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

If there’s one thing that gets in the way of you being your healthiest, it’s stress. For anyone who’s found themselves standing in front of the freezer inhaling spoonfuls of Coffee Heath Bar Crunch ice cream (not my real name!) to avoid finishing a project, or waking up three times in the wee hours of the night in anticipation of a difficult conversation, here’s some not-so-shocking news: Research shows that anxiety can make you sleep fewer hours, get sick more often, remember less, become more prone to long-term disease and—as if you needed reminding—eat more. No wonder up to 90 percent of doctor visits are for stress-related complaints, a fact that I suspect too many of you know firsthand (though you experience it as GI distress, back pain, a headache or other physical symptom).

In a recent Self.com poll, 85 percent of women said that worries interfere with their ability to catch zzz’s, while 71 percent say they’re more irritable due to stress. And given the recent headlines about the state of our economy, it’s not surprising that 52 percent of women say they are under considerably more stress than they were six months ago.

Grim, yes, but there IS hope. Just as our bodies are wired to react to stress, we’re all also programmed to know how to wind down, whether it’s by watching a funny movie, sitting in the sauna, sipping some chamomile tea (while dunking a cookie, of course!) or drinking a glass (or two) of wine with dinner. These activities switch on the brain’s pleasure centers, blocking the production of the stress hormone cortisol and churning out happiness-inducing chemicals like serotonin instead.

When I feel a tightening in my back or neck coming on, I cope by doing things I love, like going for a long, slow run in the park with my dog. Try a few of these instant soothers, and watch your own stress go from ARGH! to Ahhh.

Turn up the tunes. Listening to music that has a steady (not frenetic) beat may cause brain waves to keep time and relax you, research from a music symposium at Stanford University in California reports. Load your iPod with a playlist of the songs that make you happiest.

Phone a friend. Pouring your heart out to pals can help you cope with bad feelings and brainstorm new ways to solve problems. And don’t forget to return the favor: Lending an ear and offering support can make you feel needed and reduce anxiety.

Break a sweat. Exercising for 30 minutes makes your body release chemicals that dull the physiological effects of stress response for up to a full day. But the effect only works when the activity is something you really want to do, so make sure you’re psyched about channeling your energy in that cardiovascular direction.

Use a better bulb. Outfit your office lamp with an incandescent bulb, particularly if your cubicle is brightened by fluorescent lights. Incandescent and fluorescent lights work together to more closely mimic outside light. And it’s sunshine (or the perception of it) that regulates the body’s biorhythms. Not getting enough of it can affect hormone levels, suppressing the immune system and increasing the probability of mood swings, depression and sluggishness.

Pamper yourself. Whether you get a pedicure or splurge on a blowout, giving yourself special treatment reduces your blood pressure and gets your mind off what’s bothering you. Science supports this coping mechanism as well: A warm bath can activate neurons that increase serotonin, and a study from Bowling Green State University in Ohio found that a 15-minute massage can significantly cut anxiety levels. Not up for a splurge? Get the same effect from an at-home pedicure, manicure or blowout.

Dine by candlelight. The effect won’t just make you look gorgeous. The dim setting actually signals your brain to release melatonin, the good-for-you sleep hormone which ensures a better night’s rest. And catching enough zzz’s helps keep your stress levels under control and your immune system humming. Can’t sleep? See what your stress dreams are trying to tell you.

Snuggle with your sweetie. A simple 20-second kiss or hug increases endorphin levels, while having sex releases more calming hormones than any other form of sex play, researchers at the University of the West of Scotland at Paisley note.

Keep a journal. Jotting down your stressful thoughts can help you look at them more logically, potentially easing anxiety, mentally and physically. A study in the Journal of Health Psychology finds that a mere month of expressive writing can help reduce hypertension. Keep a pretty notebook handy at all times.

Anticipate something awesome. Or something tiny that makes you smile. The point is to look forward to something each day, whether it’s enjoying your morning java or counting down to an exotic vacation. Practicing this will keep your mind from focusing on what could go wrong that day.

