness in guys and facial hair growth in girls. Steroids can cause mental health problems, including depression and serious mood swings. Some over-the-counter supplements contain hormones that are related to testosterone (such as dehydroepiandrosterone, or DHEA for short). These supplements have similar side effects to anabolic steroids. These and other sports supplements (like creatine, for example) have not been tested in people younger than 18. So the risks of taking them are not yet known.

Salt tablets are another supplement to watch out for. People take them to avoid dehydration, but salt tablets can actually lead a person to become dehydrated. In large amounts, salt can cause nausea, vomiting, cramps, and diarrhea and may damage the lining of the stomach. In general, you are better off drinking fluids in order to maintain hydration. Any salt you lose in sweat can usually be made up in one normal meal after exercise.

Ditch Dehydration

Speaking of dehydration, water is just as important to unlocking your game power as food. When you sweat during exercise, it's easy to become overheated, headachy, and worn out — especially in hot or humid weather. Even mild dehydration can affect an athlete's physical and mental performance.

There's no one-size-fits-all formula for how much water to drink. How much fluid each person needs depends on the individual's age, size, level of physical activity, and environmental temperature.

Experts recommend that athletes drink before and after exercise as well as every 15 to 20 minutes during exercise. In general, most athletes need 1–2 cups prior to exercise and ½ to 1 cup every 15 to 20 minutes throughout exercise. Don't wait until you feel thirsty, because thirst is a sign that your body has needed liquids for a while. But don't force yourself to drink more fluids than you may need either. It's hard to run when there's a lot of water sloshing around in your stomach!

If you like the taste of sports drinks better than regular water, then it's OK to drink them. But it's important to know that a sports drink is really no better for you than water unless you are exercising for more than 90 minutes or in really hot weather. The additional carbohydrates and electrolytes may improve performance in these conditions, but otherwise your body will do just as well with water.

Avoid drinking carbonated drinks or juice because they could give you a stomachache while you're competing.

Caffeine

Caffeine is a diuretic, meaning it causes a person to urinate (pee) more. It's not clear whether this causes dehydration or not, but to be safe, it's probably a good idea to stay away from too much caffeine if you'll be exercising in hot weather.

Although some studies have found that caffeine may help with endurance sports performance, it's good to weigh any benefits against potential problems. Too much caffeine can leave an athlete feeling anxious or jittery. It can also cause trouble sleeping. All of these can drag down a person's sports performance. Plus, taking certain medications — including supplements — can make caffeine's side effects seem even worse.

Game-Day Eats

Most of your body's energy on game day will come from the foods you've eaten over the past several days. But you can boost your performance even more by paying attention to the food you eat on game day. Strive for a game-day diet rich in carbohydrates, moderate in protein, and low in fat. Here are some guidelines on what to eat and when:

• Eat a meal 2 to 4 hours before the game or event: Combine a serving of low-fiber fruit or vegetable (such as juice, plums, melons, cherries, or peaches) with a protein and carbohydrate meal (like a turkey or chicken sandwich, cereal and milk, or chicken noodle soup and yogurt).
• Eat a snack less than 2 hours before the game: If you haven't had time to have a pre-game meal, be sure to have a light snack such as crackers, a bagel, or low-fat yogurt.

It's a good idea to avoid eating anything for the hour before you compete or have practice because digestion requires energy — energy that you want to use to win. Also, eating too soon before any kind of activity can leave food in the stomach, making you feel full, bloated, crampy, and sick. Everyone is different, so get to know what works best for you. You may want to experiment with meal timing and how much to eat on practice days so that you are better prepared for game day.

Want to get an eating plan personalized for you? The U.S. government has developed a website, MyPyramid, that tells a person how much to eat from different food groups based on age, gender, and activity level.

Bursitis

Andy's a good tennis player. Correction, Andy is a great tennis player. He loves the competition and intensity of the game and is known for his dominating serve.

Recently Andy developed a sharp pain in his elbow. At first he thought nothing of it and continued his training, but the pain became unbearable. The pain was so bad he went to see his doctor, who informed him he had elbow bursitis.

What Is Bursitis?

From your head down to your big toes, your body has lots of differently shaped and sized joints. Many have something in common near the area of the joint — a customized fluid sac that provides cushioning for movement and pressure. These small cushions are known as bursae (a single one is called a bursa).

If a bursa becomes irritated, either by a direct hit or from a nearby joint repeating the same movement (like a tennis serve), then bursitis can occur. People can also get bursitis when the body has to change its balance or movement to adapt to differences; for example, if a person has one leg that's longer than the other.

Where Does Bursitis Occur?

Bursitis, especially in teens, is often likely to happen because of sports-related injuries, usually from repeated use of a particular joint or trauma from a direct hit in a contact sport. It's not only sporty types who get bursitis, though. It can sometimes be caused by other problems, such as arthritis or a bacterial infection of the bursa.

Here are some of the areas in which teens most commonly get bursitis:

• Elbow. Because the elbow is an essential part of many activities, like throwing a ball or swinging a tennis racket, elbow bursitis is one of the most common types of bursitis in teens.
• Knee. Bursitis in the knee can be the result of falling directly on the knee or any activity that requires long periods of kneeling.
• Hip. Bursitis of the hip is often associated with running injuries.
• Shoulder. Bursitis of the shoulder can be the result of something as simple as an awkward fall or as complicated as a rotator cuff injury (the rotator cuff keeps the shoulder secure).
• Ankle. Someone who goes overboard jumping, running, or walking can get ankle bursitis. Just wearing the wrong type of shoes for a particular activity can lead to ankle bursitis.

How to Detect Bursitis

Bursitis can cause a number of different symptoms:

• Pain and sensitivity in or around a joint. This is the most common and obvious sign that a person may have bursitis.
• Difficulty moving the affected joint. This happens because the bursa has swollen and made it tough to move the joint properly.
• Reddening of the skin. The inflamed bursa may cause the skin around the joint to change color.
• Burning. The irritated bursa can cause the skin to sting and feel warmer than usual.

How to Treat Bursitis

In most cases, you will probably be able to treat bursitis at home.

The key part of at-home treatment, as with many injuries, is rest. Besides resting the affected joint or region, to help get rid of bursitis try:

• Ice ice, baby. Ice should be used on the bursitis while the inflamed area is still warm to the touch. Ice can be applied several times a day for up to 20 minutes. Icing the area will also help to lessen the swelling that can occur with bursitis.
• The heat is on. Putting heat on the joint when it is no longer warm to the touch can reduce the pain. As with ice, don't apply heat for more than 20 minutes at a time.
• Elevation. Raising a joint that is swollen for any reason can help to reduce swelling. That goes for bursitis, too. If possible, elevate the affected joint so it is above the level of the heart.
• Under pressure. Avoid placing pressure on the joint. This will aggravate bursitis rather than help it to heal.
• Just like a pill. Anti-inflammatory drugs like ibuprofen may help.

