The teenage years can also be a critical time for weight gain or dietary change among young people as they gain greater independence in food choice and should wherever possible be encouraged to be active and eat a varied diet.

As your teenage years are such an important time for growth and development, a healthy, varied diet is essential to ensure that you receive all the energy and nutrients you need to concentrate well at school and take part in sports and activities.

Here are some top tips for healthy eating:

Try to have breakfast.

Some people think that not eating breakfast will help them to lose weight, but this meal is important for you. By the time you get up, it has been a long time since you last ate, so breakfast will boost energy levels. Here are some ideas:

• wholegrain toast with low-fat spread, a glass of orange juice and a low-fat yogurt.
• a bowl of cereal (low in fat, salt, and sugars) with low-fat milk (including ‘green’ semi-skimmed milk, ‘orange’ 1% milk or ‘red’ skimmed milk), and an apple or banana.
• porridge with chopped banana and a handful of blueberries or dried fruit
• boiled, poached, or scrambled egg and toast and a fruit smoothie.

Eat three meals a day – breakfast, lunch, and dinner.

Make sure each meal includes at least one portion of fruit or vegetables (they contain lots of vitamins and minerals) and plenty of starchy foods such as whole wheat pasta, wholemeal bread, or potatoes with their skins. Make sure that you eat at least five portions of fruit and vegetables every day (fresh, frozen, canned and dried all count). Examples of what counts as one portion include two or more small fruits (such as plums, satsumas); one piece of medium fruit (such as a banana or apple) and one heaped tablespoon of dried fruit.

Boost your iron.

It is important to eat plenty of foods containing iron, especially for girls who lose iron when they have their period. Iron is important for making red blood cells, which carry oxygen around the body. Almost 50% of teenage girls do not get enough iron in their diet. Sources of iron include:

• red meat and liver
• wholegrains (such as wholemeal bread)
• iron-fortified breakfast cereals (cornflakes, Weetabix)
• dark green vegetables (such as spinach, broccoli, or peas)
• beans (such as red kidney beans, chickpeas, or baked beans)
• dried fruits (such as raisins, apricots, or figs) and seeds (such as sesame seeds, pumpkin seeds)

Build up your bones.

As teenagers, you need high amounts of calcium because your bones are growing in size and density. The exact age at which the amount of bone tissue in the skeleton (known as bone mass) peaks is unclear, but it normally happens between the ages of 18-25 years, when bones reach their maximum strength and density. At least 90% of peak bone mass is acquired by the time you reach the end of your teenage years, which makes youth the best time to ‘invest’ in your bone health. The best sources of calcium include:

• dairy products such as milk, yogurt, and cheese – try to choose low-fat versions if possible.
• white and brown bread (as in the UK, calcium is added to flour by law)
• calcium-fortified dairy alternatives, such as those made from soya (particularly important if you are vegan or do not eat dairy products)
• calcium-fortified breakfast cereals
• dark green vegetables (such as spinach, peas, and cabbage)
• fish that is eaten with the bones (such as whitebait, canned sardines, or canned salmon)

Drink plenty of fluids

Especially when taking part in exercise and physical activity, as the body loses water as sweat.

Aim for about 6 to 8 glasses each day. The best sources of fluid include water and low-fat milk. Unsweetened fruit juice should be limited to a small 150ml glass a day. Try to avoid too many sugars-containing drinks and energy drinks, especially between meals as they could harm your teeth.

Limit how much fast food you eat. These foods can be high in saturated fat, salt and/or sugars, which can be bad for our health when eaten in large amounts.

Snack sensibly.

If you are hungry between meals, go for healthier snack choices such as:

• fruit (fresh or dried)
• small handful of unsalted mixed nuts and/or seeds
• yogurts
• wholemeal pitta bread with dips, for example houmous, cream cheese, or salsa.
• find more healthy snack ideas on our page on healthier snacking.

https://www.what0-18.nhs.uk/health-for-young-people

Eating disorders

We all have different ways of eating and many of these ‘eating styles’ allow us to remain healthy. However, some are driven by body shape and weight concerns (e.g. an intense fear of being at a healthy weight or becoming fat) and can upset body functioning and daily activities. These are called eating disorders and are often a way of coping with difficult experiences and emotions. They are described below.

Anorexia nervosa: The person is low in weight and has a fear of being a healthy weight. They restrict what they eat and may purge or use excessive exercise in the pursuit of thinness.

Signs and symptoms of anorexia include:

Those under 18 should be offered family therapy. You may also be offered another type of talking therapy, such as CBT or adolescent-focused psychotherapy.

https://www.nhs.uk/mental-health/conditions/anorexia/overview/

Bulimia Nervosa: The person is in a healthy weight range and frequently binge-eats. They also use harmful methods in an attempt to counter the effects of eating such as vomiting, fasting or excessive exercising.