Exhibit your exhilarating moments. Tape up pictures of three amazing days you’ve experienced, such as dancing at your wedding or crossing the finish line of a half-marathon. Honing in on the images for at least 10 seconds can lower muscle tension and stabilize your heartbeat.

Give someone props. Go on, pay a compliment to someone deserving. Research has shown that the more warm personal connections you make, the better your body is at jettisoning the effects of stress.

Stress-eater? Snack away the tension with these stress-busting foods.

Introduction

Many people worry about gaining weight when they quit smoking. Most people do gain weight, but it’s usually less than 10 pounds.¹

The good news is that there are steps you can take to keep your weight gain small.

The important thing is to quit smoking. The minute you quit, you’ll be starting a much healthier life.

Key points

• Smoking is much worse for your health than gaining a few pounds.
• If you try to lose weight at the same time that you try to quit smoking, you will probably have a harder time quitting. So deal with quitting first. Then worry about weight gain.
• While you are trying to quit, focus on eating healthy foods and being more active.

What is the connection between quitting smoking and gaining weight?

The main reason that people gain weight when they quit smoking is simple: They eat more.

There are several reasons why this happens:

• Nicotine curbs your appetite. It also perks you up when your energy is low because of hunger. When you quit smoking, you may feel hungry more often and eat more as a result.
• Nicotine dulls your taste buds. So when you quit smoking, food tastes better and you may want to eat more.
• Without cigarettes, you may turn to food as a replacement. You may need something to do with your hands and mouth at certain times of the day when you used to smoke.
• Nicotine makes your body burn calories faster. So when you quit, your body isn’t burning calories as fast as it used to. This can lead to weight gain, but usually no more than 10 pounds.

Studies show that the more cigarettes you smoke, the more likely you are to gain weight when you quit.

Why should you quit smoking if it’s going to make you gain weight?

First of all, not everyone gains weight. Some people are able to keep their weight down when they quit smoking.

And if you do gain a little weight, it’s still better than smoking:

• A few extra pounds can be lost later. Serious damage to your lungs if you keep smoking can’t be fixed later.
• Most people would have to gain 100 pounds or more to put their health in danger the way smoking does.
• As soon as you quit smoking, you lower your chances of having a heart attack or a stroke.
• After 10 years of not smoking, your chances of getting lung cancer are much lower.
• By quitting, you lower your chances of getting cancers of the voice box, mouth, throat, esophagus, intestine, bladder, kidney, and pancreas.
• When you quit, you get rid of the secondhand smoke that may be putting the health of your family in danger.
• When you quit, you stop smelling like a smoker. You’ll have fresher-smelling clothes and fresh breath.
• With the money you save by quitting, you can buy other things that you want.

How can you deal with weight gain when you quit smoking?

Be aware

Knowledge is a powerful thing. Now that you know that quitting smoking can make you want to eat more, or eat more often, you can be ready for it.

• Remember that the secret to weight control—whether you smoke or not—is eating healthy food and becoming more active.
• Start reading food labels. Know which foods are high in calories, especially fats, and don’t buy them.
• Don’t try to diet when you quit smoking. Most people who try to lose weight at the same time they are trying to stop smoking have an even harder time of stopping smoking. Instead, eat more fruits, vegetables, and whole-grain foods. And try as much as you can to avoid foods that have a lot of sugar or fat.
• Find ways to get more active. Take the stairs. Park farther away. Take walks. Start a program at the gym, or take up a new sport.

