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Tuesday, May 31, 2011

Can't Seem to Focus? Feeling Down?

Foods That Fight ADHD-Related Depression

Do you find yourself battling both ADHD and depression? Adding the right nutrients to your diet may help you better manage.

ADHD and depression often go hand in hand — studies show that roughly 70 percent of those living with ADHD undergo depression treatment at some point. “One of the reasons ADHD and depression are linked,” explains Jeffrey Rossman, PhD, director of life management at Canyon Ranch in Lenox, Mass., “is that adults with ADHD often experience frustration in accomplishing their goals. This difficulty following through can lead to low self-esteem and a sense of discouragement and frustration, which can fuel depression.”
While a mental health professional is often the first-line treatment, a few simple nutritional strategies and lifestyle changes may also ease the emotional pain.
ADHD and Depression: How Diet May Help
Studies show that certain foods, such as those high in B vitamins and in omega-3 fatty acids — found in coldwater fish, walnuts, and canola oil — can help with depression. They’ve also been proven to help with attention and memory.
“If someone is already ingesting a sufficient amount of omega-3s and B vitamins, they’re not necessarily going to benefit from taking more,” Rossman says. However, he adds, “The reality is that most Americans are deficient in omega-3s unless they’re eating a lot of oily fish. The American diet has changed over the last several decades — there’s just a lot less naturally in our diets and so people may find that taking B vitamins and eating fish or taking fish oil capsules may be helpful in fighting depression.”
Katherine Tallmadge, RD, LD, of Washington, D.C., author ofDiet Simple and a national spokesperson for the American Dietetic Association, says omega-3s don’t work for everyone, and no one knows why, but for some people they can be “pretty miraculous.”
Some of the best sources of omega-3s are:
  • Salmon, sardines, mackerel, herring, and anchovies
  • Flaxseed
  • Walnuts
  • Canola oil
It is recommended that people eat about 12 ounces of fatty fish per week, Tallmadge says. That’s equivalent to two servings a week. You can get fish oil in capsule form if you can’t find oily fish fresh or frozen at your grocery store or fish market.
Good sources of B vitamins include:
  • Animal products (meat, poultry)
  • Asparagus, avocado, broccoli, spinach, bananas, and potatoes
  • Dried apricots, dates, and figs
  • Eggs
  • Dairy products (milk, eggs, cheese, and yogurt)
  • Almonds, walnuts, and sunflower seeds
  • Shellfish including clams, oysters, mussels, and crab
  • Wheat germ and whole grain cereals
People who are vegetarians need to be careful to get sufficient vitamin B12. “They may need supplements because it’s really hard to get B12 without eating animal sources of protein,” Rossman says.
ADHD and Depression: A Healthy Approach
Other supplements, such as St. John’s wort, have been shown to help people with depression. “I’m not familiar with St. John’s wort for attention deficit hyperactivity disorder,” Rossman says. “But it has been shown in studies to work as well as antidepressants for mild to moderate depression.”
Overall, the kind of diet that seems to be most helpful for mood enhancement is the Mediterranean diet, Rossman points out. This is a diet rich in fruits and vegetables, with controlled amounts of low-fat dairy, protein, and whole grains, and low in refined foods containing white flour, sugar, and trans fats — olive oil is the fat of choice.
People with ADHD and depression also can benefit from daily exercise, says Tallmadge. “One of the things we know that’s critical for brain function is exercise because it increases blood flow and reduces blood clotting.”
If you’re experiencing incapacitating depression, if you’re not able to engage in work or meet family responsibilities, if you’re suicidal or have any thoughts of ending your life, you should seek the help of a mental health professional right away, Rossman says. “Medication has shown to be most effective for people with clinical depression.”
However, if you have mild to moderate levels of depression, you should see some improvement in your mood and attention by getting adequate omega-3s and B vitamins in your diet and exercising for 30 minutes at least three times a week.
Sound advice that will boost your overall health, too.

Monday, May 30, 2011


Today, we observe and pay tribute to those that have fallen and those still standing in bravery for our country. 

We Thank, Love, and Honor You. 

God Bless All.

-Women's Health

Friday, May 27, 2011

Symptoms That Get Worse at Night

How Sleep Problems Make Asthma Worse

Asthma symptoms can worsen at night if you have sleep-disrupting problems such as snoring and sleep apnea. Find out how to address health issues that can be robbing you of a good night's sleep.

