When I was growing up, I was big. I'm not sure where exactly I fell in relation to other kids my age, because I rarely went to the doctor. That's what happens when you don't play sports and move every couple years, and thus don't have a good relationship with a doctor. But, I was definitely bigger than most kids. And I got teased for it. Throughout high school, I wore a giant, baggy jacket, because I was so ashamed about my body. As a sophomore in high school, I was asked by another student if I was pregnant. One of my friends desperately wanted me to go to the homecoming dance as a freshman so that I could have a Cinderella moment.
Point being, I know what it's like to have a low self-esteem.
But, as a doctor, I also know the harms of childhood obesity. I've talked about it before. So, I want young girls to get healthy and be at a healthy weight.
Problem is, weight is a very sensitive subject for adolescent girls. I saw a girl in clinic who completely shut down on me, to the point where we got a social worker to come talk to her, because I mentioned she was heavier than was healthy. It's not an easy subject to discuss, and I hate bringing it up, but I do it because it's in their best interest.
Well, a recent study has come out that may affect how I bring up the topic. This study took a group of girls and asked if someone had ever called them 'too fat'. They specifically asked about family members, teachers, and peers. Girls who were labeled as such at age 10 were significantly more likely to be obese at age 19 than those who were not, independent of what weight they started at.
Makes you wonder about all that media that girls consume now, doesn't it? How they are comparing themselves to the size 0 models in magazines, or worse, real women who are photoshopped to be unrealistic in proportions. Or how Ursula and the Queen of Hearts underwent a makeover to make them skinnier.
Yes, obesity is a problem.
But you know what? I was at my healthiest weight when I felt great about myself. It took me a long time to get there--years of affirmation by someone I loved. But I became happier with myself, accepting of myself, and started to walk around with confidence. And those extra pounds melted off.
So maybe the focus should be on body image, and not weight. After all, there is also such a thing as being too skinny.
Sunday, June 29, 2014
Sunday, June 22, 2014
The Elusive Good Night's Sleep
I know, I haven't posted the past 2 weeks. This is what happens when you have to move and lack internet for a week.
Sleep is a very important part of our lives. After all, we spent roughly 1/3 of our lives sleeping. There are several theories on why, exactly, we need sleep. My favorite is the converting of short-term memory to long-term memory. Essentially, if you don't get enough sleep, you won't learn anything new. But for now, I'm going to focus on how much we need and how to get that sleep. In fact, this was the focus of a recently published article that has caught the attention of many news sites.
It's more than just memory, though. Getting less sleep than you need can result in poor academic performance. According to a small study by the American Academy of Sleep Medicine, this effect is as much as binge drinking or smoking marijuana, independent of other risk factors such as psychiatric disorders.
Sleep has also been linked to weight, particularly in adults. A recent study published in Pediatrics shows that getting less than the recommended amount of sleep in infancy and childhood is linked to obesity by age 7. Indeed, even how much a parent sleeps can affect how much the child sleeps, and thus his or her risk of obesity later in life.
Finally, sleep is the time when many hormones are released. For children, the most important of these is growth hormone. That's right--if children don't get enough sleep, they might not grow properly. As an aside, the unbalance of hormones is likely part of the reason why lack of sleep can lead to obesity--the body produces hormones to increase alertness, which promote deposition of fat for future use.
So clearly sleep is important. But how much do we need?
The amount of sleep we need is entirely based on age. Infants sleep most of the day, while adults only need 8 hours or so. Infants also don't sleep at 'normal' times, because they are accustomed to being in the womb and rocked to sleep while mom was awake and walking, and awake when mom was resting. When adults don't get enough sleep, they tend to develop quick tempers and have low energy. When children don't get enough sleep, though, they tend to become hyperactive. Many parents have experienced this with infants that cry more when they aren't put to bed on time.
By two months of age or so, the circadian rhythm starts to develop. This is our body's innate way of telling time, and is based on light clues. In a completely cut-off environment, a normal circadian rhythm lasts about 25 hours. Of course, we don't live in a world where the day is 25 hours long, so this is where the light cues come in.
