Liliana Gomez, an administrative coordinator at Cedars-Sinai Medical Center in Los Angeles, poses in an examination room at the hospital Tuesday, June 2, 2009. Gomez was one of the first Americans to undergo scarless obesity surgery, an experimental procedure where doctors snake thick tubing down the throat of a sedated patient, from which they staple portions of the upper stomach from inside.

CHICAGO – Doctors are testing a new kind of obesity surgery without any cuts through the abdomen, snaking a tube as thick as a garden hose down the throat to snap staples into the stomach. The experimental, scar-free procedure creates a narrow passage that slows the food as it moves from the upper stomach into the lower stomach, helping patients feel full more quickly and eat less.

Doctors say preliminary results from about 200 U.S. patients and 100 in Europe look promising.

After about 18 months, obese European patients have lost an average of about 45 percent of their body weight, said Dr. Gregg Nishi, a surgeon at Cedars-Sinai Medical Center in Los Angeles. He discussed the European and U.S. studies during a Chicago conference this week for digestive disease specialists.

The procedure is only being done in the studies, which recently ended enrollment. Makers of the device used in the operation plan to seek federal approval if the research continues to go as planned.

While the two studies are still under way and only brief details are being released, Nishi said results so far are slightly better than typical results from with conventional stomach stapling.

Risks include perforating the esophagus, as Nishi said happened to a patient at another center, but otherwise, he said, there have been no major complications.

Some study patients have lost weight after unknowingly undergoing fake procedures — sedation and the tube, but no stapling. Results comparing them with the real thing aren’t yet available.

Liliana Gomez, an administrative coordinator at Cedars-Sinai, was among the first Americans to have the scarless obesity surgery last year, as a test case for the U.S. study. She had planned on more invasive conventional surgery until learning that doctors at her hospital were studying the scarless stapling technique.

“When I found out it was going to be oral, through your mouth, I was like, ‘Wow, that’s kind of different,’” she said.

Since her operation in August, Gomez has lost about 40 pounds and dropped from size 22 to size 16.

The 35-year-old mother of three has a long way to go — she’s still obese according to body mass index standards. But Gomez says she has cut her meal portions by more than half and still feels full, and is optimistic she’ll continue to lose weight.

The new method is part of a medical movement to perform surgery through body openings such as the nose, mouth and vagina instead of making cuts. The idea is to reduce chances of infection and pain, and speed recovery. With no scars, there are cosmetic advantages, too.

Gomez had considered a gastric bypass operation, a more complex kind of stomach stapling, but worried about risks from that surgery. It reduces the stomach to the size of a golf ball and reroutes the digestive tract.

Whether done through one large abdominal incision or several tiny ones, gastric bypass is far more invasive and increases chances for malnutrition because it repositions how the stomach attaches to the intestines to restrict calorie absorption.

Another popular weight-loss surgery option involves putting an adjustable band around the top part of the stomach to create a small pouch.

The experimental method Gomez had is the oral version of a different kind of stomach surgery, which reduces the size of the stomach with staples but doesn’t reroute the digestive system.

Surgery is generally considered a last-resort treatment for obesity, which affects more than 15 million Americans. Still, demand is high. More than 200,000 Americans are expected to have conventional forms of obesity surgery this year, according to the American Society for Metabolic & Bariatric Surgery.

Dr. Scott Shikora, the society’s president, called the oral procedure exciting and innovative, but said, “It is too early for us to say this is going to be a breakthrough.”

Shikora said many U.S. obesity surgeons prefer the rerouting surgery or flexible bands, and that it remains to be seen whether the oral method has the same drawbacks as more outmoded stapling procedures.

The U.S. study is taking place at 10 centers. Patients will be followed for at least one year, with final results expected in 2010. They are randomly selected to undergo either the operation or a sham procedure.

Nishi said of 25 patients enrolled at his hospital, 17 got the real treatment, with no complications.

“I’m very impressed with it,” Nishi said. So far, it looks like “a viable alternative,” he said.

Satiety Inc., a California company that created the medical devices used in the technique, is paying for the research. Nishi said he has no financial ties to the company.

At Washington University School of Medicine in St. Louis, where the first U.S. procedure was done last summer, about 30 patients have undergone the treatment. Side effects have been minimal, including sore throats, nausea and some abdominal pain lasting less than a week, said Dr. J. Christopher Eagon. He said weight loss results from his center aren’t yet available.

___

On the Net:

American Society for Metabolic & Bariatric Surgery: http://www.asbs.org

Satiety, Inc.: http://www.satietyinc.com

By LINDSEY TANNER, AP Medical Writer Lindsey Tanner, Ap Medical Writer

I never used to eat breakfast. Skipping breakfast seemed like a perfectly logical way to help me cut calories and lose weight. But I learned early on in my weight-loss efforts that this was one of the reasons I wasn’t seeing success on the scale. Through trial and error I learned that I really needed to start my day with a combination of protein, healthy fat, and fiber to prevent a serious case of the midmorning munchies. Now, no matter how little time I have, I know I can throw together something fast that will keep me going until lunchtime.

