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Excerpts from Girlology Hang-Ups, Hook-Ups and Holding Out
Stuff you need to know about your body, sex, and dating
by Melisa Holmes, M.D. and Trish Hutchison, M.D.

"Am I Normal?" Body hang-ups and emotional meltdowns

Q : How do I know if I really have an eating disorder?
Quickie: Sometimes it's hard to know.
The Full Scoop: There are two major groups of eating disorders: anorexia and bulimia. Some girls have elements of both. Anorexia is characterized by a significant weight loss from excessive dieting and restricting calories. Girls with anorexia feel fat no matter how thin they may be. They are very preoccupied with food and their weight, but they find ways to ignore their feelings of hunger. The scariest thing is that 10 to 20 percent of girls with this disease will eventually die from complications related to starving themselves.
Anorexia can start off as an innocent attempt to lose a little weight. The attention and compliments that come with the weight loss feel good. So then they start to believe that losing more would make them even happier. But no matter how much weight is lost, it is never enough. They never seem to be happy or satisfied. Sometimes by focusing so much on weight loss and food, they can ignore bigger problems that are too painful to deal with. The weight loss becomes excessive and a controlling force in their lives.
Bulimia is characterized by a cycle of binge eating followed by purging to try to rid the body of the unwanted calories.A binge may be different for each person. One person's binge may be three cheeseburgers, supersize fries, and a half gallon of ice cream. Another's may be one cookie. A purge may be different for each person as well. Purging can be attempted through vomiting, laxative abuse, excessive exercise, fasting, or using diuretics, diet pills, and enemas.
With bulimia, food becomes a source of comfort. Hoarding and bingeing on food may become a way of blocking or letting out feelings. The binge brings on terrible guilt, so bulimics purge to rid themselves of all the calories. Usually they vow to never binge again, but the cycle begins again when they feel out of control. Sometimes it takes years to break the cycle completely.
Below is a list of signs and symptoms of eating disorders. This list may help you recognize an eating disorder in yourself or someone else.
Losing weight quickly or having a weight that goes up and down a lot
Talking about being fat ALL THE TIME
Spending a lot of time reading food labels, memorizing calorie contents, and studying recipes
Feeling like you have to be perfect at everything
Eating very little, secretly eating, or making excuses for not eating meals
Spending a lot of time in the bathroom
Exercising excessively
Using alcohol, diet pills, or illegal drugs to lose weight
Eating way too much and later feeling very guilty about it
Avoiding social events that involve food
Weighing yourself frequently and allowing your weight to affect your moods
Having symptoms of depression, irritability, or even mood swings
There are also medical complications that are associated with eating disorders. These are:
Lack of energy
Irregular period or no period at all
Headaches
Constipation and diarrhea
Hair loss
Dizziness
Sores on the knuckles from inducing vomiting
Appearance of fine downy hair on back and face
Stomach pain
Tooth decay and loss of enamel from frequent vomiting
Life-threatening things such as kidney and liver damage, anemia, low blood pressure,
loss of bone mass, and possibly cardiac arrest and death
As you can see, this is a very scary and serious illness. If you know anyone who has these signs or symptoms, or you have these yourself, the first step to getting better is to tell someone. Anorexia and bulimia are diseases that can be treated with proper therapy and medical attention, but the treatment is very difficult for many girls with anorexia to accept. Relapses are common and the treatment may take several years. A dedicated and experienced therapist is important. With therapy and medical attention, most of the complications are reversed, resulting in proper weight gain and changes in eating habits.

Q: I have had stretch marks for a while. My doctor says they will disappear, but they haven't. What can I do?
Quickie: Unfortunately, not much.
The Full Scoop: Stretch marks are a normal part of growth and usually show up when your body grows rapidly during puberty or with a drastic change in your body weight.
Skin is usually elastic (meaning stretchy), but too much stretch on the tissues underneath the skin can cause stretch marks. They usually start as a streak or line that looks red to dark pink to purple. With time, the color fades and eventually they become lighter and less noticeable.
Most teen girls and adult women have stretch marks somewhere on their body.There are a few girls out there who will never get any. Lucky genetics. The most common places you'll see them are on your breasts, buttocks, hips, and thighs. Some women don't get any stretch marks until pregnancy when their belly grows quickly. Even guys can get them. Medications containing steroids can also cause or worsen them.
The good news is that stretch marks will fade and sometimes disappear over time. If you are just noticing some, you may need to change your clothing style for a little while to keep them covered up. Keeping them covered is also a good idea because exposing them to sunlight or light from a tanning bed can make them look worse. Stretch marks won't tan, so they might become more noticeable if the rest of your skin is tanned or darker. Some girls find that sunless tanning lotions and sprays can help camouflage them.