Avoiding Bursitis

Bursitis is often the result of a hard impact on a joint or overworking a joint, and sometimes these injuries are unavoidable. But there are some steps you can take to avoid getting bursitis:

• Stay in shape. Working out regularly strengthens muscles and joints, which helps protect against bursitis.
• Don’t overdo it. Too much of anything can be bad, and the same goes for overworking joints.
• Start and stop workouts properly. One of the best ways to prevent bursitis is by working out properly. Warming up and cooling down are essential parts of working out and should never be skipped. Gradually starting and stopping your workout is less stressful for your joints and body.
• Stretch it out. Stretching not only helps improve flexibility but it is also useful in preventing bursitis.
• Mix it up. Whether you're rotating exercises while lifting weights or just taking a breather from a strenuous activity, your joints will thank you.
• Better padded than sorry. Use cushions on wooden or metal chairs and kneepads when kneeling on hardwood or concrete floors to help reduce the risk of developing bursitis. Also avoid putting extreme amounts of pressure or weight directly on joints.
• Keep it moving. Don't stay planted on your butt, knees, or other joints for long periods of time. Even if it's for a few minutes, get up and move around.

If you realize that a particular activity causes you to get bursitis, stop doing it and talk to your doctor or coach about safer methods.

Be on the lookout for bursitis if you participate in a sport. The best way to avoid it is by using the proper techniques and equipment. If your bursitis was caused by something like ill-fitting shoes or other equipment, replace that equipment with something that fits you better.

5 Facts About Goal Setting

These practical tips on goal setting can help make it easier to set and reach goals:

1. Specific, realistic goals work best. When it comes to making a change, the people who succeed are those who set realistic, specific goals. "I'm going to recycle all my plastic bottles, soda cans, and magazines" is a much more doable goal than "I'm going to do more for the environment." And that makes it easier to stick with.
2. It takes time for a change to become an established habit. It will probably take a couple of months before any changes — like getting up half an hour early to exercise — become a routine part of your life. That's because your brain needs time to get used to the idea that this new thing you're doing is part of your regular routine.
3. Repeating a goal makes it stick. Say your goal out loud each morning to remind yourself of what you want and what you're working for. (Writing it down works too.) Every time you remind yourself of your goal, you're training your brain to make it happen.
4. Pleasing other people doesn't work. The key to making any change is to find the desire within yourself — you have to do it because you want it, not because a girlfriend, boyfriend, coach, parent, or someone else wants you to. It will be harder to stay on track and motivated if you're doing something out of obligation to another person.
5. Roadblocks don't mean failure. Slip-ups are actually part of the learning process as you retrain your brain into a new way of thinking. It may take a few tries to reach a goal. But that's OK — it's normal to mess up or give up a few times when trying to make a change. So remember that everyone slips up and don't beat yourself up about it. Just remind yourself to get back on track.

5 Ways to Spot a Fad Diet

Lots of today's popular diets take advantage of our desire to drop weight quickly. Unfortunately, though, "quick-fix" diets don't work.

Here are 5 clues that a diet may be more about empty promises than real results:

1. The diet is based on drastically cutting back calories. Starvation-type diets that require the body to fast often promise quick results. But our bodies simply aren't designed to drop pounds quickly. In fact, doctors say it's nearly impossible for a healthy, normally active person to lose more than 2 to 3 pounds per week of actual fat, even on a starvation diet.
   
   Here's the trick that very low-calorie diets rely on: The body's natural reaction to near-starvation is to dump water. So most, if not all, of the weight lost on quick-weight-loss diets is not fat — it's just water. And the body sucks this lost water back up like a sponge once a person starts eating normally again.
   
   
2. The diet is based on taking special pills, powders, or herbs. These are usually just gimmicks — and the only thing they slim down is your wallet.
   
   Many diet pills contain laxatives or diuretics that force a person's body to eliminate more water. Just like restricted-calorie diets, the weight lost with these supplements is mostly water, not fat.
   
   Other supplements claim that their ingredients speed up metabolism; suppress appetite; or block the absorption of fat, sugars, or carbohydrates. For most diet supplements, there's no reliable scientific research to back up their claims. And doctors consider diet supplements risky for teens because not much is known about how the ingredients affect the growing body.
   
   
3. The diet tells you to eat only specific foods or foods in certain combinations. There's no reliable scientific proof that combining certain foods works. And limiting the foods you eat means you might not get all the nutrition you need.
   
   
4. The diet makes you completely cut out fat, sugar, or carbs. Depriving our bodies of needed food groups is a bad idea (especially when they're still growing). It's better to eat smaller portions in well-rounded meals (meals that contain servings of protein, grains, fruits, and veggies). When your body gets the right balance of nutrition, it's less likely to send you willpower-busting cravings! Eating smaller portions also helps you set good eating habits that will help you keep the weight off.
   
5. The diet requires you to skip meals or replace meals with special drinks or food bars. As with diets that ban certain food groups, skipping or substituting meals can mean you don't get the nutrition needed to support healthy development. Plus, you miss out on the enjoyment of sharing a satisfying meal with friends or family.

5 Ways to Reach a Healthy Weight

Diets aren't the way to go when it comes to losing weight. That's because they create temporary eating patterns — and, therefore, temporary results. Most dieters gain back any lost weight when they go back to their old eating habits. So what's the best way to drop excess weight? Create a new normal!

Weight loss is most likely to be successful when people change their habits, replacing old, unhealthy ones with new, healthy behaviors. Here are 5 ways to make that happen:

1. Exercise. Regular physical activity burns calories and builds muscle — both of which help you look and feel good and keep weight off. Walking the family dog, cycling to school, and doing other things that increase your daily level of activity can all make a difference. If you want to burn more calories, increase the intensity of your workout and add some strength exercises to build muscle. The more muscle you have, the more calories you burn, even when you aren't exercising.
2. Reduce screen time. One reason people get less exercise these days is because of an increase in "screen time" — the amount of time spent watching TV, looking at the computer, or playing video games. Limit recreational screen time to less than 2 hours per day. If you're with friends at the mall, you're getting more exercise than if you're IMing them from your room.
3. Watch out for portion distortion. Serving sizes have increased over the past 10 years, and these extra calories contribute to obesity. Another key factor in weight gain is that more people drink sugary beverages, such as sodas, juice drinks, and sports drinks. So choose smaller portions (or share restaurant portions) and go for water or low-fat milk instead of soda.
4. Eat 5 servings of fruits and veggies a day. Fruits and veggies are about more than just vitamins and minerals. They're also packed with fiber, which means they fill you up. And when you fill up on fruits and veggies, you're less likely to overeat when it comes to high-calorie foods like chips or cookies.
5. Don't skip breakfast. Breakfast kick-starts your metabolism, burning calories from the get-go and giving you energy to do more during the day. People who skip breakfast often feel so hungry that they eat more later on. So they get more calories than they would have if they ate breakfast. In fact, people who skip breakfast tend to have higher BMIs than people who eat breakfast.

How Much Sleep Do I Need?

Most teens need about 8½ to more than 9 hours of sleep each night. The right amount of sleep is essential for anyone who wants to do well on a test or play sports without tripping over their feet. Unfortunately, though, many teens don't get enough sleep.