Have a plan

Keeping control of your weight will be easier if you have a plan. Before your quit day:

• Know what activities will tempt you to smoke or eat, and avoid them. It may help to keep a journal of the times when you’re most tempted.
• Think about how you will fill the time when you usually smoke. For example, if you love that after-meal cigarette, don’t replace that cigarette with more food. Get up and brush your teeth, go for a walk, or wash the dishes.
• Try to get all high-fat, high-sugar foods out of your house. Family members may be very happy to help if it will help you quit smoking.
• Make a list of healthy foods that you especially like. Try some new low-calorie, low-fat snacks and drinks. Stock up on the ones you like.
• Think about how you can work more exercise into your life. Besides helping you stay away from cigarettes, exercise burns calories. Plan to take short walks or do some stretches at times when you would ordinarily smoke.

Tips for avoiding weight gain

Think positive, and keep temptation away:

• Don’t quit smoking during holiday periods. You’re more likely to eat more then.
• Stay away from alcohol. Alcoholic drinks have a lot of calories, so avoiding them will help you control your weight. And drinking can weaken your willpower, especially if you usually smoke when you drink.
• Eat at least 3 healthy meals a day so you don’t get hungry. For some people, eating smaller healthy meals more than 3 times a day works better. And eat more whole-grain foods. They stay with you longer and help keep you from getting hungry.
• Consider getting professional help. Nutritionists, fitness instructors, and therapists can all help you control your weight when you quit smoking.
• Make regular activity part of your life. Walking is a great exercise that most people enjoy and can do. It may help to walk or exercise with a partner or group.
• Weigh yourself at least once a week. Keep a pencil and paper near the scales, and write your weight down. That way the extra pounds won’t “sneak up” on you.
• Remind yourself every day of how much healthier you are for having quit smoking.

Remember, looking good is much more important than how much you weigh. Smelling clean and smoke-free, having fresh breath, having fingers and teeth free of yellow tobacco stains, and feeling healthier all make you more attractive.

A big reason people gain weight is that they reach for food instead of a cigarette after they quit.

• When you have a craving for a cigarette or food, remember that cravings usually last only a few minutes. Do something else to occupy your time for those few minutes.
• Rather than eating candy or other food to replace the cigarettes, try chewing on a drinking straw, toothpick, or coffee stirrer.
• If you must have something sweet in your mouth, eat fruit or try sugar-free gum or candy.
• Come up with something else to keep your hands busy so you don’t use them to eat. For example, take up knitting, beading, doing crossword puzzles, or just doodling.
• People often turn to food at times of tension or stress. Find other ways to deal with those times. Go for a walk. Vacuum the floor.

Where to go from here

Now that you have read this information, you are ready to control your weight as you quit smoking.

Talk with your doctor

If you have questions about this information, make an appointment with your doctor and take the information with you. Your doctor may have more ideas on how to help you quit smoking and control your weight.

If you would like more information on quitting smoking, the following resources are available:

Organizations

Treatment Overview

Liposuction removes fat from your body using suction. Traditional liposuction is called nontumescent liposuction—small, thin blunt-tipped tubes (cannula) are inserted through tiny incisions in the skin. Fat is suctioned out through these tubes as the doctor moves the tubes around under the skin to target specific fat deposits.

In recent years, improved techniques have made liposuction safer, easier, and less painful. These newer techniques include:

• Tumescent liposuction. This is considered the safest and most effective liposuction technique, with the quickest recovery time. First, you are given a local anesthetic to numb the area of your body where the tube will be inserted. Next, a large amount of an anesthetic solution containing lidocaine and epinephrine is injected into the fatty tissue before traditional liposuction is performed. The solution makes the fat expand and become firmer, which allows the tubes to move more smoothly under the skin. It also causes the blood vessels to temporarily shrink (vasoconstriction), which greatly reduces blood loss during the procedure. With the large volume of anesthetic solution injected, tumescent liposuction may not require general anesthesia (which makes you sleep through the procedure) and thus does not carry some of the risks of traditional liposuction. It also reduces bruising, swelling, and pain after the procedure.
• Ultrasound-assisted (ultrasonic) liposuction. This newer technique uses energy created by ultrasound to liquefy the fat before it is removed. The tubes move more smoothly under the skin after the fat has been liquefied, so this technique may be particularly helpful in areas where the fat is very firm or fibrous—such as the sides, the back, male breasts, and the area around the navel—or when removing large amounts of fat. Ultrasound-assisted liposuction may take 2 to 4 hours longer than traditional or tumescent liposuction.