One of the first things we, as pediatricians, do when we hear a child is not getting enough sleep is to ask about sleep hygiene. Where do you sleep? What time do you go to bed? What time do you get up? What else is in your room?
Lack of light triggers the release of melatonin, a hormone that helps us feel sleepy and fall asleep. If your room is filled with light, even lights from computers, iPads, televisions, etc, you could inhibit your release of melatonin and have a harder time falling asleep. So, one of the first things we recommend is to get those computers and televisions and whatnot out of the bedroom. Even if you don't use them right before bed, the lights that stay on can influence your melatonin production. You can also condition yourself unintentionally into not associating the bedroom with sleep, but rather with activity.
Getting up and going to bed at the same time every day, even on weekends, can also help your body just get used to going to sleep at the same time. I realize this isn't ideal for adults, but there's no reason kids shouldn't have a consistent bedtime.
Finally, as we get older (by early elementary school), our sleep cycles become more consistent and average out to 90 minutes each. Waking in the middle of a sleep cycle can be very disorienting, and can make you feel tired all day. So, bedtime and alarms should be planned so there is a multiple of 90 minutes in the sleep time. In other words, you should try to ensure you are getting 6 hours, 7.5 hours, 9 hours, or 10.5 hours of sleep (depending on age, with younger kids needing more sleep), rather than 8, 10, or 6.5 hours.
This is only an introduction, and I'm sure I'll talk about it more in the weeks to come, but to not bore you too much, I'll leave it there for now.
Have additional questions? Leave them in the comments!
Sleep is a very important part of our lives. After all, we spent roughly 1/3 of our lives sleeping. There are several theories on why, exactly, we need sleep. My favorite is the converting of short-term memory to long-term memory. Essentially, if you don't get enough sleep, you won't learn anything new. But for now, I'm going to focus on how much we need and how to get that sleep. In fact, this was the focus of a recently published article that has caught the attention of many news sites.
It's more than just memory, though. Getting less sleep than you need can result in poor academic performance. According to a small study by the American Academy of Sleep Medicine, this effect is as much as binge drinking or smoking marijuana, independent of other risk factors such as psychiatric disorders.
Sleep has also been linked to weight, particularly in adults. A recent study published in Pediatrics shows that getting less than the recommended amount of sleep in infancy and childhood is linked to obesity by age 7. Indeed, even how much a parent sleeps can affect how much the child sleeps, and thus his or her risk of obesity later in life.
Finally, sleep is the time when many hormones are released. For children, the most important of these is growth hormone. That's right--if children don't get enough sleep, they might not grow properly. As an aside, the unbalance of hormones is likely part of the reason why lack of sleep can lead to obesity--the body produces hormones to increase alertness, which promote deposition of fat for future use.
So clearly sleep is important. But how much do we need?
The amount of sleep we need is entirely based on age. Infants sleep most of the day, while adults only need 8 hours or so. Infants also don't sleep at 'normal' times, because they are accustomed to being in the womb and rocked to sleep while mom was awake and walking, and awake when mom was resting. When adults don't get enough sleep, they tend to develop quick tempers and have low energy. When children don't get enough sleep, though, they tend to become hyperactive. Many parents have experienced this with infants that cry more when they aren't put to bed on time.
By two months of age or so, the circadian rhythm starts to develop. This is our body's innate way of telling time, and is based on light clues. In a completely cut-off environment, a normal circadian rhythm lasts about 25 hours. Of course, we don't live in a world where the day is 25 hours long, so this is where the light cues come in.
One of the first things we, as pediatricians, do when we hear a child is not getting enough sleep is to ask about sleep hygiene. Where do you sleep? What time do you go to bed? What time do you get up? What else is in your room?
Lack of light triggers the release of melatonin, a hormone that helps us feel sleepy and fall asleep. If your room is filled with light, even lights from computers, iPads, televisions, etc, you could inhibit your release of melatonin and have a harder time falling asleep. So, one of the first things we recommend is to get those computers and televisions and whatnot out of the bedroom. Even if you don't use them right before bed, the lights that stay on can influence your melatonin production. You can also condition yourself unintentionally into not associating the bedroom with sleep, but rather with activity.