Q: How does cutting make someone feel better?
Quickie: This is serious. Read on.
The Full Scoop: Currently in America, about 10 percent of teen girls are cutting. It's serious, because girls who cut themselves usually have other dangerous behaviors and are often dealing with some heavy emotional problems. They say they do it because they don't know any other way to cope with strong emotions like depression, anger, shame, and frustration. These emotions may result from bad relationships, abuse, or intense peer pressure. Some don't even know why they have these negative emotions.
For cutters, they usually don't know how to deal with their emotions, so they hurt themselves to find relief or comfort. That doesn't seem to make sense does it? There can be different reasons for it: bad coping abilities, a way to "wake up" from a numbing emotional experience, or simply an attempt to relive the pain of a bad experience or to hurt themselves as punishment. For some, though, it's just a way to seem rebellious and radical.
Whatever the reason, cutting only provides a temporary solution. It's not normal, and it's not cool.Cutting is a cry for help, but once it's discovered, it can be a wake-up call for some. Most girls admit that the first step is the hardest--telling someone. A trusted adult should be able to help you find a professional. That's what it will take to begin the healing process. Treatment can help you understand the triggers that start the cutting in the first place, but rea lize that it will take some work on your part. Getting treatment or help is important.

Q: I need to concentrate better in school and my friend offered me one of his Ritalin pills; is it safe for me to take it?
Quickie: You should never take anyone else's prescription drugs.
The Full Scoop: It might seem like prescription drugs are safer than illegal drugs because they are prescribed by a doctor. Some are safe, some aren't. That's why a prescription is necessary. It's written so that the drug is only used as directed to
treat a specific condition for a specific patient. Frequently abused prescription drugs include pain medicines; valium and other antianxiety medications; and amphetamines like Ritalin, Adderall, and weight loss drugs. None of them are safe for recreational use and many can be addictive. Sometimes these drugs are sold on the street like other illegal drugs (and, yes, taking a prescription drug that is not yours is illegal!). These are particularly dangerous because many of them are "counterfeit" and were made in someone's "basement pharmacy." They can look just like the real thing, but actually be much more potent and dangerous.
A National Survey on Drug Use and Health in 2003 showed that almost 25 percent of teens from twelve to seventeen had tried prescription drugs for recreational use at least once. Recreational use includes using the drug to get high, lose weight, relax, focus better, or numb painful emotions. If you feel like you need drugs for any of these reasons, you should see your own doctor. If a prescription is necessary, your doctor can prescribe the medication that will work best for your needs or condition.
Now, back to Ritalin. Ritalin is prescribed for some cases of ADD or ADHD. On the street it is better known as "rits" or "vitamin R," and it's a methylphenidate, which is in a class of drugs called stimulants. Adderall is also in this group. Stimulants work by increasing brain activity, which results in greater attention, energy, and alertness, but if you don't have ADD, you may just experience the side effects. Don't count on your friends to make the diagnosis.

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©2007. Melisa Holmes, M.D. and Trish Hutchison, M.D. All rights reserved. Reprinted from Girlology: Hang-Ups, Hook-Ups, and Holding Out: Stuff You Need to Know About Your Body, Sex, & Dating. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, without the written permission of the publisher. Publisher: Health Communications, Inc., 3201 SW 15th Street, Deerfield Beach FL, 33442


Library of Congress subject headings for this publication:
Teenage girls -- Sexual behavior -- United States.
Teenage girls -- United States -- Attitudes.
Sex instruction for teenagers -- United States.
Hygiene, Sexual -- United States.