donald trump made waves during a town hall appearance this past week after claiming michael jackson's down fall he said was due to bad plastic surgery. that got a lot of people fired over. let's look at what mr. trump had to say. >> i knew him well. i know "the real story." he was an unbelievably talented guy. he lost his confidence. he lost tremendous confidence because of honestly bad, bad, bad surgery. he had the worst. he had people that did numbers on him that were us just unbelievable. >> how much plastic surgery is too much. doctor saddamy, you are a surgeon. you know he received it very commonly. we've seen these cases where people keep going back and back and back and back. >> plastic surgery is a big business. it's about $10 billion and growing over the last decade or so. in fact if you look at the number of liposuction between teens between 19 and 30 years

old, 30% are getting procedures. we've seen 200% growth over the last few years. why is this happening? the message to people and patients is there is no such thing as a perfect nose or body. and as a result of the media, reality tv shows, nip and tuck and all these other stuff people want to look like a star. they say i'm going to get botox during the lunch hour and come back and look great. you have to have real expectations and not put it so high up. the other thing is, also doctors are responsible in this because there are times that people have this disorder, dysmorphic images of their body and there are tons of doctors or plastic surgeons who say you are a beautiful girl, you don't need this. >> or guys, guys ar it, too. >> you are the wrong guy to ndo this and you don't need it. that said, i think there are a lot of plastic surgeries out there that's absolutely

necessary. someone who has enlarged breasts and they have neck or back pain, reduction surgery is a great way to go. if you have a deviated sent up in your nose. webbed fingers. mastectomy, post reconstruction, those are great surgeries, and i think when it's necessary it's absolutely the best thing that had happen. the issue is, as a country we are having kids that have some psychological issues that are mental issues, obsession with these surgeries and you need to know that these are sometimes irreversible. some of these surgeries that you get may have major complications, bleeding, infections, and really can disfigure your whole body and it's not necessary. >> and i think that it's just too casual. the approach to it is casual. i can't believe that you are telling me that 30% of teens are getting liposuction. this is when your body is formulating your muscles are, you know, kinds of retaining

memory, et cetera. tell me how dangerous this really is? and how do we stop it, dr. siegel. >> the first point, david and donald trump made this, the emotional impact of plastic surgery is huge. when your body doesn't look like it did yesterday. it looks different today, you need time to adapt to it. at first you may be depressed, then euphoric. and then over time it may get worse again. it leads to an emotional cycle and disassociation where you dent identify with the new body. with teens, one third of liposuction where you literally suck the fat out -- the other problem with liposuction is the neighboring area may be a problem. in other words it sucks the fat out of one area and what about the area sex next to it. people think of it as a form of weight loss. as an internist i worry about infection, scarring afterwards and you can't use to it lose

weight. >> what do you mean? everyone thinks you suck out the fat -- >> the fat is still there. >> the only way to lose weight is to lose weight. if you take lipoyou can lose weight in one area like a thigh or act babb or abdomen but you can't overall lose weight. if you lose weight, you get on the treadmill and you lose weight then the area you had lipoon looks bad compared to the areas where you did it naturally. >> let me say, for example, there are people who is 300, 400 pounds they get a gastric bypass, and after they lose 100 pords pounds, so plastic surgery is good for that after you find out if your guy is board certified, is it something he does all the time and done in a set up -- >> you are talking about a procedure that saves someone life if you are vastly overweight. what about going in and having

tweak after tweak after tweak. >> you talk about saving someone's life when they are overweight, you know you actually cannot have liposuction if you have diabetes or heart disease. that is too much of a risk to have the sudden fluid shift, the risks of the surgery. >> what's your best advice for people who keep on wanting to go back and have something done, changed? >> the first thing i want people to realize is over the past 19 years we've seen ten times the amount of these procedures as we've had before. it's even worse with something like botox, the non-surgical. we're talking about 400,000 cases of lipo. but we have 4 million cases of botox done. botox is where you paralyze the muscle. >> i think parents need to pay attention to their kids. they need the maid make sure to treat psychological issues. cognitive therapies work well with these kids and you can find out if there is depression or anxiety. peer pressure in school can