Why Aren't Teens Getting Enough Sleep?

Until recently, teens were often given a bad rap for staying up late, oversleeping for school, and falling asleep in class. But recent studies show that adolescent sleep patterns actually differ from those of adults or kids.

These studies show that during the teen years, the body's circadian rhythm (sort of like an internal biological clock) is temporarily reset, telling a person to fall asleep later and wake up later. This change in the circadian rhythm seems to be due to the fact that the brain hormone melatonin is produced later at night for teens than it is for kids and adults. This can make it harder for teens to fall asleep early.

These changes in the body's circadian rhythm coincide with a time when we're busier than ever. For most teens, the pressure to do well in school is more intense than when they were kids, and it's harder to get by without studying hard. And teens also have other time demands — everything from sports and other extracurricular activities to fitting in a part-time job to save money for college.

Early start times in some schools may also play a role in this sleep deficit. Teens who fall asleep after midnight may still have to get up early for school, meaning that they may only squeeze in 6 or 7 hours of sleep a night. A couple hours of missed sleep a night may not seem like a big deal, but can create a noticeable sleep deficit over time.

Why Is Sleep Important?

This sleep deficit impacts everything from a person's ability to pay attention in class to his or her mood. Research shows that more than 20% of high school students fall asleep in class, and experts have been able to tie lost sleep to poorer grades. Lack of sleep also damages teens' ability to do their best in athletics.

Slowed responses and concentration from lack of sleep don't just affect school or sports performance, though. The fact that sleep deprivation slows reaction times can be life threatening for people who drive. The National Highway Safety Traffic Administration estimates that 1,500 people are killed every year in crashes caused by drivers between the ages of 15 and 24 who are simply tired. (More than half of the people who cause crashes because they fall asleep at the wheel are under the age of 26.)

Lack of sleep has also been linked to emotional troubles, such as feelings of sadness and depression. Sleep helps keep us physically healthy, too, by slowing our body's systems enough to re-energize us after everyday activities.

How Do I Know if I'm Getting Enough?

Even if you think you're getting enough sleep, you may not be. Here are some of the signs that you may need more sleep:

• difficulty waking up in the morning
• inability to concentrate
• falling asleep during classes
• feelings of moodiness and even depression

How Can I Get More Sleep?

Recently, some researchers, parents, and teachers have suggested that middle- and high-school classes begin later in the morning to accommodate teens' need for more sleep. Some schools have already implemented later start times. You and your friends, parents, and teachers can lobby for later start times at your school, but in the meantime you'll have to make your own adjustments.

Here are some things that may help you to sleep better:

• Set a regular bedtime. Going to bed at the same time each night signals to your body that it's time to sleep. Waking up at the same time every day can also help establish sleep patterns. So try to stick to your sleep schedule even on weekends. Don't go to sleep more than an hour later or wake up more than 2 to 3 hours later than you do during the week.
• Exercise regularly. Try not to exercise right before bed, though, as it can rev you up and make it harder to fall asleep. Many sleep experts believe that exercising 5 or 6 hours before bedtime (in late afternoon) may actually help a person sleep.
• Avoid stimulants. Don't drink beverages with caffeine, such as soda and coffee, after 4 PM. Nicotine is also a stimulant, so quitting smoking may help you sleep better. And drinking alcohol in the evening can also cause a person to be restless and wake up during the night.
• Relax your mind. Avoid violent, scary, or action movies or television shows right before bed — anything that might set your mind and heart racing. Reading books with involved or active plots may also keep you from falling or staying asleep.
• Unwind by keeping the lights low. Light signals the brain that it's time to wake up. Staying away from bright lights (including computer screens!), as well as meditating or listening to soothing music, can help your body relax.
• Don't nap too much. Naps of more than 30 minutes during the day may keep you from falling asleep later.
• Avoid all-nighters. Don't wait until the night before a big test to study. Cutting back on sleep the night before a test may mean you perform worse than you would if you'd studied less but got more sleep.
• Create the right sleeping environment. Studies show that people sleep best in a dark room that is slightly on the cool side. Close your blinds or curtains (and make sure they're heavy enough to block out light) and turn down the thermostat in your room (pile on extra blankets or wear PJs if you're cold). Lots of noise can be a sleep turnoff, too.
• Wake up with bright light. Bright light in the morning signals to your body that it's time to get going.

Body Image and Self-Esteem

I'm fat. I'm too skinny. I'd be happy if I were taller, shorter, had curly hair, straight hair, a smaller nose, bigger muscles, longer legs.

Do any of these statements sound familiar? Are you used to putting yourself down? If so, you're not alone. As a teen, you're going through a ton of changes in your body. And as your body changes, so does your image of yourself. Lots of people have trouble adjusting, and this can affect their self-esteem.

Why Are Self-Esteem and Body Image Important?

Self-esteem is all about how much people value themselves, the pride they feel in themselves, and how worthwhile they feel. Self-esteem is important because feeling good about yourself can affect how you act. A person who has high self-esteem will make friends easily, is more in control of his or her behavior, and will enjoy life more.

Body image is how a person feels about his or her own physical appearance.

For many people, especially people in their early teens, body image can be closely linked to self-esteem. That’s because as kids develop into teens, they care more about how others see them.

What Influences a Person’s Self-Esteem?

Puberty

Some teens struggle with their self-esteem when they begin puberty because the body goes through many changes. These changes, combined with a natural desire to feel accepted, mean it can be tempting for people to compare themselves to others. They may compare themselves to the people around them or to actors and celebs they see on TV, in movies, or in magazines.

But it’s impossible to compare ourselves to others because the changes that come with puberty are different for everyone. Some people start developing early; others are late bloomers. Some get a temporary layer of fat to prepare for a growth spurt, others fill out permanently, and others feel like they stay skinny no matter how much they eat. It all depends on how our genes have programmed our bodies to act.

The changes that come with puberty can affect how both girls and guys feel about themselves. Some girls may feel uncomfortable or embarrassed about their maturing bodies. Others may wish that they were developing faster. Girls may feel pressure to be thin but guys may feel like they don’t look big or muscular enough.

Outside Influences

It’s not just development that affect self-esteem, though. Lots of other factors (like media images of skinny girls and bulked-up guys) can affect a person’s body image too.

Family life can sometimes influence a person’s self-esteem. Some parents spend more time criticizing their children and the way they look than praising them. This criticism may reduce a person’s ability to develop good self-esteem.

People may also experience negative comments and hurtful teasing about the way they look from classmates and peers. Sometimes racial and ethnic prejudice is the source of such comments. Although these comments often come from ignorance on the part of the person who makes them, sometimes they can affect a person's body image and self-esteem.

Healthy Self-Esteem

If you have a positive body image, you probably like and accept yourself the way you are. This healthy attitude allows you to explore other aspects of growing up, such as developing good friendships, growing more independent from your parents, and challenging yourself physically and mentally. Developing these parts of yourself can help boost your self-esteem.

A positive, optimistic attitude can help people develop strong self-esteem. For example, saying, "Hey, I'm human," instead of "Wow, I'm such a loser," when you've made a mistake. Or not blaming others when things don't go as expected.