Medically reviewed by Pat F. Bass III, MD, MPH
Asthma attacks may cause you to miss school and work, but asthma can also put you at risk for a more basic problem — getting enough sleep.
“Asthmatics frequently have trouble at night,” says Stanley Fineman, MD, an allergist with the Atlanta Allergy and Asthma Clinic, in Georgia.
Studies have shown a link between asthma and sleep problems such as snoring and obstructive sleep apnea, as well as such sleep-robbing symptoms as coughing, wheezing, and breathing issues. Addressing these challenges can help you get more and better sleep — and possibly improve your asthma symptoms.
What’s Keeping You Awake?

Certain factors in particular can worsen or trigger asthma symptoms at night, including:
Increase in airway resistance. One of the normal changes in the body’s nighttime biological rhythm is a natural increase in inflammation of breathing passages. “Airways tend to have more spasms at night due to normal hormonal fluctuations,” says Dr. Fineman. “They tend to be more open in the afternoon and then more closed at nighttime.”
Decrease in airway function. Another bodily function that is affected by the body’s biological clock or circadian rhythm is how well the airway works. “Respiratory drive goes down at night,” says Todd Rambasek, MD, an adult and pediatric allergist at ENT and Allergy Health Services, in Cleveland, Ohio. That means that the body has to work harder to breathe to make up for the decreased airflow.
Decrease in the body’s natural steroids. “Internal natural steroid production goes down at night,” says Fineman. People who do not have asthma may not be affected by that natural decrease in steroids, which are powerful anti-inflammatory agents, but it can have consequences for people with asthma. Asthma occurs when the airways become inflamed, making breathing difficult. When the levels of the natural steroids decrease, the risk for airway inflammation goes up.
Congestion. A stuffy nose can make sleep apnea and snoring worse and can exacerbate asthma symptoms.
Allergens in the bedroom. Pet dander, dust mites, and other allergens may be the cause of asthma symptoms.

When a Medical Condition Is To Blame

Certain disorders can also make it even harder for people with asthma to sleep well:
Sleep apnea. Sleep apnea is a sleep disorder in which people stop breathing for periods of time and fail to get enough air into the lungs. Sleep apnea leads to increased inflammation in the bronchial tubes, which leads to asthma symptoms.
GERD. One of the more surprising asthma triggers is gastroesophageal reflux disease, or GERD. “Reflux is a big trigger for asthma,” says Dr. Rambasek. “It tends to get worse at night.” Here’s how the conditions are related: The esophagus and lungs have the same nerve supply, similar to the way nerves connect the heart to the arms, says Rambasek. “If the acid gets high enough, it can go right into the windpipe and into the lungs, triggering asthma symptoms.”
Obesity. Being overweight can also increase the risk for sleep apnea, which leads to fatigue and lethargy in the daytime and contributes to decreased activity and exercise. Lack of exercise contributes to obesity, creating an unhealthy cycle of obesity, sleep apnea, and asthma.

How to Get a Better Night’s Sleep

Taking these steps to control your asthma and its triggers can translate to more restful sleep:
Pinpoint the trigger. “Find out what is triggering your asthma,” says Fineman. “If it’s dust mites, take precautions. For pet dander, do not have animals in your bedroom. For pollen, wash your hair and change clothes when you come inside, keep windows closed, and so on.”
Be vigilant about asthma medications. “Take asthma controller
medications regularly and as directed,” says Rambasek. If you have sleep problems that are causing asthma, it is especially important to take your control medications to reduce inflammation in airways during the night.
Take steps to prevent GERD. “To prevent reflux, elevate the head of your bed and avoid late night meals and alcohol,” says Rambasek.

While sleep problems do not affect everyone with asthma, if they’re getting between you and your needed forty winks, work with your doctor to find solutions that will bring you sweet dreams.

Learn more in the Everyday Health
Asthma Center.

Thursday, May 26, 2011

Why Delaying Delivery by Just Two Weeks Boosts Baby's

Why Delaying Delivery by Just Two Weeks Boosts Baby's

What if you could make the difference between life and death for your baby, simply by being patient? A new study published in the June issue of Obstetrics & Gynecology shows that mortality rates are halved by waiting until at least 39 weeks rather than 37 weeks to give birth.