Tina Haupert

15 minutes to spare
My go-to breakfast is a big bowl of oatmeal full of fun toppings, which keeps my routine from getting boring. I combine ½ cup dry-oats oatmeal with 1 cup water or soy milk  and microwave for two minutes. My topping combinations vary, but my favorites include walnuts, pumpkin seeds, raisins, a spoonful of canned pumpkin, ground flaxseed meal, wheatberries, and—my favorite—a spoonful of nut butter.

I also like to toss in some fruit, too, such as banana slices or berries. Eating fruit with breakfast is such a small thing, but it sets a healthy tone for my day.

10 minutes to spare
If I hit snooze one too many times, I whip up a quick, homemade smoothie. I blend ½ cup nonfat yogurt, ½ cup frozen berries, a banana, 1 tablespoon of hemp protein,½ cup soy milk, and ½ cup ice, and drink it on the go. The extra protein helps keep me satisfied. This smoothie takes less than 10 minutes, including cleanup.

Less than five minutes
If I am really pressed for time, my favorite store-bought breakfast is an Odwalla bar, a piece of whole fruit, and a soy-milk misto. A misto is simply a cup of brewed coffee with steamed milk, and it has far fewer calories—and costs less—than a latte or cappuccino.

By Tina Haupert

Among the many mysteries that befuddle autism researchers: why the disorder affects boys four times more often than girls. But in new findings reported online today by the journal Molecular Psychiatry, researchers say they have found a genetic clue that may help explain the disparity.

The newly discovered autism-risk gene, identified by authors as CACNA1G, is more common in boys than in girls (why that’s so is still not clear), and the authors suggest it plays a role in boys’ increased risk of the developmental disorder. CACNA1G, which sits on chromosome 17, amid other genes that have been previously linked to autism, is responsible for regulating the flow of calcium into and out of cells. Nerve cells in the brain rely on calcium to become activated, and research suggests that imbalances in the mineral can result in the overstimulation of neural connections and create developmental problems, such as autism and even epilepsy, which is also a common feature of autism. (See six tips for traveling with an autistic child.)

“Our current theories about autism suggest that the disorder is related to overexcitability at nerve endings,” says Geri Dawson, chief science officer of Autism Speaks, an advocacy group that provided the genetic data used by the study’s authors. “It’s interesting to see that the gene they identified appears to modulate excitability of neurons.”

For the new study, researchers at the University of California, Los Angeles (UCLA), combed the genetic database of the Autism Genetic Resource Exchange (AGRE), a resource of DNA from 2,000 families with at least one autistic child. The scientists focused on the more than 1,000 genetic samples of families in which at least one son was affected by the disorder, prompted by the results of an earlier study using the same database, which identified a rich autism-related genetic region on chromosome 17 that contained genetic variants more common in boys than in girls. While nearly 40% of the general population has the most common form of CACNA1G, one variant of the gene was more prevalent in autistic boys, researchers found. “There is a strong genetic signal in this region,” says Dr. Daniel Geschwind, director of UCLA’s Center for Autism Research and Treatment and one of the study’s co-authors. “But this gene doesn’t explain all of that signal or even half of it. What that means is that there are many more genes in this region contributing to autism.” (See pictures of inside a school for autistic children.)

That’s not surprising for a disorder as complex as autism - actually, a spectrum of developmental disorders involving impairment in language, social behavior and certain physical behaviors - with symptoms that range widely in number and severity. So far, studies have linked a handful of genes, all of which play a role in the way nerve cells connect and communicate, with autism spectrum disorders. It’s likely not only that a large number of genes contribute to the disorder, but also that a different combination of genes - as well as unique interactions between genes and environment - are responsible for each individual case of autism.

So it’s certainly a daunting challenge to begin teasing out the individual genes that may contribute to autism, as the UCLA team has with CACNA1G, but databases like AGRE make the job slightly easier. The next step will be to try to use known autism genes to help develop screening tools or early interventions. “We are going to have a much better understanding of the causes of autism over the next five to 10 years,” says Dawson. “We’re in a period of great discovery.”

By ALICE PARK

The reason we use food as a source of comfort has been examined from every angle by individuals a lot smarter than me. I’m not here to tell you what to do, but I want to give you a few suggestions on how to deal with tackling a food issue.

1. Do not skip breakfast.

People are 75% more likely to overeat the rest of the day if they skip breakfast. Now, if you have a hard time wanting food in the morning, make a nutritional smoothie: Throw in some frozen fruit, greens, protein powder, a little almond butter for satisfying fat and your liquid of choice. Oatmeal is an easy one in the morning. I have said this a lot, but remember that sugary cereal (aka cardboard with sugar) and bagels are not breakfast. Boil eggs and eat with a slice of toast or some avocado. Get your day started right.

2. Bored at work or home? Find a distraction other than food.

If you’re at work and have a break, go for a walk or bring a healthy snack to eat. If you’re doing “the kitchen roam” and find yourself with the fridge open, call a friend or give yourself an indulgent 10 minutes online. This will be one of the only times I say this, but go look up something silly or even informative online to distract yourself from food.