Getting up and going to bed at the same time every day, even on weekends, can also help your body just get used to going to sleep at the same time. I realize this isn't ideal for adults, but there's no reason kids shouldn't have a consistent bedtime.
Finally, as we get older (by early elementary school), our sleep cycles become more consistent and average out to 90 minutes each. Waking in the middle of a sleep cycle can be very disorienting, and can make you feel tired all day. So, bedtime and alarms should be planned so there is a multiple of 90 minutes in the sleep time. In other words, you should try to ensure you are getting 6 hours, 7.5 hours, 9 hours, or 10.5 hours of sleep (depending on age, with younger kids needing more sleep), rather than 8, 10, or 6.5 hours.
This is only an introduction, and I'm sure I'll talk about it more in the weeks to come, but to not bore you too much, I'll leave it there for now.
Have additional questions? Leave them in the comments!
Sunday, June 1, 2014
Yes, All Women...
This happened after I posted my blog post last week, and rather than take it down and post this one to make it timely, I decided to wait a week and see what sort of clarity that brought to the situation.
On May 23, 2014, there was a shooting near the UCSB campus in California. Elliot Rodger was identified as the shooter, and he killed his three roommates, two young women in a sorority, and a bystander before taking his own life. Thirteen other people were also injured. Prior to his killing spree, he posted a Manifesto and YouTube video explaining that he was doing this because he had been shunned by women. Because he did not feel he had gotten the attention he deserved, as a male, from women his age. How he hated other men for getting that attention.
Evidently, there was a cry of support for Rodger's actions on some social media sites, some even stating that more young women needed to die because feminism was destroying society. In response, Twitter started trending #YesAllWomen, essentially an outcry against rape culture and victim blaming. This hashtag trended for at least 4 days, and has sparked plenty of discussion since. If you haven't read any of the tweets yet, I encourage you to stop and do so now.
As a young woman, I've experienced this rape culture myself. During my first year of medical school, I went to a bar with some girlfriends. It was crowded, and we easily got separated. A guy came up to me and asked if I wanted to dance. I turned him down, and went to seek out my friends. He came up to me about 5 minutes later asking if I was here with someone. I gestured to my friends and moved away. Still a third time, when I was dancing, he came up and started dancing with me. My friends quickly moved me to the inside of our dance circle. Thankfully, that was the end of it.
A friend and I were walking to a bar with her boyfriend. We had to walk through a less than desirable part of town. Down the block, on the opposite side of the street, a lone man was standing, watching us. We continued on our path and actively had to block my friend's boyfriend from crossing the street near the man: he had not noticed the man standing there.
In my town, we get an e-mail whenever there is a report of violence near the University campus or involving University students. Nine times out of ten, probably more, the victim is female. For instance: "The victim was walking [after dark] when an unidentified male approached her from behind, putting an arm around her neck and fondling her breast and genitalia with the other hand." "The victim reported she was sexually assaulted after being forced into the bathroom of the apartment where she was attending a party."
Young girls are taught to never go out alone, to always order their own drinks and not leave them unattended, to dress conservatively so as to not draw attention to themselves. We're taught to use the line 'I have a boyfriend,' or give out a fake number when we're not interested in a guy, because 'no' isn't good enough. It's the reason I'm not okay with going out by myself at night, but my male friends don't think twice about it. It's the reason my dad gave me pepper spray when I was in high school.
How prevalent rape is in our society is debatable, because many believe that it is grossly underreported. However, the CDC cites that roughly 1 in 5 women report being sexually assaulted sometime in their life. In a surprising statistic that I will expound more on at a later time, over 50% of the time, the perpetrator is an intimate partner. Men are not victimless either, as 1 in 71 men also report being sexually assaulted during their lifetime.