Symptoms of bulimia include:

These symptoms may not be easy to spot in someone else because bulimia can make people behave very secretively.

Treatment for children and young people:

Family therapy- Children and young people will usually be offered family therapy. This involves you and your family talking to a therapist, exploring how bulimia has affected you and how your family can support you to get better.  If family therapy is not suitable, you may be offered CBT, which will be similar to the CBT offered to adults.

https://www.nhs.uk/mental-health/conditions/bulimia/overview/

Eating Disorder Not Otherwise Specified (EDNOS): The person has most but not all the diagnostic signs of anorexia nervosa or bulimia nervosa.

If you are aged 8-18 you can be referred to the Children and young people’s eating disorder service

https://www.cornwallft.nhs.uk/children-and-young-people-eating-disorder-service

What happens if you are referred to the service?

We understand that coming to meet unfamiliar people and sharing personal information with us can feel an overwhelming or worrying experience. Your first experience of meeting our team will be at your new patient assessment. This assessment hopes to explore a range of topics so that we can better understand you.

We will ask you questions about:

We offer you time to be seen alone in the assessment if that would be helpful for you. We encourage you to think about some of these topics, your strengths, and challenges ahead of the appointment and you are welcome to write notes down and bring this with you. This might be helpful in making sure you share as much information with us as you can to help your assessment outcome.

We are here to learn what your needs are. This might mean that other services might be more helpful for you based on your what you would like support with.

Attending appointments is not something you have to do. It is your choice to work with us as your care will be led by you. If you do not feel ready to work with us, or if you decide you would like to stop attending once you have started, we will respect your decision and will provide safety planning for you. If we feel that you are at high risk of harm and not feeling able to work with us, we may discuss alternative options with you and your parent or carers.

All information you share with us in your appointments will be kept confidential between yourself and the team. If you share any information with a professional that suggests you may have been or are currently at risk of harm from others or to others, we have a duty of care to share this with the relevant services. If we need to do this, we will be open with you as to why we are doing this and who we are sharing this information with.

Anorexia: Katie’s story | NHS
https://www.youtube.com/watch?v=tOouAmEEnlc

It happens to boys too….

Freddie Flintoff reveals the eating disorder he has kept secret for over 20 years – BBC
https://www.youtube.com/watch?v=d7qYccObggc

https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/eating-disorders/overview/

What it means to have an eating disorder NHS
https://www.youtube.com/watch?v=DRQe8NcqvVY

Resources for young people

If you are a young person struggling with an eating disorder, you might find the resources below to be useful.

https://www.beateatingdisorders.org.uk/

https://www.cci.health.wa.gov.au/ – Provides self help modules which you can work through on your own or with a parent or carer.

Alcohol and drugs

Drinking alcohol at any time before the age of 18 can be harmful, the younger you are when you start drinking alcohol, the more harmful it can be with longer lasting effects.

As some drugs such as alcohol make you feel more relaxed, outgoing and sociable, some people use them to help with anxiety in the short term. While this may help reduce feelings of anxiety in the moment, it can have negative long-term effects. For example, you may find that you start to feel as though you “need it” to cope in these situations in future; it may make feelings of anxiety or depression worse once the effects have worn off; or it may make you physically ill.

When you take drugs, there is always some risk involved. This is because drugs can affect different people in different ways, and it can be hard to know exactly what you are taking, as you often don’t know where the drugs have come from.

If you take drugs regularly, you might reach a point where you feel like the drug is in control of you, rather than the other way around. Maybe you’re using it in private, away from friends, and your life revolves around getting more of it. Or perhaps drugs and alcohol are becoming the main things you think about. If so, you could be getting addicted, and addiction is closely linked with mental health problems.

Adolescence is a critical period in a young person’s development towards adulthood. What they learn during their teenage years, and how they learn it, can set the young person’s path for later life. Drinking alcohol during the teenage years can cause permanent brain changes resulting in memory problems, inability to learn, problems with verbal skills, alcohol dependence and depression and other problems in later life.

Alcohol can affect a teenager’s social development if they start drinking at an early age; for example, they may spend their time drinking instead of participating in sports or other recreational activities with peers/friends. They may use alcohol as a coping strategy for any worries, difficulties or problems which may lead to misuse of other substances. If early or excessive alcohol use leads to memory problems, learning difficulties and poor verbal skills this may potentially impact on a young person’s ability to attend school, achieve academically and affect confidence with their peers. This will increase the likelihood of mental health problems such as anxiety, depression, more self-harming behaviours and suicidal thoughts.

https://www.youngminds.org.uk/young-person/coping-with-life/drugs-and-alcohol/https://www.gov.uk/alcohol-young-people-law