tgA new survey from the Partnership for Drug-Free Kids has found that 11 percent of the 3,705 teens participating in their survey report “having used”

synthetic human growth hormones (HGH) without a prescription, up dramatically from just 5 percent in 2012. One in five teens reported knowing at least one friend who uses a performance- enhancing drug. Why are teens turning to human growth hor- mones? Many of the answers lie in pressures for teens to achieve the “perfect body,” and the belief that growth hormones can help in this quest.

What are synthetic human growth hormones?

Synthetic human growth hormone was developed in 1985 and FDA approved for very specific uses in children and adults. In children, HGH injections are approved for treating short stature of unknown cause as well as poor growth due to a number of medical causes. But the most common uses for HGH are not FDA approved. Some people use the hormone, as well as other performance-enhancing drugs such as anabolic steroids, to build muscle and improve athletic performance. There is also the belief that synthetic HGH promotes weight loss. While there have been a few small studies that linked HGH injections with fat loss and muscle gain, the changes seen were minimal – just a few pounds – while the risks were substantial. 

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Eating disorders and body image issues appear to be a common concern for young people in the United States. Nearly 6 percent of young women and 3 percent of boys have disordered eating behaviors. For athletes, the statistics are staggering. Studies have shown that the rate of eating disorders among athletes is more than quintuple that of non-athletes. Statistics show 26 percent to 36 percent of athletes report disordered eating behaviors and more than 25 percent of athletes have concerns regarding body image.4 Women and girls mostly concern themselves with being lean and toned, while men and boys worry about being lean and muscular.

I have worked with many young athletes in middle school and high school. Often there is the pressure to perform, even at a young age. Coaches want their athletes faster, stronger and more effective than their opponents. In addition, athletes are wearing clothing that highlight a competitor’s body in such a way that everyday clothing does not. Runners, wrestlers, swimmers, cheerleaders, soccer players and other athletes require revealing uniforms that can make them uncomfortable or self-conscious in front of parents, friends and other spectators. Having worked with wrestlers for two decades, I often hear spectators, friends and even adults comment on the skin-tight, body-forming singlets that wrestlers are required to wear. One parent told me, “My son isn’t going to wear that if he has to wrestle,”and a cheerleader crying in my office lamented that she “looks so fat in her cheering outfit” that she’s afraid her teammate will drop her on the lift or the girls will ridicule her and dump her from the team.

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Eating disorders are progressive, complex and life-threatening diseases. If identified and managed by a qualified team of practitioners, they can be effectively treated. The sooner treatment is started, the better the prognosis for recovery.

Let’s start with an overview of the most common eating disorders seen in practice:

Anorexia Nervosa

Essential features include an intense fear of becoming fat, which does not diminish as weight loss progresses; distorted body image (claiming to “feel fat” even when emaciated) and significant weight loss (at least 15 percent of normal body weight). Other defining characteristics include refusal to maintain a minimal normal body weight, no known physical illness that would account for weight loss and loss of menstruation for at least three consecutive months.

Anorexia Nervosa affects many organ systems throughout the body, including the central nervous system, heart, kidneys and bones, as well as the digestive tract, skin and endocrine system.

Lack of proper caloric and nutrient intake creates an environment where there are limited nutritional building blocks to create neurotransmitters, hormones and anti- bodies. Effects on the brain and nerves include bad memory, irritable mood, inability to think clearly and changes in brain chemistry. Hair and nails become brittle, skin becomes dry and bruises easily. Sometimes we see a condition called lanugo, where fine hair grows all over the body to help combat coldness. Low blood pressure, slow heart rate, heart palpitations and even heart failure can occur. Anemia is common, as is osteopenia and osteoporosis, increasing their risk of broken bones due to lack of essential bone nutrients. Patients also experience low electrolytes, kidney stones and digestive symptoms such as bloating and constipation. Depending on the age of onset, growth and development can be directly and irreversibly affected.

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