Liposuction is usually done as an outpatient procedure in a properly equipped doctor’s office, ambulatory surgery center, or hospital. In general, it does not require an overnight hospital stay unless a large volume of fat is being removed. However, liposuction of large areas of the body should only be done in a hospital or licensed surgical center.²Local anesthesia is used in some cases, and you may or may not be given a sedative to help you relax. If traditional (nontumescent) liposuction is being done, or if a large area or volume of fat is being treated, general anesthesia or deep sedation with a local anesthetic may be used.

What To Expect After Treatment

After the procedure, the area of the body that was treated is firmly wrapped to help reduce swelling, bruising, and pain. Elastic bandages and tape, support hose (such as those used to treat varicose veins), a special girdle, or another type of firm-fitting garment may be used, depending on which part of the body was treated. You may have to wear the compression garment or wrap for 3 to 4 weeks. Expect a lot of bruising and swelling for at least the first 7 to 10 days.

If you have had tumescent liposuction, fluid may drain from the incision sites for several days. In some cases, you may be given antibiotics to reduce the risk of infection.

Most people are able to get up and move around as soon as the treatment is finished and after the effects of the anesthesia and any sedation have worn off. You can return to normal activities as soon as you feel comfortable, although this may take several days to a few weeks. Most people can return to work within a few days. Recovery may take longer if large areas were treated.

Why It Is Done

The main purpose of liposuction is to reshape one or more areas of your body, not to reduce body weight. Liposuction is typically used on “problem” areas that have not responded well to diet and exercise. These areas are often on the outer thighs and hips on women and the waist and back on men. The face, neck, abdomen, back, buttocks, legs, and upper arms are all commonly treated areas.

Liposuction is sometimes used in combination with other cosmetic surgery procedures, such as a “tummy tuck” (abdominoplasty), breast reduction, or face-lift.

Liposuction may also be used to treat certain medical conditions, including:

• Benign fatty tumors (lipomas).
• Abnormal enlargement of the male breasts (gynecomastia or pseudogynecomastia).
• Problems with metabolism of fat in the body (lipodystrophy).
• Excessive sweating in the armpit area (axillary hyperhidrosis).

Liposuction is not used to treat obesity. It will not get rid of cellulite or stretch marks.

How Well It Works

Liposuction is usually very effective at removing fat deposits in small areas. But if you regain weight after having liposuction, the fatty bulges that were removed are likely to return.

Some improvement in body contour is usually noticeable right after surgery, and improvement may continue for several weeks or even months as the swelling goes away. The full effects of having liposuction may not be visible for several months to a year.

Liposuction generally does not tighten the skin over the treated area. After fat has been removed, the skin around the area may be somewhat loose. It may take up to 6 months for the skin to tighten around the treated area. Some people’s skin is very elastic and retracts more quickly than other people’s skin. Younger skin tends to have greater elasticity than older skin.

People who expect liposuction to help them lose weight are usually disappointed.

Risks

Liposuction performed by an experienced doctor in a properly equipped facility is usually safe. Having more than one area treated, or having a very large area treated, may increase the risk of complications during or after the procedure. Tumescent liposuction is considered the safest technique.³

Common side effects of liposuction include:

• Temporary swelling, bruising, soreness, and numbness in and around the treated areas. Tumescent liposuction minimizes these effects in comparison to traditional liposuction.
• Irritation and minor scarring around the incision sites where the cannulas were inserted.
• Baggy or rippling skin. The skin will usually tighten and retract after a few months. In some people, however, the skin may remain somewhat loose.

Less common side effects include:

• Permanent color changes in the skin.
• Uneven skin surface over the treated area.
• Damage to the nerves and skin. The heat generated during ultrasonic liposuction may burn the skin or damage the tissue under the skin.

