EDITORIAL

Under construction

Would you advise against any of the following (assuming either parents or a teenager seeks your advice)? Why?

• A 14-year-old boy wants to lift weights to enhance his upper body strength

• A 13-year-old girl wants to have cosmetic surgery to reduce the size of her nose

• A 15-year-old boy wants to take protein supplements to increase his body mass

• A 16-year-old girl whose hair is dark brown wants to color her hair red

• A 17-year-old boy wants to take creatine to increase his strength and his chances of playing varsity football

• A 16-year-old boy wants to lose 8 pounds before he has to weigh in for a wrestling match.

As far as I'm aware, none of these efforts to affect appearance or performance causes temporary or lasting physical harm. Many readers would probably not be concerned about some, or perhaps any, of these proposals. But is there a point at which an effort to achieve a more ideal appearance or to succeed athletically is unhealthy just because of what it says about the adolescent's (or adult's) inability to accept who and what he or she is? Or are attempts to improve appearance just a normal part of growing up, expected and acceptable as long as they aren't harmful?

We all try to alter our appearance, and some of us take vitamin pills we probably don't need and harmless supplements to avoid memory loss and other horrors of getting older. Each of us has her own idea about when these attempts are excessive, silly, too expensive, or not worth the risk. Adults should be able to help adolescents find that line, providing them, respectfully, with the information they need to make healthy choices and helping the adolescents understand that by the time they are old enough to worry about memory loss, the accomplishments and relationships they cherish most will have nothing to do with muscles or the size of their nose.

Julia A. McMillan, MD, Editor-in-chief of Contemporary Pediatrics, is Vice Chair, Pediatric Education, and Director, Residency Training, Johns Hopkins University School of Medicine, Baltimore

Julia McMillan. Editorial: Under construction.

Contemporary Pediatrics

2000;7:9.