The study is the largest to confirm a message that public-health agencies and professional medical groups have been eager to spread: early elective deliveries are a bad idea. “Up until the last several years, we thought term pregnancies between 37 and 41 weeks were the same,” says Alan Fleischman, medical director at the March of Dimes. “This is not the case. It's a biological continuum. The new data makes us pause and realize we ought not intervene unless there's a very good medical reason.”

Researchers at the National Institutes of Health, the March of Dimes and the U.S. Food and Drug Administration collaborated to analyze mortality rates for babies born between 37 and 40 weeks. Forty weeks is an actual full-term pregnancy, but many have considered gestation to weeks 37 to 38 as more or less equivalent; babies born before 37 weeks are classified as pre-term.

Yet the researchers found that babies born at 37 weeks had twice the risk of death as 40-weekers, regardless of race or ethnicity. Using 2006 statistics, the team found that the infant mortality rate was 3.9 per 1,000 babies born at 37 weeks, compared with 1.9 deaths for every 1,000 live births for babies born at 40 weeks. “Mortality is the tip of an iceberg so there are large numbers of babies who don't die but are sick and require neonatal intensive care interventions and hospitalizations that they would not have needed if they were born a few weeks later,” says Fleischman.
Of course, there are situations in which early delivery is essential for medical reasons. But the new research highlights the importance of not scheduling delivery electively before 39 weeks at the earliest, which dovetails with a recommendation from the American College of Obstetricians and Gynecologists. Earlier this year, the March of Dimes called on hospitals to actively combat the surge in early elective deliveries by requiring proof of medical necessity from doctors scheduling such procedures. In explaining the rationale for early delivery, I wrote:

On one hand, it's understandable. Doctors want to be able to better control their schedule, eliminating middle-of-the-night deliveries and ensuring that they — and not one of their partners — delivers a baby since the delivering physician often receives the bulk of reimbursement. ... It's kind of surprising that insurance providers haven't curtailed the practice of early elective deliveries entirely as babies born sooner tend to have more health complications and cost more. Even babies delivered at 37 to 38 weeks can end up costing 10 times as much as a full-term newborn, according to the March of Dimes. One study found that reducing early elective delivies to under 2% could save close to $1 billion in health care each year.

Although not dangerously premature, babies born around the 37-week mark are more likely to have breathing problems and require ventilation. They may have higher bilirubin levels, which contribute to jaundice, or low blood sugar.

Often, those charged with taking care of babies are to blame for too-early deliveries. “There's collusion between mothers and doctors,” says Fleischman. “Sometimes the mother is suggesting early delivery and sometimes it's the doctor.”

Tuesday, May 24, 2011

Weight Gain Between Pregnancies Raises Gestational

Weight Gain Between Pregnancies Raises Gestational Diabetes Risk
Women Putting on Pounds Between First and Second Pregnancy Increase Their Odds of Gestational Diabetes, Researchers Say
By Cari Nierenberg

The amount of weight a woman gains or loses between a first and second pregnancy influences her risk forgestational diabetes, new research reveals.
In the study, which appears in the online issue of Obstetrics & Gynecology, researchers analyzed the medical records over a decade of more than 22,000 Northern California women who belonged to the same health plan. They looked at how many pounds a woman gained or lost between a first and second pregnancy, in normal weight and overweight women.
To find out whether interpregnancy weight changes affect a woman's risk for gestational diabetes, researchers used a measure called body mass index (BMI) units. (One BMI unit was about 6 pounds based on the average 5-feet 4-inches height of study participants.)
Scientists found that women who had gestational diabetes in their first pregnancy but not during their second gained the fewest BMI units. Women who did not have gestational diabetes in their first pregnancy but developed it in their second gained the most BMI units.
Gestational diabetes occurs when a pregnant woman develops elevated blood sugar levels. Higher-than-normal glucose levels during pregnancy can increase a woman's odds of having a larger baby and a more complicated delivery, and it also puts her and her child at greater risk of having type 2 diabetes later in life.
Gestational diabetes affects 2% to 10% of all pregnancies, according to the American Diabetes Association. Women who are overweight or obese before having a baby are at a greater risk for gestational diabetes.

