Normal Weight Obesity: Why Losing Weight Is Not Always the Answer

Weight loss is one of the most common recommendations that doctors make.  How do we know if a patient should lose weight?  We usually use the Body Mass Index (BMI) which is a way to compare a patient’s weight to her height.  (For all you math geeks, it’s the weight in kilograms divided by the height in meters squared.  For all you physicists, I know the units make no sense.)  A BMI of 18.5 to 25 is considered normal.  A BMI of 25 to 30 is considered overweight, and over 30 is considered obese.  ...
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A New Treatment for Clostridium difficile

You may not yet have heard of the bacterium Clostridium difficile (C. dif.), but in the next few years it will likely become a household name, as well known as Staph and Strep.  C. dif. causes a severe infection of the colon leading to severe diarrhea.  It frequently results as a consequence of antibiotic use.  Antibiotics can kill the normal intestinal bacteria and allow harmful bacteria like C. dif. to proliferate. Decades ago, C. dif....
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To Clot or to Bleed?

Aspirin has long been known to prevent strokes and heart attacks in patients with a previous stroke or heart attack.  But aspirin has potentially serious side-effects.  Aspirin can cause stomach ulcers, and it inhibits blood clotting raising the risk of life-threatening bleeding. If we knew in advance that a patient was going to be in a car accident or have a bleeding stomach ulcer, we would discontinue the aspirin a week before the event and minimize the bleeding risk.  (This is exactly what w...
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Antidepressants for Mild Depression May Not Help Much

Treatments for depression are difficult to study.  First, depression is a condition that can improve without treatment.  So any treatment must be compared to placebo to see if the treatment is responsible for the improvement or if the depression improved on its own.  Also, depression can not be measured objectively.  There is no objective test like an X ray or a blood test that can diagnose depression.  (At least not yet.  As our understanding of brain function improves, such a test is certainly...
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