Dangerous complications

Although death is very rare with liposuction, it can happen. If you are having a large amount of fat removed, are obese, or have health problems, your risks go up. You will be watched closely for several hours or overnight after a liposuction. Staying in the hospital is sometimes best.² Possible complications include:

• Excessive blood and fluid loss, leading to shock. This is extremely unlikely with the tumescent and ultrasonic techniques, because they usually result in very little blood loss.
• Fat clots or blood clots, which may travel to the lungs (pulmonary embolism) and become life-threatening.
• Buildup of fluid in the lungs (pulmonary edema). This is most likely to occur with tumescent liposuction, during which a large volume of fluid may be injected into the body.
• Infection. In some cases, antibiotics may be given before or after liposuction to help prevent infection.
• Toxic reaction to the injected solution (lidocaine toxicity).

Liposuction should not be done in people with severe heart problems, blood-clotting disorders (such as thrombophilia, a disorder in which the blood clots easily or excessively), or during pregnancy.¹

What To Think About

Liposuction should be done only by a doctor who has special training in liposuction and surgery of the skin and in how to respond to complications during surgery. You will also be at less risk for complications if liposuction is not done at the same time as other cosmetic procedures.¹

If you are trying to lose weight, liposuction is not a substitute for exercise and a balanced diet. In fact, most cosmetic surgeons agree that the best candidates for liposuction are healthy people who are at or close to a healthy weight but who have stubborn fat deposits that do not respond to exercise. The results of liposuction can be long-lasting if you exercise regularly, eat a balanced diet, and maintain a healthy weight after the procedure. When people gain weight after having liposuction, the fatty bulges that were removed often return.

Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.

References

Citations

1. Coleman WP III, et al. (2001). Guidelines of care for liposuction. Journal of the American Academy of Dermatology, 45: 438–447.
2. American Society of Plastic Surgeons (2003). Practice Advisory on Liposuction: Executive Summary. Available online: http://www.plasticsurgery.org/Narins RS, et al. (2003). Tumescent liposuction. In IM Freedberg et al., eds., Fitzpatrick’s Dermatology in General Medicine, 6th ed., vol. 2, chap. 274, pp. 2557–2559. New York: McGraw-Hill.

Credits

Author:Kathe Gallagher, MSW

Medical Review:Patrice Burgess, MD - Family MedicineMartin Gabica, MD - Family Medicine

For the first time in “The Biggest Loser” history, YOU will vote on who will compete at the Live Finale! Two players, Roger and Mark, fell below the yellow line, and you can help decide (vote at NBC.com) which one will join Ali and Kelly as part of the final 3 competing for the big prize.

http://www.controlweightlossnow.com/

Ali started the show weighing 234 lbs. Her final weight at “The Biggest Loser” ranch was 135 lbs. Will Ali be the first woman to win the big prize? Tune in to NBC Tuesday, April 15th to see her final weigh-in.
NBC/Trae Patton - Wednesday, April, 9, 2008, 4:9 PM

www.FreeLapbandSeminar.com :: Toll Free  (877) 500-2525
FDA approved WEIGHT LOSS PROCEDURE :: SOCAL LAP-Band :: Center Of Excellence
Beverly Hills Weight Loss Clinic, Lose Weight, Weight Loss, Lap Band, Lap-Band,The least invasive surgical option,Allows individualized band size for ideal long-term weight long-term weight loss rate,it can be adjusted without surgery

Kelly started the show weighing 271 lbs. Her final weight at “The Biggest Loser” ranch was 178 lbs. Will Kelly be the first woman to win the big prize? Tune in to NBC Tuesday, April 15th to see her final weigh-in.
NBC/Trae Patton

www.FreeLapbandSeminar.com :: Toll Free  (877) 500-2525
FDA approved WEIGHT LOSS PROCEDURE :: SOCAL LAP-Band :: Center Of Excellence