Knowing what makes you happy and how to meet your goals can help you feel capable, strong, and in control of your life. A positive attitude and a healthy lifestyle (such as exercising and eating right) are a great combination for building good self-esteem.

Tips for Improving Your Body Image

Some people think they need to change how they look or act to feel good about themselves. But actually all you need to do is change the way you see your body and how you think about yourself.

The first thing to do is recognize that your body is your own, no matter what shape, size, or color it comes in. If you are very worried about your weight or size, check with your doctor to verify that things are OK. But it is no one's business but your own what your body is like — ultimately, you have to be happy with yourself.

Next, identify which aspects of your appearance you can realistically change and which you can’t. Everyone (even the most perfect-seeming celeb) has things about themselves that they can't change and need to accept — like their height, for example, or their shoe size.

If there are things about yourself that you want to change and can (such as how fit you are), do this by making goals for yourself. For example, if you want to get fit, make a plan to exercise every day and eat nutritious foods. Then keep track of your progress until you reach your goal. Meeting a challenge you set for yourself is a great way to boost self-esteem!

When you hear negative comments coming from within yourself, tell yourself to stop. Try building your self-esteem by giving yourself three compliments every day. While you're at it, every evening list three things in your day that really gave you pleasure. It can be anything from the way the sun felt on your face, the sound of your favorite band, or the way someone laughed at your jokes. By focusing on the good things you do and the positive aspects of your life, you can change how you feel about yourself.

Where Can I Go if I Need Help?

Sometimes low self-esteem and body image problems are too much to handle alone. A few teens may become depressed, lose interest in activities or friends — and even hurt themselves or resort to alcohol or drug abuse. If you’re feeling this way, it can help to talk to a parent, coach, religious leader, guidance counselor, therapist, or an adult friend. A trusted adult — someone who supports you and doesn’t bring you down — can help you put your body image in perspective and give you positive feedback about your body, your skills, and your abilities.

If you can't turn to anyone you know, call a teen crisis hotline (check the yellow pages under social services). The most important thing is to get help if you feel like your body image and self-esteem are affecting your life.

Fitness: Liz's Story

I've played field hockey since the eighth grade. I am now a varsity player entering my senior year of high school, but I have to admit that I wasn't always physically fit. I was a scrawny little kid who was always the shortest and most petite in my class. My mom had always feared that if I played competitive sports, I'd get hurt by aggressive players. So I wasn't very athletically involved during my childhood.

From Humiliated to Motivated

When I entered middle school, a lot of my friends were signing up for the school's sports teams. One of my friends convinced me to try out for the soccer team with her. I had played a little bit of soccer before, so I figured that it wouldn't be too bad since I already knew the rules and how to dribble, pass, and shoot. On the first day of tryouts, I entered the field feeling quite optimistic until the coach told us to run laps for warm-up.

Bells and whistles went off in my head because I knew that I could not run for very long without getting really tired. As I struggled to keep up with the team, I found myself falling farther and farther behind until I was the last one to finish. Before we could even get a water break, the coach then made us do sprints back and forth across the field! I was so exhausted that by the time we did dribbling and passing drills I barely had any strength left to kick the ball!

After tryouts were over, my name never made it on the list. I was disappointed, but at the same time, I expected it. It was at that moment that I knew I had to do something about my health and fitness. I didn't want to be humiliated like that again.

When springtime rolled around, I made a big decision to sign up for the track and field team. People thought I was crazy because I ran a slow 11-minute mile in gym class, but I was determined to get into shape and improve my mile time. The first day of practice was one of the hardest workouts I've ever had. It was a lot of running for me, especially since I decided to participate in the long-distance events.

Fortunately, I wasn't the only slow runner trying to get into shape. A few others were on the same level as me with a similar goal. Day after day we supported and cheered each other on during practices and meets. As the season progressed, I found that I could run longer, faster, and without as much pain as I used to. One of the happiest days of my life was the last meet of the season when my mile time was 9 minutes. I could not believe that I had cut my time down by 2 minutes in just one season! It was painful and a lot of work, but the results were definitely worth it.

Eighth grade soon rolled around and I was feeling really confident about trying out for another fall sport. Instead of attempting soccer a second time, I decided to give field hockey a try. Again, the coach instructed us to run a lot of laps and sprints. This time, I was well prepared. After a week of tryouts, I was ecstatic to see that my name made it on the list.

I was inspired. I even took up kung-fu lessons in addition to being on both the track and field and hockey teams. Being in shape helped me feel energized, flexible, and strong. I also felt accomplished: My best mile time ever was 6 1/2 minutes - a long way from the 11 minutes that I started with.

Junior-Year Setbacks

After I got fit I learned another important lesson: Once you do get into shape, don't stop or give up!

In high school, juggling all my athletic activities and schoolwork during my freshman and sophomore years was challenging but not impossible. But then junior year rolled around and I had the added responsibilities of planning for college, scholarships, PSATs, SATs, and finding a job so I could buy gas for my car.

It became almost impossible to manage my time. The job gave me gas money, but it wore me out so much that I would often come home at night exhausted. Halfway through the year, I gave up some of my commitments to focus on priorities: Since I want to go to art school, I decided to spend more time on my artwork and my academics and less time on sports. I quit taking kung-fu lessons after 3 years of training and I quit track early in my fifth season. I knew my fitness would suffer, but I pledged to run on weekends and whenever I had free time.

Unfortunately, I didn't keep my own promise. When I did have free time, I spent it going out with friends or catching up on sleep. I could feel my body getting more and more sluggish, but I kept telling myself that I would run the next day. I kept putting off exercising, and eventually I found myself stressed out and moody. My body kept sending signals that I wasn't healthy, but I ignored them. When it came to the point that going up the stairs in my house became tiring, I realized that - busy or not - exercise had to be a priority.

Getting back into shape was extremely hard. When I was on the track team, I could run for miles. Now running for just 15 minutes left me really tired. It was slow and painful, and yet at the same time, I was feeling better and stronger again. Although I may never be able to get back into the tip-top shape I used to be in, I've found that even a little exercise makes a difference. Staying fit and healthy is one of the best things I can do for my body.

Choosing the Right Sport for You

Corey and Angie, twin brother and sister, enjoy playing all kinds of outdoor games and sports with their friends. They especially love playing pickup games of basketball and touch football. On particularly nice days, Corey and Angie have been known to kick around the soccer ball, toss around the baseball, or go on long runs.

In just a month the twins will be high school freshmen and neither can figure out which sport to try out for in the fall. Corey is deciding between football, soccer, and cross-country. Angie is debating whether to try her hand at a sport she has never played, like field hockey, or go with one she knows, like soccer or cross-country. They're facing a dilemma a lot of teens face — which sports to play and which sports to give up.

So Many Sports, Only One You!

For some people, choosing which sports to pursue throughout high school is hard because they have never really played an organized sport before and aren't sure what they'll most enjoy. For others it's a tough decision because their friends don't like to play the same sports.