affect thaem. and make sure you don't go to a spa that claim they can do botox without a license. find a license surgeon who can do a good job. >> dr. seeingel -- >> i wanted to get back to what botox is. >> okay. >> it's where you paralyze the muscle. in paralyzing the muscle the wrinkles or the areas over it relaxes. the problem is you can overdo it and paralyze the neighbor muscle. i'm not geks botox but i'm against what david said originally. why are people out there doing this? they are not all on fv. not all models. people have to be comfortable with who they are. >> that's what i said, they watch the reality tv shows they want to be like them and that effect of being a star and hollywood star makes them think by going and betting a simple procedure they are going to look like that. >> has botox been around long enough to know the results ten

years later? >> that's a good point. the long term effect of botox is not clear. a lot of times people are getting them now and you may have drooping of the eyelids. it is a toxin. it paralyzes the muscle. and what you really don't know what the long term effect of it is. so you have got to be careful. >> i think botox -- we also have medical uses for botox, an unstable gladder. >> migraine. >> migraines it's useful for. final point, to reiterate something david mentioned. who is doing this? what's their expertise? how many cases have they done? he has done over 6 howe robotic surgeries. how many cases has the person done and how is certifying them. >> you hear about botox parties at their house. >> what? >> botox parties. >> they share the mix. >> that was interesting. thank you. when we come back, a painful and debilitating condition that's on the rise. we are talking about kidney stones. who is most at risk.

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welcome back. a new study showing kidney stones are on the rise. but what's shocking doctors is not only the number of new cases, but that they are also developing in people not considered high risk in the past, including children, women, and african-americans. so dr. siegel, why the increase i first of all? and is it a recurring problem? meaning if you had stones, you get rid of it and does it keep coming back? >> first, what is a kidney stone? it's crystal that forms in your system between the kidney and the bladder, or in the kidney itself. most of the time it's between the kidney and the bladder. testimony these stones, crystals

are often forms of calcium and uric acid. people know that, from goutd. let's focus on calcium. now, calcium comes from your diet. people out there probably think you are getting it by eating too much calcium. that's not the case. it's the calcium that's in your bloodstream that's the problem. now, if you take a lot of calcium supplements you could actually form these. but i'm more worried about something in your diet like spinach, like nuts, like rhubarb. things that cause a compound called objection late which bonds with the calcium and gets into your kidneys. you have to drink a lot of water. that's the bottom line. if you drink a lot of water your risk of stones goes down. if you have kidney stones the risk of passing them goes up. water is the key. >> consume. one crucial thing if i may. you said that calcium, taking calcium could help build these stones. did you say that if you have kidney stones should you not take calcium? >> it's not the calcium.

animal proteins cause it, and salt, too much salt causes it. being overweight causes it. genetics cause it. these are conditions that cause it. eating calcium in your diet wasn't cause it unless you go over the top on that. i get that from a very reputable source dr. smamed ay. >> i grew up thing spicy foods. is that true? >> it could actually affect the increasing in your kidney stones but the bottom live is why is this happening? the reason is our diet. we are taking too much salt. when you take too much salt you dump calcium in your urine and you can get calcium objection late. it happens to be the most common kidney stone. but you could have uric acid, animal fat, animal protein, meat, eggs chicken all of those can get a lot of uric acid. there are people with gout or parathyroid problems, glands that secret a lot of vit lin d.

if you are lowe in your calcium, you can increase your calcium objection late. if you are taking too much calcium, lass problem. monitor that. stay away from sugar. high fructose corn syrup. fluid is perfect. we can treat you perfectly well. anybody who mass a kidney stone knows it is a disaster. they can end up in the emergency room. once treatment fails and you have a cat scan that shows the stone there. as a urology we can go up find the stone, laser it, pull it out and treat it. it can recur. the color of your you urine should be white not dark yellow. if it's dark yellow that means you are not drinking enough water. how much should you drink? at least two to two and a half liters and you should be making about two liters of urine. go to dr. david samadi. >> facebook. >> look at the color of your

urine. that's a great way to tell how healthy -- it's the way to tell whether you are hydrated or not. >> should be closer to clear. >> coming up here on "sunday housecall," depression, you know it affects millions of us. now there are new guidelines. coming up, why doctors are now being told to screen practically every patient, including children for this so common condition. blp oh remotes, you've had it tough.