Mark started the show weighing 285 lbs. His final weight at “The Biggest Loser” ranch was 169 lbs. Will America choose Mark to join Ali and Kelly as an official finalist? Tune in to NBC April 15th to see his final weigh-in.
NBC/Trae Patton -

www.FreeLapbandSeminar.com :: Toll Free  (877) 500-2525
FDA approved WEIGHT LOSS PROCEDURE :: SOCAL LAP-Band :: Center Of Excellence

Roger started the show weighing 363 lbs. His final weight at “The Biggest Loser” ranch was 219 lbs. Will America choose Roger to join Ali and Kelly as an official finalist? Tune in to NBC April 15th to see his final weigh-in.
NBC/Trae Patton

www.FreeLapbandSeminar.com :: Toll Free  (877) 500-2525
FDA approved WEIGHT LOSS PROCEDURE :: SOCAL LAP-Band :: Center Of Excellence

Jay started the show weighing 293 lbs. After he was eliminated, “The Biggest Loser” followed up to learn he now weighs 193 lbs. Tune in to NBC April 15th to see the final weigh-in.
NBC/Trae Patton - Wednesday, April, 9, 2008, 4:9 PM

Surgery patients 5 times more likely to see disease disappear, study says

CHICAGO - A new study gives the strongest evidence yet that obesity surgery can cure diabetes.

Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers.

Most of the surgery patients were able to stop taking diabetes drugs and achieve normal blood tests.

“It’s the best therapy for diabetes that we have today, and it’s very low risk,” said the study’s lead author, Dr. John Dixon of Monash University Medical School in Melbourne, Australia.

The patients had stomach band surgery, a procedure more common in Australia than in the United States, where gastric bypass surgery, or stomach stapling, predominates.

Gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month, said Dr. David Cummings, who wrote an accompanying editorial in the journal but was not involved in the study.

“We have traditionally considered diabetes to be a chronic, progressive disease,” said Cummings of the University of Washington in Seattle. “But these operations really do represent a realistic hope for curing most patients.”

Diabetes experts who read the study said surgery should be considered for some obese patients, but more research is needed to see how long results last and which patients benefit most. Surgery risks should be weighed against diabetes drug side effects and the long-term risks of diabetes itself, they said.

The diabetes benefits of weight-loss surgery were known, but the Australian study in Wednesday’s Journal of the American Medical Association is the first of its kind to compare diabetes in patients randomly assigned to surgery or standard care. Scientists consider randomized studies to yield the highest-quality evidence.

The study involved 55 patients, so experts will be looking for results of larger experiments under way.

‘New way of thinking about diabetes’
“Few studies really qualify as being a landmark study. This one is,” said Dr. Philip Schauer, who was not involved in the Australian research but leads a Cleveland Clinic study that is recruiting 150 obese people with diabetes to compare two types of surgery and standard medical care.

“This opens an entirely new way of thinking about diabetes.”

Obesity is a major risk factor for diabetes, and researchers are furiously pursuing reasons for the link as rates for both climb. What’s known is that excess fat can cause the body’s normal response to insulin to go haywire. Researchers are investigating insulin-regulating hormones released by fat and the role of fatty acids in the blood.

Test yourself

In the Australian study, all the patients were obese and had been diagnosed with type 2 diabetes during the past two years. Their average age was 47. Half the patients underwent a type of surgery called laparoscopic gastric banding, where an adjustable silicone cuff is installed around the upper stomach, limiting how much a person can eat.

Both groups lost weight over two years; the surgery patients lost 46 pounds on average, while the standard-care patients lost an average of 3 pounds.

Blood tests showed diabetes remission in 22 of the 29 surgery patients after two years. In the standard-care group, only four of the 26 patients achieved that goal. The patients who lost the most weight were the most likely to eliminate their diabetes.

Both patient groups learned about low-fat, high-fiber diets and were encouraged to exercise. Both groups could meet with a health professional every six weeks for two years.