No matter what your sports dilemma is, you have to make the decision that is best for you. If you're great at soccer but would rather play football because you think it's more fun, then give the pigskin a go (just make sure it's cool with mom and dad)!

Sports are meant to be fun. If there is a sport you really enjoy but you aren't sure if you can make the team, try out anyway. What's the worst that can happen? If you get cut you can always try another sport. And sports like cross-country and track don't typically cut participants from the team. You can still participate even if you're not on the meet squad.

Every Now and Then There's an "I" in Team

Some sports, like lacrosse or field hockey, require every person on the field to be on the same page. Sure, certain people stand out more than others but superstars don't necessarily make a good team!

Sports like tennis, track and field, cross-country, swimming, gymnastics, and wrestling are all sports where individual performances are tallied into team scores. Of course there are exceptions, like relays in track and swimming, but for the most part it's possible to win a solo event in these sports and still have your team lose or vice-versa.

No one knows you better than you do. Maybe you enjoy the spotlight. Maybe you get annoyed by the way teammates act when they are über-competitive. Or maybe you just don't like competing with friends for a spot in the starting lineup. For whatever reason, team sports might not be your thing — and that’s fine. Luckily, there are many individualized sports to choose from.

If Your School Doesn't Have Your Sport

Some schools are limited in resources — a city school may not have a lot of fields, for example, while a rural school may not have enough students to make up a team for every sport.

A school's geographic region can also play a role. If you live in a climate where it snows from the fall to the spring, your school may not be able to participate in a lot of outdoor sports.

If your school doesn't have your sport, don't let it get you down. You can always try out for a different sport during the same season or look into whether your local town has a recreational league that you can join.

If Organized Sports Aren't Your Thing

Many people are attracted to the competition and popularity that can come with team sports. Others love the camaraderie and unity that are present in a team atmosphere. But for some people, teams are just frustrating and another form of cliques. If you're not the biggest fan of organized sports, where you have to follow someone else's schedule and rules, many other fun and exciting options are out there for you.

You might already have an exercise routine or activity you like to do in your free time, but if you're looking for something that will both keep you busy and allow you to blow off steam, try some of these activities:

Climb to the top. If you scaled trees and walls when you were younger, then the perfect activity for you is rock climbing. Rock climbing offers participants one of the best all-around workouts possible. As a rock climber, you work your hands, arms, shoulders, back, stomach, legs, and feet — ALL AT ONCE!

Take a hike (yes, you can bring your bike)! Ever wonder what kinds of cool things are waiting on those nature trails not too far from your house? Why not find out? While you're at it, you'll get a good workout. Hiking and trail biking are two great ways to learn about nature while still getting that heart rate up. Even if you are just going to a local trail, always bring at least one other person along in case something happens. If you're going for an intense multi-day hike, you should bring someone who is experienced and trained in hiking.

Water world … starring: YOU! The water is the perfect place to give yourself new challenges. There are plenty of water activities for all levels of difficulty and energy. Besides swimming, try canoeing, kayaking, fishing, rowing, sailing, wakeboarding, water skiing, windsurfing, and, if you're feeling particularly daring, surfing.

Find your inner self. Many activities can strengthen you physically and mentally. Workouts like yoga, Pilates, and T'ai Chi can be relaxing and taxing all at once.

• Yoga has tons of benefits. It can improve flexibility, strength, balance, and stamina. In addition to the physical benefits, many people who practice yoga say that it reduces anxiety and stress and improves mental clarity.
• Pilates is a body conditioning routine that seeks to build flexibility, strength, endurance, and coordination without adding muscle bulk. Pilates also increases circulation and helps to sculpt the body and strengthen the body's "core" or "powerhouse" (torso). People who do Pilates regularly feel they have better posture, are less prone to injury, and experience better overall health.
• T’ai chi is an ancient Chinese martial art form that is great for improving flexibility and strengthening your legs, abdominal or core muscles, and arms.

Make Sure to Take an Off-Season — But Not a Season Off!

Whether you choose one sport or three, make sure you give yourself a break from intense competition with some cross-training activities. Through cross-training you can take a rest from your sport or sports while still getting a workout and staying in shape.

Two examples of cross-training are swimming and cycling. They not only help build cardiovascular strength, but also help in muscle growth. Swimming can really help tone your upper body, while cycling strengthens your upper legs.

You can also try outdoor bike rides and runs on nice days, stopping periodically to do sit-ups and push-ups. These simple exercises can work and tone your core muscles.

That time between seasons is also the perfect opportunity to get into a strength-training routine. Before starting strength training, consult your doctor and school's strength and conditioning coach. Your doc will be able to give you health clearance to participate in the different types of physical activities, and your strength coach can come up with a workout to help you prepare for your specific sports.

Allergy Testing

If your family doctor thinks you might have an allergy, he or she will probably refer you to an allergist (a doctor who specializes in diagnosing and treating allergies) for further testing. Here's what to expect.

An allergist will ask questions, such as:

• What symptoms do you notice when you have a reaction? (e.g., hives or a scratchy throat)
• How often does the reaction happen?
• How long does it take between eating a particular food and the start of the symptoms?
• Do any family members have allergies or conditions like eczema and asthma?

The allergist will probably also do tests. Skin tests are the most common type of testing used to diagnose allergies. A skin prick or scratch test involves placing liquid extracts of allergens (such as pollen, or food) on a person's forearm or back, then pricking the skin a tiny bit. The allergist then waits 15 minutes or so to see if reddish, raised spots (called wheals) form, indicating an allergy.

A few doctors may do a similar test, called an intradermal test, under the surface of the skin. This type of test is usually done to look for environmental allergiesenvironmental allergies.

If the doctor thinks a person might be allergic to more than one thing — or if it's not clear what's triggering a person's allergy — the allergist will probably skin test for several different allergens at the same time.

Skin tests may itch for a while. The allergist might give you antihistamine or steroid cream after the test to lessen the itching.

Tests for Different Types of Allergies

Doctors use skin tests to diagnose environmental allergies. But it's different with food allergies. When a skin test shows up as positive with a certain food, that only means a person might be allergic to that food. In these cases, doctors may want to do additional testing.

To diagnose a food allergy for certain, an allergist may do a blood test in addition to skin testing. This involves taking a small sample of a person's blood and sending it to a laboratory for analysis. The lab checks the blood for IgE antibodies to specific foods. If there are enough IgE antibodies to a particular food in the blood, it means it's very likely that person has an allergy.

Doctors often use a combination of skin testing and blood testing to diagnose a food allergy. If both come up positive, there's no need for further testing.

If the results of the skin and blood tests are still unclear, though, an allergist might do something called a food challenge. During this test, the person is given gradually increasing amounts of the potential food allergen to eat while the doctor watches for symptoms.

Because food allergies can trigger serious reactions in people, this test can be risky. So it needs to be done in an allergist's office or hospital that has access to medications and specialists to control reactions like anaphylaxisanaphylaxis. Doctors only occasionally use the food challenge to diagnose a person with a food allergy. Most of the time, this type of test is done to find out if someone has outgrown a known allergy.