The lesson? A girl is not 'asking for it' by wearing a low-cut or high riding dress. She's not asking for it by having a bit too much to drink. She has the right to walk down the street, day or night, without getting catcalls or being fondled, or worse, raped. We need to have real punishments for those who violate the personal boundaries of others. We need to empower those who are victims and allow them to tell their stories without feeling shame. Men and women alike need to take these lessons to heart, as women can be just as bad as the men in perpetuating the victim-blaming.
Most social media campaigns do little to change the status quo, but I have a feeling that the popularity and insight this one has produced will change something, even if it's just getting a few men more interested in the lives of their female friends and family members.
This is not about blaming men. This is about getting the good ones to help us fight back enough that women don't need to feel this way anymore.
On May 23, 2014, there was a shooting near the UCSB campus in California. Elliot Rodger was identified as the shooter, and he killed his three roommates, two young women in a sorority, and a bystander before taking his own life. Thirteen other people were also injured. Prior to his killing spree, he posted a Manifesto and YouTube video explaining that he was doing this because he had been shunned by women. Because he did not feel he had gotten the attention he deserved, as a male, from women his age. How he hated other men for getting that attention.
Evidently, there was a cry of support for Rodger's actions on some social media sites, some even stating that more young women needed to die because feminism was destroying society. In response, Twitter started trending #YesAllWomen, essentially an outcry against rape culture and victim blaming. This hashtag trended for at least 4 days, and has sparked plenty of discussion since. If you haven't read any of the tweets yet, I encourage you to stop and do so now.
As a young woman, I've experienced this rape culture myself. During my first year of medical school, I went to a bar with some girlfriends. It was crowded, and we easily got separated. A guy came up to me and asked if I wanted to dance. I turned him down, and went to seek out my friends. He came up to me about 5 minutes later asking if I was here with someone. I gestured to my friends and moved away. Still a third time, when I was dancing, he came up and started dancing with me. My friends quickly moved me to the inside of our dance circle. Thankfully, that was the end of it.
A friend and I were walking to a bar with her boyfriend. We had to walk through a less than desirable part of town. Down the block, on the opposite side of the street, a lone man was standing, watching us. We continued on our path and actively had to block my friend's boyfriend from crossing the street near the man: he had not noticed the man standing there.
In my town, we get an e-mail whenever there is a report of violence near the University campus or involving University students. Nine times out of ten, probably more, the victim is female. For instance: "The victim was walking [after dark] when an unidentified male approached her from behind, putting an arm around her neck and fondling her breast and genitalia with the other hand." "The victim reported she was sexually assaulted after being forced into the bathroom of the apartment where she was attending a party."
Young girls are taught to never go out alone, to always order their own drinks and not leave them unattended, to dress conservatively so as to not draw attention to themselves. We're taught to use the line 'I have a boyfriend,' or give out a fake number when we're not interested in a guy, because 'no' isn't good enough. It's the reason I'm not okay with going out by myself at night, but my male friends don't think twice about it. It's the reason my dad gave me pepper spray when I was in high school.
How prevalent rape is in our society is debatable, because many believe that it is grossly underreported. However, the CDC cites that roughly 1 in 5 women report being sexually assaulted sometime in their life. In a surprising statistic that I will expound more on at a later time, over 50% of the time, the perpetrator is an intimate partner. Men are not victimless either, as 1 in 71 men also report being sexually assaulted during their lifetime.
The lesson? A girl is not 'asking for it' by wearing a low-cut or high riding dress. She's not asking for it by having a bit too much to drink. She has the right to walk down the street, day or night, without getting catcalls or being fondled, or worse, raped. We need to have real punishments for those who violate the personal boundaries of others. We need to empower those who are victims and allow them to tell their stories without feeling shame. Men and women alike need to take these lessons to heart, as women can be just as bad as the men in perpetuating the victim-blaming.
Most social media campaigns do little to change the status quo, but I have a feeling that the popularity and insight this one has produced will change something, even if it's just getting a few men more interested in the lives of their female friends and family members.
This is not about blaming men. This is about getting the good ones to help us fight back enough that women don't need to feel this way anymore.
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