The death rate for stomach band surgery, which can cost $17,000 to $20,000, is about 1 in 1,000. There were only minor complications in the study. Stomach stapling has a 2 percent death rate and costs $20,000 to $30,000.

In the United States, surgeons perform more than 100,000 obesity surgeries each year.

The American Diabetes Association is interested in the findings. The group revises its recommendations each fall, taking new research into account.

“There is a growing body of evidence that bariatric surgery is an effective tool for managing diabetes,” said Dr. John Buse of the University of North Carolina School of Medicine in Chapel Hill, the association’s president for medicine and science.

“It’s just a question of how effective is it, for what spectrum of patients, over what period of time and at what cost? Not all those questions have been answered yet.”

Medical devices used in the study were provided by the manufacturers, but the companies had no say over the study’s design or its findings, Dixon said.

Obesity surgery seen as diabetes cure

CHICAGO - A new study gives the strongest evidence yet that obesity surgery can cure diabetes.

Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers.

Most of the surgery patients were able to stop taking diabetes drugs and achieve normal blood tests.

“It’s the best therapy for diabetes that we have today, and it’s very low risk,” said the study’s lead author, Dr. John Dixon of Monash University Medical School in Melbourne, Australia.

The patients had stomach band surgery, a procedure more common in Australia than in the United States, where gastric bypass surgery, or stomach stapling, predominates.

Gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month, said Dr. David Cummings, who wrote an accompanying editorial in the journal but was not involved in the study.

“We have traditionally considered diabetes to be a chronic, progressive disease,” said Cummings of the University of Washington in Seattle. “But these operations really do represent a realistic hope for curing most patients.”

Diabetes experts who read the study said surgery should be considered for some obese patients, but more research is needed to see how long results last and which patients benefit most. Surgery risks should be weighed against diabetes drug side effects and the long-term risks of diabetes itself, they said.

Experts generally agree that weight-loss surgery would never be appropriate for diabetics who are not obese, and current federal guidelines restrict the surgery to obese people.

The diabetes benefits of weight-loss surgery were known, but the Australian study in Wednesday’s Journal of the American Medical Association is the first of its kind to compare diabetes in patients randomly assigned to surgery or standard care. Scientists consider randomized studies to yield the highest-quality evidence.

The study involved 55 patients, so experts will be looking for results of larger experiments under way.

“Few studies really qualify as being a landmark study. This one is,” said Dr. Philip Schauer, who was not involved in the Australian research but leads a Cleveland Clinic study that is recruiting 150 obese people with diabetes to compare two types of surgery and standard medical care.

“This opens an entirely new way of thinking about diabetes.”

Obesity is a major risk factor for diabetes, and researchers are furiously pursuing reasons for the link as rates for both climb. What’s known is that excess fat can cause the body’s normal response to insulin to go haywire. Researchers are investigating insulin-regulating hormones released by fat and the role of fatty acids in the blood.

In the Australian study, all the patients were obese and had been diagnosed with type 2 diabetes during the past two years. Their average age was 47. Half the patients underwent a type of surgery called laparoscopic gastric banding, where an adjustable silicone cuff is installed around the upper stomach, limiting how much a person can eat.

Both groups lost weight over two years; the surgery patients lost 46 pounds on average, while the standard-care patients lost an average of 3 pounds.

Blood tests showed diabetes remission in 22 of the 29 surgery patients after two years. In the standard-care group, only four of the 26 patients achieved that goal. The patients who lost the most weight were the most likely to eliminate their diabetes.

Both patient groups learned about low-fat, high-fiber diets and were encouraged to exercise. Both groups could meet with a health professional every six weeks for two years.

The death rate for stomach band surgery, which can cost $17,000 to $20,000, is about 1 in 1,000. There were only minor complications in the study. Stomach stapling has a 2 percent death rate and costs $20,000 to $30,000.

In the United States, surgeons perform more than 100,000 obesity surgeries each year.

The American Diabetes Association is interested in the findings. The group revises its recommendations each fall, taking new research into account.