If an allergist decides that a person has an allergy, he or she will recommend a course of action. Treatment depends on the allergy — for people with environmental allergies, this might mean the allergist prescribes medication or allergy shots. For a food or other allergy, the allergist will advise the patient on ways to avoid the allergen.

Can I Pierce My Own Eyebrow?

I want to get my eyebrow pierced and was wondering: Why can't I do it myself or have a friend do it?

– Anne*

Whenever part of the body is pierced, there's a risk of infection, prolonged bleeding, scarring, tetanus, and sometimes even nerve damage. These risks are especially high if the piercing is done using amateur equipment or if the person performing the piercing doesn't know what he or she is doing.

Because of the risks, many U.S. states require piercing locations to be licensed and monitored for safety. People who are licensed to do piercings know:

• how to keep everything clean (which requires a special piece of equipment called an autoclave)
• the kind of needle to use
• what type of jewelry to insert
• what instructions to give you so that you can keep your piercing healthy and clean

For more information, check out this article:
Body Piercing

Tattoos

It seems like everyone has a tattoo these days. What used to be the property of sailors, outlaws, and biker gangs is now a popular body decoration for many people. And it's not just anchors, skulls, and battleships anymore — from school emblems to Celtic designs to personalized symbols, people have found many ways to express themselves with their tattoos. Maybe you've thought about getting one. But before you head down to the nearest tattoo shop and roll up your sleeve, there are a few things you need to know.

So What Exactly Is a Tattoo?

A tattoo is a puncture wound, made deep in your skin, that's filled with ink. It's made by penetrating your skin with a needle and injecting ink into the area, usually creating some sort of design. What makes tattoos so long-lasting is they're so deep — the ink isn't injected into the epidermis (the top layer of skin that you continue to produce and shed throughout your lifetime). Instead, the ink is injected into the dermis, which is the second, deeper layer of skin. Dermis cells are very stable, so the tattoo is practically permanent.

Tattoos used to be done manually — that is, the tattoo artist would puncture the skin with a needle and inject the ink by hand. Though this process is still used in some parts of the world, most tattoo shops use a tattoo machine these days. A tattoo machine is a handheld electric instrument that uses a tube and needle system. On one end is a sterilized needle, which is attached to tubes that contain ink. A foot switch is used to turn on the machine, which moves the needle in and out while driving the ink about 1/8 inch (about 3 millimeters) into your skin.

Most tattoo artists know how deep to drive the needle into your skin, but not going deep enough will produce a ragged tattoo, and going too deep can cause bleeding and intense pain. Getting a tattoo can take several hours, depending on the size and design chosen.

Does It Hurt to Get a Tattoo?

Getting a tattoo can hurt, but the level of pain can vary. Because getting a tattoo involves being stuck multiple times with a needle, it can feel like getting a bunch of shots or being stung by a hornet multiple times. Some people describe the tattoo sensation as "tingling." It all depends on your pain threshold, how good the person wielding the tattoo machine is, and where exactly on your body you're getting the tattoo. Also, keep in mind that you'll probably bleed a little.

If You're Thinking About It

If you're thinking about getting a tattoo, there is one very important thing you have to keep in mind — getting it done safely. Although it might look a whole lot cooler than a big scab, a new tattoo is also a wound. Like any other slice, scrape, puncture, cut, or penetration to your skin, a tattoo is at risk for infections and disease.

First, make sure you're up to date with your immunizations (especially hepatitis and tetanus shots) and plan where you'll get medical care if your tattoo becomes infected (signs of infection include excessive redness or tenderness around the tattoo, prolonged bleeding, pus, or changes in your skin color around the tattoo).

If you have a medical problem such as heart disease, allergies, diabetes, skin disorders, a condition that affects your immune system, or infections — or if you are pregnant — ask your doctor if there are any special concerns you should have or precautions you should take beforehand. Also, if you're prone to getting keloids (an overgrowth of scar tissue in the area of the wound), it's probably best to avoid getting a tattoo altogether.

It's very important to make sure the tattoo studio is clean and safe, and that all equipment used is disposable (in the case of needles, gloves, masks, etc.) and sterilized (everything else). Some states, cities, and communities set up standards for tattoo studios, but others don't. You can call your state, county, or local health department to find out about the laws in your community, ask for recommendations on licensed tattoo shops, or check for any complaints about a particular studio.

Professional studios usually take pride in their cleanliness. Here are some things to check for:

• Make sure the tattoo studio has an autoclave (a device that uses steam, pressure, and heat for sterilization). You should be allowed to watch as equipment is sterilized in the autoclave.
• Check that the tattoo artist is a licensed practitioner. If so, the tattoo artist should be able to provide you with references.
• Be sure that the tattoo studio follows the Occupational Safety and Health Administration's Universal Precautions. These are regulations that outline procedures to be followed when dealing with bodily fluids (in this case, blood).

If the studio looks unclean, if anything looks out of the ordinary, or if you feel in any way uncomfortable, find a better place to get your tattoo.

What's the Procedure Like?

Here's what you can expect from a normal tattooing procedure:

• The tattoo artist will first wash his or her hands with a germicidal soap.
• The to-be-tattooed area on your body will be cleaned and disinfected.
• The tattoo artist will put on clean, fresh gloves (and possibly a surgical mask).
• The tattoo artist will explain the sterilization procedure to you and open up the single-use, sterilized equipment (such as needles, etc.).
• Using the tattoo machine (with a sterile, single-use needle attached), the tattoo artist will begin drawing an outline of the tattoo under your skin.
• The outline will be cleaned with antiseptic soap and water.
• Sterile, thicker needles will be installed on the tattoo machine, and the tattoo artist will start shading the design. After cleaning the area again, color will be injected.
• Any blood will be removed by a sterile, disposable cloth or towel.
• When finished, the area, now sporting a finished tattoo, will be cleaned once again and a bandage will be applied.

Taking Care of a Tattoo

The last step in getting a tattoo is very important — taking care of the tattoo until it fully heals. Follow all of the instructions the studio gives you for caring for your tattoo to make sure it heals properly. Also, keep in mind that it's very important to call your doctor right away if you see or feel any signs of infection such as pain, spreading redness, swelling, or drainage of pus. To make sure your tattoo heals properly:

• Keep a bandage on the area for up to 24 hours.
• Avoid touching the tattooed area and don't pick at any scabs that may form.
• Wash the tattoo with an antibacterial soap (don't use alcohol or peroxide — they'll dry out the tattoo). Use a soft towel to dry the tattoo — just pat it dry and be sure not to rub it.
• If you don't have an allergy to antibiotic ointment, rub some into the tattoo. Don't use petroleum jelly — it may cause the tattoo to fade.
• Put an ice pack on the tattooed area if you see any redness or swelling.
• Try not to get the tattoo wet until it fully heals. Stay away from pools, hot tubs, or long, hot baths.
• Keep your tattoo away from the sun until it's fully healed.

Even after it's fully healed, a tattoo is more susceptible to the sun's rays, so it's a good idea to always keep it protected from direct sunlight. If you're outside often or hang out at the beach, it's recommended that you always wear a sunscreen with a minimum sun protection factor (SPF) of 30 on the tattoo. This not only protects your skin, but keeps the tattoo from fading.