Preventing Gestational Diabetes

This study revealed that new mothers who put on 12 to 17 pounds between their first and second pregnancy more than double their risk for gestational diabetes compared to women whose weight changed very little. Women who gained 18 pounds or more between births more than triple their chances of developing the condition.
Although gaining weight between pregnancies was shown to increase gestationaldiabetes risk, this study is the first to explore whether losing weight before expecting a second child could prevent it from recurring.
Weight loss was associated with a lower risk of gestational diabetes primarily among women who were overweight or obese in their first pregnancy, study researcher Samantha Ehrlich, MPH, a project manager at the Kaiser Permanente Division of Research in Oakland, Calif., says in a news release.
"The results support the avoidance of gestational weight retention and postpartum weight gain to decrease the risk of gestational diabetes in a second pregnancy as well as the promotion of postpartum weight loss in overweight or obese women, particularly those with a history of gestational diabetes," Ehrlich says.

Monday, May 23, 2011

Sterilization form leaves some badly misinformed

Sterilization form leaves some badly misinformed
Confusion about surgery is common, study finds
Dr. Nikki B. Zite

A new study involving TennCare patients reveals women often don’t understand what they’re signing when they give consent to undergo surgical sterilization.

The federally required form is written at a reading level that is difficult for women with low literacy skills to comprehend. The form poses problems for women who want the surgery as well as those who don’t, the study showed.

The form requires written consent 30 days inadvance of the surgery. Dr. Nikki B. Zite, an author of the study in this month’s issue ofObstetrics & Gynecology, became interested in the subject when she was a medical resident in Memphis.

“Women who had nine babies would be crying to me, ‘I want my tubes tied,’ but I could not tie their tubes because they didn’t have these papers signed,” Zite said.

The surgery can be done at the same time as a cesarean section.
Improving comprehension

Zite, now an associate professor at the University of TennesseeGraduate School of Medicine in Knoxville, evaluated the comprehension level of two groups of TennCare patients.

Two hundred women participated. Half were given the standard form, which is written at a high school reading level, while the other half got a modified version written at a sixth-grade level. Women who filled out the modified version were much more likely to give correct answers on a followup questionnaire.

The biggest gap concerned understanding the time frame for the consent form. More than half of the women given the modified form correctly answered that the permission expired in six months, but only 1 in 5 got the answer right after reading the standard form.

Ninty-three percent of the women given the modified form understood the 30-day requirement before surgery, compared with just under 70 percent for the group using the standard form.

But the most disturbing difference showed that the form often failed at its intended purpose. More than a third of the women — 34.3 percent — who were given the standard form incorrectly agreed that “In a few years, if I change my mind, doctors can easily fix my tubes so I can have another baby.” Fewer than 19 percent of the women given the modified form had this misconception.

The modified form spelled out the consequences in simple language: “If I decided to have my tubes tied, I know that I will NOT be able to have a baby now or later on.” The relevant phrase in the standard form is longer with bigger words.
Barriers to change

Federal regulations require all state Medicaid programs, including TennCare, to use the standard form.

“The text of that form is included in our federal rules, so changes to that form would have to be made at the federal level,” said Kelly Gunderson, director of communications for TennCare.

At this point, the Centers for Medicare & Medicaid Services is not considering any changes to the wording, said Lee Millman, a spokeswoman for the federal agency.

“CMS would like to make clear that, while states should not be amending the consent form, nothing prohibits states from issuing separate forms that clarify these requirements in language the state believes to be more understandable,” Millman said.

The federal government began requiring the consent form in the 1970s after the Southern Poverty Law Center filed suit on behalf of two mentally disabled girls, aged 14 and 12, who were surgically sterilized in Ala. Their mother, who could not read, signed a consent form with an X and testified she thought they would be given birth control shots. The lawsuit contended that tens of thousands of poor, black women in the South were being coerced into surgical sterilization.

Zite believes there’s still a problem.

“People who don’t understand are getting sterilized,” she said. “But there are also women who are very appropriate for sterilization. They have had five or six babies and they want the sterilization, but they don’t make it to that one prenatal care visit where you would sign your papers.”

Women who failed to sign the consent form in advance of a cesarean section are unlikely to come back for another surgical procedure, she said.

“These papers were created with good intentions, but now they act as barriers for numerous reasons,” Zite said.

Asked if CMS or the U.S. Department of Health and Human Services had conducted research on how well women comprehend the form, Millman made an inquiry.

“We are not aware of any such research,” she said. “However, CMS would be interested in reviewing research gathered from other stakeholders.”

Sunday, May 22, 2011

"Yippee! Pap Tests Every Three Years!"