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now for should i worry. our weekly segment in which we talk about everything that worries us. this comes amid two recommendations from the federal department of health and human services. that new ruling urges doctors to screen practically all their patients including young children for depression. first of all, how do we know or someone know if you do suffer g from depression? >> they are against psa screening and mammograms but on this one they're right. depression affects about 60 million americans, 40,000 people attempt suicide and we spend billions of dollars in this field. any doctor, primary care, pediatricians, to pay attention and catch them early and save

his life, family's lives and others people affected by this. i like the n how do you find someone? if you see someone who is suffering from lack of sleep, they don't have any kind of interest. they lack interest. if they don't have energy. that's listed there. this he don't feel guilty. no energy. loss of concentration. appetite has changed. any change in your appetite? obviously most important all of this is suicidal ideations. thought about suicide and a patient of mine came from iraq post-traumatic stress disorder. how are you doing? this morning i had a gun. i didn't want to live. if it wasn't for a picture of his daughter, i would have

killed myself. today he's alive. >> how do you know if someone is just down? just down. how do you know if you suffer from depression? what do you do? >> one of those things is loss of pleasure and hopelessness and fatigue and behavior changes and you gain weight and your diet changes. i deal with this every single day in my office. one thing that astounds me about the task force recommendation. in 2009, we don't have mental health personnel available so we won't recommend it. if there's no psychiatrist available, internists have to deal with it. the recommendation should be based on our tremendous need to discover this epidemic and not which doctor is treating it. let's discover it. let's discover if someone has a change of behavior if they're down and depressed. if i can't find a psych iiatris to treat it, i have to treat it myself with whatever i think is

necessary. >> just really quickly, how do i know if i'm not just in a rut for a couple weeks? how long is too long to be in a rut? >> the answer is complicated. what is intensity of your rut? do you have suicidal thoughts? are you hopeless? what's your relationship like? are you crying? are you tearful? and then how long does your rut last? it's a combination of the depth of the rut and how -- i like the word rut. >> if symptoms are continuing over a couple of months, then you're in trouble. we're not talking about somebody with a bad day or bad week. it's a prolonged period. the other question comes up that having made it clear is how often should you be screening these patients and the thought is perhaps once a year. on this one, i think u.s. task force is right because we're seeing a lot of teens that are being bullied and under a lot of depression and they take it out by going out there and mass murdering. it affects the society and family. the sooner you get it, prevention is key.

>> someone comes to you, what's your best advice? >> my best advice is to be honest with your physician. you might not be honest with your spouse. you may be too embarrassed to be with your children of course or your parents. be honest with your physician. confide in your physician. had a big breakup? tell me about it. not doing well at work. boss is yelling at you, tell me about it. don't be afraid. i better on my side have plan of what to do. >> so important. >> very good. okay. they're going to make me read this. turning up the heat after the lights go down. so when we come back, we'll talk about the best way to set the mood for those in their golden years and why it could lead to better health. >> i think she's talking about sex. diabetes, steady is exciting. only glucerna has carbsteady, clinically proven to help minimize blood sugar spikes. so you stay steady ahead.

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the nissan rogue. with the power and performance of our intuitive all-wheel drive. now get a $189 per month lease on the 2016 nissan rogue. welcome back. a new report showing sex in your later years can help improve brain health. how so? >> i believe this is true. first of all, you're in the game instead of out of the game. that's number one. you're relationship is better for it. everyone is happier. hormones go up in brain. the ones we need. happy ones. rather than talking about the body failing as you get older and how to overcome that, i'll leave that to david, i would like to say how about kissing more as you get older, how about hugging more and cuddling more.

all of that also releases the hormones that we need. start touching. don't just jump right into sex. do the touching and hugging and cuddling. >> like when you were dating. >> get back to romance. the candle-lit dinner. >> let's talk about the benefit of sex. let's talk about sex. health benefits of sex shows it can boost your immune system and it's heart healthy and helps with prostate cancer. if you have sex 10 to 15 times a month you can reduce the risk of prostate cancer. i'll post a prescription on facebook to take to your wife. women as they get older there will be physiological changes. let's not forget about women. estrogen goes down and things get dry down there. you can use lubrications. >> i said how does sex in later

life help women? >> it can help their cognition, brain power, memory. >> women aren't the only ones that have to worry about things changing. men do, too. thank you very much. a day after his big win in the south carolina primary, donald trump speaks out on fox news with this message to the gop establishment. what's your view of the gop establishment now, sir? >> i think it's a mess. i think it's a mess. i think they better get their act together because they're going to keep losing elections. >> we'll break down what trump's win and jeb bush's exit from the race, what those two things mean for the rest of the gop candidates. >> meanwhile, hillary clinton is celebrating her win out west in nevada. who sided with bernie sanders could have big implications going forward. we'll break it down. fear in michigan. police say this man randomly opened fire outside an a