What Are the Risks?

If you decide to get a tattoo, chances are everything will go as planned. But if disinfection and sterilization steps aren't followed, there are some things you need to be aware of that can go wrong. If you don't go to a tattoo studio or the tattoo studio doesn't follow precautions like using sterilized equipment or if it shares ink between customers, you're putting yourself at risk for getting viral infections such as hepatitis, bacterial skin infections, or dermatitis (severe skin irritation).

Also, some people have allergic reactions to the tattoo ink. And if you already have a skin condition such as, you may have flare-ups as a result of the tattoo.

Serious complications can result if you attempt to do a tattoo yourself, have a friend do it for you, or have it done in any unclean environment. Because tattooing involves injections under the skin, viruses such as HIV and hepatitis B and C can be transferred into your body if proper precautions aren't followed. For this reason, the American Red Cross and some other blood banks require people to wait 12 months after getting a tattoo before they can donate blood.

Tattoo Removal

A lot of people love their tattoos and keep them forever. But others decide a couple of years down the road that they really don't like that rose on their ankle or snake on their bicep anymore. Or maybe you broke up with your boyfriend or girlfriend and no longer want his or her initials on your stomach. What then?

In the past, tattoo removal required surgery, but now there are several other methods that can be used. One common method is laser removal. Some tattoo shops also offer tattoo removal, but it's a better idea to make sure the person doing the removal is a medical doctor. Before you go just anywhere to get your tattoo removed, check with your doctor or contact the American Dermatological Association to find a reputable laser removal specialist in your area.

Although it's called tattoo removal, completely removing a tattoo can be difficult depending on factors like how old the tattoo is, how big the tattoo is, and the types and colors of inks that were used. Removal of the entire tattoo is not always guaranteed. It's best to consult with a dermatologist who specializes in tattoo removal to get your questions answered — such as whether anesthesia is used. The dermatologist can also give you a good idea of how much (if not all) of the tattoo can be removed.

Laser tattoo removal usually requires a number of visits, with each procedure lasting only a few minutes. Anesthesia may or may not be used. What happens is the laser sends short zaps of light through the top layers of your skin, with the laser's energy aimed at specific pigments in the tattoo. Those zapped pigments are then removed by your body's immune system.

Removing a tattoo by laser can be uncomfortable and can feel a lot like getting a tattoo. The entire process usually takes several months.

Just like when you get a tattoo, you must look after the wound area after a tattoo is removed. The area should be kept clean, but it shouldn't be scrubbed. Also, it might turn red for a few days and a scab might form. Don't rub or scrub the area or pick at the scab. Let it heal on its own.

Laser tattoo removal is usually effective for the most part, but there can be some side effects. The area can become infected or scarred, and it can also be susceptible to hyperpigmentation, which causes the area where your tattoo used to be to become darker than your normal skin, or hypopigmentation, which causes the area where your tattoo used to be to become lighter than your normal skin color.

Now for the big part — tattoo removal can be pretty expensive. Depending on factors like the size and design of the tattoo, removal can cost significantly more than the actual tattoo.

So Is It Worth It?

Is getting a tattoo worth the money and hassle? It's up to you. Some people really enjoy their tattoos and keep them for life, whereas others might regret that they acted on impulse and didn't think enough about it before they got one. Getting a tattoo is a big deal, especially because they're designed to be permanent.

If you've thought about it and decided you want a tattoo, make sure you do a little detective work and find a clean, safe, and professional tattoo shop. Also, remember that getting and maintaining a tattoo involves some responsibility — after you leave the tattoo shop, it's up to you to protect and treat it to prevent infections or other complications.

Blood

Just about everyone knows that we can't live without blood. And that the blood in our bodies is pumped by the heart through a network of arteries and veins. But beyond those blood basics, what do you know about that red stuff beneath your skin?

Blood is essential for good health because the body depends on a steady supply of fuel and oxygen to reach its billions of cells. Even the heart couldn't survive without blood flowing through the vessels that bring nourishment to its muscular walls. Blood also carries carbon dioxide and other waste materials to the lungs, kidneys, and digestive system; from there they are removed from the body.

Without blood, we couldn't keep warm or cool off, we couldn't fight infections, and we couldn't get rid of our own waste products.

So how exactly does blood do these things? How is it made, and what's in it? How does blood clot? It's time to learn a little about the mysterious, life-sustaining fluid called blood.

What Is Blood and What Does It Do?

Two types of blood vessels carry blood throughout our bodies: The arteries carry oxygenated blood (blood that has received oxygen from the lungs) from the heart to the rest of the body. The blood then travels through the veins back to the heart and lungs, where it receives more oxygen. As the heart beats, you can feel blood traveling through the body at your pulse points — like the neck and the wrist — where large, blood-filled arteries run close to the surface of the skin.

The blood that flows through this network of veins and arteries is called whole blood. Whole blood contains three types of blood cells:

1. red blood cells
2. white blood cells
3. platelets

These blood cells are mostly manufactured in the bone marrow (the soft tissue inside our bones), especially in the bone marrow of the vertebrae (the bones that make up the spine), ribs, pelvis, skull, and sternum (breastbone). These cells travel through the circulatory system suspended in a yellowish fluid called plasma (pronounced: plaz-muh). Plasma is 90% water and contains nutrients, proteins, hormones, and waste products. Whole blood is a mixture of blood cells and plasma.

Red Blood Cells

Red blood cells (RBCs, and also called erythrocytes, pronounced: ih-rith-ruh-sytes) are shaped like slightly indented, flattened disks. Red blood cells contain an iron-rich protein called hemoglobin (pronounced: hee-muh-glow-bun). Blood gets its bright red color when the hemoglobin in RBCs picks up oxygen in the lungs. As the blood travels through the body, the hemoglobin releases oxygen to the tissues. The body contains more RBCs than any other type of cell, and each has a life span of about 4 months. Each day, the body produces new RBCs to replace those that die or are lost from the body.

White Blood Cells

White blood cells (WBCs, and also called leukocytes, pronounced: loo-kuh-sytes) are a key part of the body's system for defending itself against infection. They can move in and out of the bloodstream to reach affected tissues. The blood contains far fewer white blood cells than red cells, although the body can increase production of WBCs to fight infection. There are several types of white blood cells, and their life spans vary from a few days to months. New cells are constantly being formed in the bone marrow.

Several different parts of blood are involved in fighting infection. White blood cells called granulocytes (pronounced: gran-yuh-low-sytes) and lymphocytes (pronounced: lim-fuh-sytes) travel along the walls of blood vessels. They fight germs such as bacteria and viruses and may also attempt to destroy cells that have become infected or have changed into cancer cells.

Certain types of WBCs produce antibodies, special proteins that recognize foreign materials and help the body destroy or neutralize them. Someone with an infection will often have a higher white cell count than when he or she is well because more WBCs are being produced or are entering the bloodstream to battle the infection. After the body has been challenged by some infections, lymphocytes "remember" how to make the specific antibodies that will quickly attack the same germ if it enters the body again.