"Yippee! Pap Tests Every Three Years!"
By Diane Hibbs

According to a new study reported in Medscape Medical News, cervical cancer screening can be done only every three years rather than the previously recommended annual screening. But hold on there, Missie! Before you go jumping for joy and deleting your regularly scheduled gynecology appointment from your calendar for the next three years, let’s look a little closer.

The American College of Obstetrics and Gynecology (ACOG) has been recommending three year follow-up for women with a negative Pap test and a negative HPV test (a test for human papillomavirus, the virus that can cause cervical cancer), though this has not been widely adopted by practicing physicians. This study, by Hormuzd Katki, PhD from the National Cancer Institute, suggests that the HPV test alone could be used every three years. Katki and his researchers found that the 5-year risk of cervical cancer with a negative HPV test alone was not appreciably lower with the addition of a negative Pap test and that the Pap test could be reserved for use with positive HPV test results only. His research supports the adoption of the ACOG guideline and actually goes further by suggesting Pap tests only if the HPV test is positive.

But whether for a Pap test and/or for HPV screening, it is vitally important for women to have routine exams. An annual, well woman exam is important for other reasons than cervical cancer screening and may include STD screening, breast exams, hormonal evaluations and other indicated components.

Many women have had the misconception that a pelvic exam always involves a Pap test. For example, some women who have had a pelvic exam in the emergency department believe they had a Pap test at that time, while most ER physicians will tell you they haven’t done a Pap test since medical school, though they routinely do pelvic exams when indicated. The Pap test is just one component of a well woman exam, just like vaccinations are just one component of a well baby exam.

While the scientists and journalists have done their jobs by reporting these facts, the general population must interpret them accurately, not only in regards to what they are saying, but also what they are not saying. Women must continue to receive annual exams from their gynecologists, whether or not that includes a Pap test and/or an HPV test – or neither test.

Saturday, May 21, 2011

New HIV Drug Approved By FDA

New HIV Drug Approved By FDA

WASHINGTON -- The Food and Drug Administration said Friday it approved a ne
w HIV drug from Johnson & Johnson for patients who have not been treated with other medications for the virus.
The once-a-day pill Edurant works by blocking the virus from reproducing. It is designed for use as part of a drug cocktail that reduce levels of HIV in the blood.
"Patients may respond differently to various HIV drugs or experience varied side effects. FDA's approval of Edurant provides an additional treatment option for patients who are starting HIV therapy," said Dr. Edward Cox, FDA's director of antimicrobial products.
The FDA approved the drug based on a study of 1,368 patients showing it was as effective as Sustiva, an older HIV drug already on the market. After 48 weeks of study, 83 percent of patients taking Edurant had undetectable viral levels, compared with 80 percent of patients taking Sustiva.
The most common side effects with Edurant included depression, trouble sleeping, headache and rash.
Edurant is manufactured by Tibotec Therapeutics, a division of Johnson & Johnson's Ortho Biotech Inc.

Friday, May 20, 2011

Home Births Jump 20 Percent in 4 Years

Home Births Jump 20 Percent in 4 Years: U.S. Report

Increase follows 15-year decline; experts remain divided on safety.

Thursday, May 19, 2011

The Psoriasis-Stress Connection

The Psoriasis-Stress Connection — and What You Can Do to Manage Stress

Stress plays a crucial role in psoriasis: Having psoriasis can be stressful, and stress itself can trigger flare-ups. Here's how to make stress management a valuable part of your psoriasis treatment plan.