3.  Eat only when you are hungry.

Don’t just mindlessly shove food in your face because it’s something to do. If you can not stop eating when you are bored, then try substituting it with a new habit.

4.  Eat until you are full.

Put it in front of me and I will eat it. Hey, I was always taught to clean my plate, so of course I will eat until all my food is gone, even if it’s long after I’m full. Either control your portions, or buy smaller dinner plates. If you are out to eat, (even if it feels
tacky) have them put half your food to go as soon as you get it.  

5. Avoid fast food and vending machines.

This never ends pretty. Most of the food is fattening, tastes really good (so you overeat), and doesn’t have much nutritional integrity. It’s like dating a hot male or female that you know is psycho. Fun, exciting, but not going to end pretty. If you are on the road and have no other options, then try to pick the best of the bad. Don’t super size your order and avoid fried anything, sodas the size of 5 gallon buckets with a free refiill, and bread. In general, reach for chicken, salads, and, if you can, drink water.

6. If you are stressed out or having a personal crisis reach for the phone, not food.

Call a good friend or ask someone to go on a walk in a peaceful place so that you can vent. Don’t sit at home, alone, crying into a bowl of ice cream.

7. Find other things social to do that don’t always involve food.

This is tricky because when you look at how we structure our days and lives, a lot of social interaction is around food. That’s fine, but create a strategy for where you meet and eat. If you can combine it with some exercise and a healthy meal after, even better! This will provide a positive example for everyone.

8. Write it down. Keep a food journal.

You will be able to pin point exactly what foods and beverages are getting you where.

9. Have some fun.

Paul Chek told me that if we do the right thing 80% of the time in
our lifestyle habits, then we can have some fun the other 20%. Moderation, not denial.

By Gabrielle Reece

WASHINGTON – House Speaker Nancy Pelosi said Wednesday that her chamber would have a sweeping health care bill on the floor by the end of July, an announcement that President Barack Obama hailed.

“That’s the kind of urgency and determination that we need to achieve what I believe will be historic legislation,” the president said at the White House, standing on the south driveway with Pelosi and Democratic leaders of the relevant House committees.

“Our health care system is broken,” Obama said. “We are not going to rest until we’ve delivered the kind of health care reform that’s going to bring down costs for families, improve quality, affordability, accessibility for all Americans.”

Pelosi, D-Calif., and other House Democrats had met with Obama and Vice President Joe Biden in the Oval Office just before going outside to make their announcement. No Republicans were present, and neither were any senators.

“We promised him that we will have this important legislation on the floor of the House before the August break,” Pelosi announced. “Our goal is to have a healthier America.”

Neither the speaker nor the president offered details of how the legislation will look, the subject of ongoing debate on Capitol Hill. The White House is remaining mostly quiet as proposals emerge for discussion among lawmakers, preferring to let Congress come up with a plan and engage more on the specifics later on.

Obama’s plan to provide coverage to some 50 million uninsured Americans is the cornerstone of his promise to enact a larger overhaul of the health care system. Independent experts put the costs at about $1.5 trillion over 10 years.

But turning that vision into reality remains the biggest challenge for the president and his backers, because hard cash — not just ideas — is required to cover upfront costs of expanding coverage.

The final financing package is likely to include a mix of tax increases and spending cuts in federal health programs. Among the possibilities are tax increases on alcoholic beverages, tobacco products and sugary soft drinks, and restrictions on other health care-related tax breaks, such as flexible spending accounts.

Senators also are considering limiting — but not eliminating — the tax-free status of employer-provided health benefits.

Employer-provided health insurance technically is considered part of workers’ compensation, but unlike wages, it is not taxed. The forgone revenue to the federal government amounts to about $250 billion a year.

So even if they’re lucky enough to avoid going to the doctor or hospital, and never use their job-based health insurance, some Americans may find themselves paying taxes on at least part of its value.

Some taxes don’t seem to be on the table, such as a federal sales levy to pay for health care or a new payroll tax.

On the question of taxing health benefits, Senate Finance Committee Chairman Max Baucus, D-Mont., who chaired a round table of senators on Tuesday, is staking out a position that could put him at odds with Obama.

The president adamantly opposed such taxes during the campaign, arguing they would undermine job-based coverage. Obama’s aides now say he’s open to suggestions from Congress, even if he criticized Republican presidential rival John McCain for proposing a sweeping version of the same basic idea.

Baucus said he wants to modify the tax break, not abolish it.

“We are not going to repeal it,” he said.

Baucus suggested that the benefit could be limited by taxing health insurance provided to high-income individuals, although he did not specify at what income levels. He also said that plans offering rich benefits — for example, no co-payments or deductibles — might be taxed once their value exceeded a yet-to-be-determined threshold.

Many experts say Congress won’t be able to come up with the kind of money needed to provide coverage for all unless limitations on the health care tax break are part of the mix.

___

On the Net:

Senate Finance Committee health care round table: http://finance.senate.gov/sitepages/hearing051209.html

By RICARDO ALONSO-ZALDIVAR, Associated Press Writer