Platelets

Platelets (also called thrombocytes, pronounced: throm-buh-sytes) are tiny oval-shaped cells made in the bone marrow. They help in the clotting process. When a blood vessel breaks, platelets gather in the area and help seal off the leak. Platelets survive only about 9 days in the bloodstream and are constantly being replaced by new cells.

Blood also contains important proteins called clotting factors, which are critical to the clotting process. Although platelets alone can plug small blood vessel leaks and temporarily stop or slow bleeding, the action of clotting factors is needed to produce a strong, stable clot.

Platelets and clotting factors work together to form solid lumps to seal leaks, wounds, cuts, and scratches and to prevent bleeding inside and on the surfaces of our bodies. The process of clotting is like a puzzle with interlocking parts. When the last part is in place, the clot happens — but if only one piece is missing, the final pieces can't come together.

When large blood vessels are severed (or cut), the body may not be able to repair itself through clotting alone. In these cases, dressings or stitches are used to help control bleeding.

In addition to the cells and clotting factors, blood contains other important substances, such as nutrients from the food that has been processed by the digestive system. Blood also carries hormones released by the endocrine glands and carries them to the body parts that need them.

An interesting thing about blood is that blood cells and some of the special proteins blood contains can be replaced or supplemented by giving a person blood from someone else. This process is called a transfusion. In addition to receiving whole blood transfusions, people can also receive transfusions of a particular component of blood that they need. For example, someone can receive only platelets, red blood cells, or a clotting factor. When people donate blood, the whole blood can be separated into its different parts and used in this way.

Things That Can Go Wrong With Blood

Most of the time, blood functions normally, but sometimes, blood disorders or diseases can cause problems. Diseases of the blood that commonly affect young people can involve any or all of the three types of blood cells (red blood cells, white blood cells, or platelets) or the proteins and chemicals in the plasma that are responsible for clotting.

Some of the diseases and conditions involving the blood include:

Diseases of the Red Blood Cells

The most common condition affecting the red blood cells of teens is anemia (pronounced: uh-nee-mee-uh), a lower-than-normal number of red cells in the blood. Anemia is accompanied by a decrease in the amount of hemoglobin present in the blood. Anemia symptoms — such as pale skin, weakness, and a fast heart rate — happen because of the blood's reduced capacity for carrying oxygen. Causes of anemia can be grouped into two categories: anemia caused by insufficient RBC production and anemia caused by RBCs being destroyed too soon.

• Anemia resulting from inadequate red blood cell production:
  Several conditions can cause a reduced production of red blood cells, including:
  • Iron deficiency anemia. Iron deficiency anemia is the most common type of anemia and can affect people who have a diet low in iron or who've lost a lot of RBCs (and the iron they contain) through bleeding. Premature babies, infants with poor nutrition, menstruating teenage girls, and those with ongoing blood loss due to illnesses such as inflammatory bowel disease are especially likely to have iron deficiency anemia.
  • Anemia due to chronic disease. People with chronic diseases (such as cancer or human immunodeficiency virus infection [HIV]) often develop anemia as a complication of their illness.
  • Anemia due to kidney disease. The kidneys produce erythropoietin, a hormone that stimulates production of red cells in the bone marrow. Kidney disease can interfere with the production of this hormone.
• Anemia resulting from unusually rapid red blood cell destruction:
  When red blood cells are destroyed more quickly than normal by disease (this process is called hemolysis, pronounced: hih-mah-luh-sus), the bone marrow will make up for it by increasing production of new red cells to take their place. But if RBCs are destroyed faster than they can be replaced, a person will develop anemia. Several causes of increased red blood cell destruction can affect teens:
  • G6PD deficiency. G6PD is an enzyme that helps to protect RBCs from the destructive effects of certain chemicals found in foods and medications. When the enzyme is deficient, these chemicals can cause red cells to hemolyze, or burst. G6PD deficiency is a common hereditary disease among people of African, Mediterranean, and Southeast Asian descent.
  • Hereditary spherocytosis (pronounced: sfeer-o-sye-toe-sus). In this inherited condition, RBCs are misshapen (like tiny spheres, instead of disks) and especially fragile because of a genetic problem with a protein in the structure of the red blood cell. This fragility causes the cells to be easily destroyed.
  • Autoimmune hemolytic anemia. Sometimes — because of disease or for no known reason — the body's immune system mistakenly attacks and destroys red blood cells.
  • Sickle cell anemia. Most common in people of African descent, sickle cell anemia is a hereditary disease that results in the production of abnormal hemoglobin. The RBCs become sickle shaped, cannot carry oxygen adequately, and are easily destroyed. The sickle-shaped cells also tend to abnormally stick together, causing obstruction of blood vessels. This blockage in the blood vessels can seriously damage organs and cause bouts of severe pain.

Diseases of the White Blood Cells

• Neutropenia (pronounced: noo-truh-pee-nee-uh) occurs when there aren't enough of a certain type of white blood cell to protect the body against bacterial infections. People who take certain chemotherapy drugs to treat cancer may develop neutropenia.
• Human immunodeficiency virus (HIV) attacks certain types of white blood cells (lymphocytes) that work to fight infection. Infection with the virus can result in AIDS (acquired immunodeficiency syndrome), leaving the body prone to infections and certain other diseases. Teens and adults can get the disease from sexual intercourse with an infected person or from sharing contaminated needles used for injecting drugs or tattoo ink.
• Leukemias (pronounced: loo-kee-mee-uhz) are cancers of the cells that produce white blood cells. These cancers include acute myeloid leukemia (AML), chronic myeloid leukemia (CML), acute lymphocytic leukemia (ALL), and chronic lymphocytic leukemia (CLL). The most common types of leukemia affecting kids are ALL and AML. Scientists have made great advances in treating several types of childhood leukemia, most notably certain types of ALL.

Diseases of Platelets

• Thrombocytopenia (pronounced: throm-buh-syte-uh-pee-nee-uh), or a lower than normal number of platelets, is usually diagnosed because a person has abnormal bruising or bleeding. Thrombocytopenia can happen when someone takes certain drugs or develops infections or leukemia or when the body uses up too many platelets. Idiopathic thrombocytopenic purpura (ITP) is a condition in which the immune system attacks and destroys platelets.

Diseases of the Clotting System

The body's clotting system depends on platelets as well as many clotting factors and other blood components. If a hereditary defect affects any of these components, a person can have a bleeding disorder. Common bleeding disorders include:

• Hemophilia (pronounced: hee-muh-fil-ee-uh), an inherited condition that almost exclusively affects guys, involves a lack of particular clotting factors in the blood. People with severe hemophilia are at risk for excessive bleeding and bruising after dental work, surgery, and trauma. They may experience episodes of life-threatening internal bleeding, even if they haven't been injured.
• Von Willebrand disease, the most common hereditary bleeding disorder, also involves a clotting-factor deficiency. It affects both guys and girls.

Other causes of clotting problems include chronic liver disease (clotting factors are produced in the liver) and vitamin K deficiency (the vitamin is necessary for the production of certain clotting factors).