Adolescents and Social Media

When I first entered practice in 1985, the term “social media” wasn’t even a thing yet.  Now, of course, its a major issue in the lives of virtually everyone and in particular adolescents.  It is a frequent topic that I discuss with parents.

A recent study in a British public health journal demonstrated some very troubling patterns here.  They enrolled almost 10,000 children and followed them from ages 10-15 to > 16 years.  Initial surveys collected data on social media sites and amount of usage reported, then after several years standardized mental health questionnaires measuring both well being and negative emotions were completed by  the now young adult subjects.

In girls they found a clear and quite strong association of increasing media usage with more negative feelings and greater emotional difficulties in late adolescence.  Interestingly, they found no such correlation among boys.  Greater prevalence was demonstrated in homes of lower economic or parental educational achievement. Unsurprisingly, more social media usage increased sedentary lifestyle.  Racial differences were inconclusive.  Another non-factor was type of usage–“passive”(reading only) vs “active”(posting and responding)–girls did worse either way.

There may be several reasons for this observation.  Girls seemed to make a greater effort at online presence and often put greater emphasis comparing themselves to perceived online personality or situations.  “Likes’ and “hits” are viewed very directly as popularity in ways similar to public opinion polls.  Online, as opposed to in person, conversation is more “indirect,” allowing less emotional commitment to the relationship, less effort at properly expressing oneself, and no opportunity to learn to judge facial expression, voice inflection, or body language which may result in a person with more limited social development.  Needless to say, online interactions may increase risks of such negative interactions as stalking, bullying, or public shaming.

So–what’s a parent to do?  As always, I say “you are your child’s best teacher and best toy.”  Be a role model–don’t obsess with your phone and social media yourself.  Use only at specific times and situations.  Try not to walk into your home using the phone, no use of phone at meals or parent/child interactions interrupted(except true emergency, of course).  Endeavor to develop ongoing activities of interest for your adolescent and take an interest in their participation.  Spend time with them (a challenge–important part of adolescent development is to establish autonomy from parents, so don’t overdo it here; try to do things with them on their terms).  Also I believe it is fine–almost essential— to place concrete time limits on phone/social media use, particularly in the evening when it can most commonly be an impediment to a good night’s sleep. I always counsel that cellphones NOT be kept in the teen’s bedroom overnight but rather in some fairly distant location in the house to avoid that frequent problem.

Here are useful tools from the AAP that can help you manage your family’s social media in English and Spanish


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More Thoughts on Child Obesity

We are all aware of the obesity epidemic throughout our population; as a pediatrician I focus on its presence in children.  In this month’s Pediatrics a study followed overweight children, who’s parents encouraged dieting for weight loss, for 15+ years into adulthood. They found  72%> binge eating, 79%> unhealthy weight control behaviors into adulthood.  The “adult kids” were 50%> pushing their kids to diet and 40%> having unhealthy family food communication (teasing)– important and wholly predictable information.

My advise is don’t initiate specific, direct dieting/weight loss discussion.  OK if your teen asks for dieting advise to be encouraging–“I think its a good idea.  You’ll feel better and better about yourself.  How can I help you?”–good, complete response(follow through, please).  Otherwise even pushing about “healthy eating”  is largely unhelpful–most teens are savvy enough to see “health” as a thinly veiled euphemism for “weight.”  Discussing “manners” and “etiquette” is fair game (see below)– kids are mostly unconcerned at the thought of being “unmannerly” rather than “unattractive.”  Mostly concentrate on environment(“under the radar”), so better food choices are obvious and made by them.   Suggestions:

  1. Limit fluid calories.  Lower fat milk, mostly water, seltzer (a squeeze of orange, lemon, or lime). Loaded with “empty” calories (fattening, not satisfying) and carbs.  Simply don’t have these in the house, period. Fruit juice is virtually identical (OK for breakfast).  Sugar causes pancreatic insulin release for absorption which also stimulates appetite.  The dissolved sugar in drinks causes faster and greater insulin release and appetite stimulus..
  2. More fiber–fresh fruit and especially low carb vegetables, some whole grain starches (bread or pasta).  Less fast food and prepared food from boxes or freezer.  The sugars in the fruit, unlike the juice, is INSIDE the cells.  Your body has to “break open” the cells to absorb it.  This slows down the process causing less and slower insulin release and less appetite stimulation.
  3. Eat slower and wait >15′ before “seconds” (especially desert/snacks).  Slows down the process as above and allows the “insulin rush” appetite stim from the first helping to dissipate.  Here’s where “etiquette” comes in.  Make conversation during mealtime.  Then you can say “stop talking while you are eating.  It’s impolite.”  They can perform table chores–clear used dishes, get ketchup out (“help your poor Mother–be polite.”)  NOT getting seconds–you do that (“Be polite–wait until everybody has had.” “I will serve seconds; you’ll spill and make a mess for me to clean.  Be polite.”)  Get it?
  4. OK to have some “fun food” snacks (pastry, ice cream)–modest amounts lasting a week.  If they finish off quickly, here’s your answer: “I don’t have all the time and money to go back to the supermarket repeatedly, so you’ll have to wait.  Next week pace yourself.  Be polite.” To stop one child from gorging  from siblings buy or cut into individual serving sizes and mark for each.  Taking others’ things is stealing and impolite.
  5. Exercise.  I say “throw the bums out”(weather permitting).  if they are outside with their friends they are more likely to engage in calorie burning play instead of staring at the computer. Exercise with them some.  Better for your health and  family bonding as well.

Above you have never mentioned weight, appearance, even health.  But you make the point.  Finally– delicately–be a role model.  It’s useless to forbid soda but bring it home to guzzle yourselves.  Kids hate hypocrisy and they’ll likely just steal and drink it themselves anyway.

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