People with psoriasis want to do everything they can to keep their condition under control. Taking medication and avoiding known triggers — including psychological stress — can help you minimize flare-ups.
That’s because psoriasis and stress are intricately linked. Although psoriasis is a genetic condition, environmental triggers such as stressful life event often trigger it, according to the American Academy of Dermatology. And having psoriasis is stressful in itself, which can trigger future flare-ups. That’s why it’s crucial to make stress management a key component of your psoriasis treatment plan.
Psoriasis, Stress, and Your Immune System
Psoriasis is an inflammatory skin condition. Doctors and researchers do not yet fully understand what causes this condition, but it is thought to occur when the immune system turns on the body, causing skin cells to grow abnormally and rapidly. Because stress can have an impact on the immune system, doctors have long suspected a link between stress and psoriasis, and recent research supports the theory.
"Psoriasis is very stress-dependent. It flares very easily when patients are under stress, and it tends to improve when they're relaxed," says Vesna Petronic-Rosic, MD, MSc, a dermatologist and associate professor of medicine at the University of Chicago Medical Center. Many people with psoriasis even recall their first outbreak happening during a difficult time in their lives.
Psoriasis-Related Stress
Psoriasis itself can be a stressful thing to deal with, and that can make psoriasis management more difficult.
People with psoriasis may be uncomfortable exposing areas of their skin that show signs of the condition. "Psoriasis is a stigmatizing disease for many people because it's so visible," says Dr. Petronic-Rosic. Someone with psoriasis might avoid wearing warm-weather clothing, instead choosing to sweat in long sleeves and pants because they want to hide their skin. Feeling self-conscious or worried about these physical symptoms increases emotional stress, which can cause psoriasis to flareeven more.
Before focusing on stress management, however, you should address the symptoms of the disease itself. "You can't just tell a patient, 'Don't stress and your psoriasis will improve,'" says Petronic-Rosic. "First try to get the disease under control. When the skin feels and looks better, then move on to doing other things that are beneficial for well-being."
Psoriasis Treatment: Stress Management
Stress management techniques can help you keep psoriasis under control, and there are many effective methods to try. For one, exercise: It's a great stress reliever with innumerable other health benefits. "I will very often tell patients to take up an exercise hobby — something that they will enjoy doing that will help alleviate the stress," says Petronic-Rosic. Ideas include yoga, meditation, and Pilates.
People with psoriasis also should limit other behaviors related to stress. Alcohol and drugs, which people may use to reduce stress, actually make stress worse. "There's a lot to be said about managing these addictive behaviors," says Petronic-Rosic. "Stress-induced behaviors, such as alcoholism and smoking, aggravate psoriasis and correlate directly to the severity of the psoriasis."
Identifying your main sources of stress can help you keep them in check — but stress management doesn't have to be done alone. Having a strong support system, including involved family members, is important for coping with a chronic condition. Counseling could also help bring stress levels under control when other techniques are not enough.
Psoriasis is a chronic condition and often requires an effective method to continually manage associated stress. "Psoriasis will get better or worse, go into remission or flare, but it's probably going to be there for the rest of their life," says Petronic-Rosic. Psoriasis patients need to develop a coping mechanism so that they're not "constantly stressing themselves out because they have this disease." Doing so will benefit emotional health, and may positively impact psoriasis symptoms as well.

Wednesday, May 18, 2011

Who May Be at Risk for Alcoholism

Some More Sensitive to Effects of Alcohol, Study Finds

That response may make them more vulnerable to alcoholism, researchers say.

Tuesday, May 17, 2011

Some doctors refuse to treat fat patients: Is that fair?

Some doctors refuse to treat fat patients: Is that fair?

CBS) No fatties allowed! That seems to be the policy of some doctors in Florida - and medical ethicists are crying foul.
In a poll of 105 obstetrics-gynecology practices in South Florida, 15 said they refuse to treat even healthy patients who exceed certain weight cut-offs. Some practices set the cut-off at 200 pounds.
The poll was conducted by the Fort Lauderdale's Sun Sentinel newspaper.
Why the no -fat-patients policies? Some practices said their exam tables and other equipment couldn't handle the extra load, the paper reported. Others said they avoid fat patients because they are more likely than thinner patients to develop hard-to-treat medical complications.
"People don't realize the risk we're taking by taking care of these patients," Dr. Albert Triana, whose South Miami practice declines to treat obese patients, told the paper. "There's more risk of something going wrong and more risk of getting sued. Everything is more complicated with an obese patient" when it comes to gynecological surgery or pregnancy.
It may be true that obese patients are harder to take care of, Dr. Charles D. Rosen, president of the Association for Medical Ethics, told CBS News. But, he said, that doesn't mean it's okay for doctors to exclude fat patients from their practices.
"To refuse to even see a patient because they are overweight is not reasonable and not ethical," he said. "This is discriminating against people who have a medical problem. It is like discriminating against someone who is African-American or short or has a certain employment." 
More than a third of adults in the U.S. are obese. If that percentage goes up much more, "unethical" might not be the only label some use for doctors who decline to see fat patients. What else might they be called?
Out of work.
 What do you think? Should doctors be able to turn away fat patients? Or is that unfair?