“There is a growing body of evidence that bariatric surgery is an effective tool for managing diabetes,” said Dr. John Buse of the University of North Carolina School of Medicine in Chapel Hill, the association’s president for medicine and science.

“It’s just a question of how effective is it, for what spectrum of patients, over what period of time and at what cost? Not all those questions have been answered yet.”

Medical devices used in the study were provided by the manufacturers, but the companies had no say over the study’s design or its findings, Dixon said.

(CNN) — Standing near the coffin of one of her closest friends, Patty Hill made a promise that would forever change her life.

Her friend, Gail, had died from a blood clot just a week after undergoing gastric bypass surgery to make her stomach smaller. Hill was scheduled to have the same surgery and believed it was the only way to end her lifelong struggle with obesity.

Tipping the scales at 280 pounds and standing 5 feet 5 inches tall, Hill says she was depressed, moody and always defensive. The 47-year-old mother from Weymouth, Massachusetts, was morbidly obese, and after her friend’s death, she was beginning to lose hope.

“That was the end of the gastric bypass for me,” remembers Hill. “At her wake, I promised everyone that I would not go ahead with surgery.”

Hill wore a 26/28 dress size and had heart problems. Now, not only was she afraid that she couldn’t lose the weight, but she was even more afraid she’d die, leaving her daughters, ages 23 and 14, to grow up without her.

Just when she’d lost all hope, her cardiologist asked if she had ever considered Lap-Banding — a less-invasive form of weight-loss surgery.

Hill immediately started researching the procedure, in which an adjustable band is placed around the upper part of the stomach to restrict the amount of food the stomach will hold. According to MayoClinic.com, the band creates a small pouch opening to the stomach. The amount of food your stomach will hold is controlled by injecting or removing fluid from the band. Even though gastric banding restricts the amount of food, it does not reduce the absorption of calories or nutrients.

In the United States, where two-thirds of the population is either overweight or obese, weight-loss surgeries have increased in recent years, according to the Centers for Disease Control and Prevention. While the surgeries are successful at helping people lose weight and reduce their risk for hypertension, diabetes and other chronic illnesses — patients have to carefully weigh the benefits of the procedure with the serious risks, side effects and even death in some cases.

Some of the more common side effects of weight-loss surgery can be difficulty digesting starchy foods and protein, which can lead to other physical conditions including hair loss, fatigue, swelling and muscle weakness.

Once she did her homework on gastric banding, Hill says she knew the procedure was for her. She sought treatment at Tufts-New England Medical Center in Boston, Massachusetts. The program required six weeks of pre-operation behavior-modification classes and monthly support meetings.

On February 28, 2005, Hill’s Lap-Band surgery was a success.

She immediately started losing weight, dropping 20 pounds the first month, and continued to lose 10 to 15 pounds a month. Six months later, at the end of August, she had dropped 75 pounds.

As the second anniversary — or “Bandiversary” — of her surgery approached, Hill had lost 130 pounds and reached her original target weight of 150 pounds.

That’s when she began exercising and keeping track of her daily food intake via the Web site FitDay.com.

“You don’t realize how many calories you’re taking in until you start keeping track,” said Hill.

Ultimately, Hill surpassed her original weight loss goal and lost another 10 pounds. She currently weighs 140 pounds and, after dropping 10 dress sizes, now fits perfectly into a size 8, she says.

Despite the rapid weight loss, surgery wasn’t an easy way out. Hill says she still has to plan her meals and eat properly, and one of the biggest downsides is that she has difficulty digesting some starchy foods.

“I can’t eat bread, potatoes, rice,” says Hill. “I have to cut up everything into pencil eraser-size [pieces] and chew, chew, chew.”

Still, the surgery has restored her life, Hill says.

One of the biggest perks of losing 140 pounds is traveling with greater ease. She doesn’t have to ask for a seat belt extender and no longer feels like she’s spilling into her neighbor’s seat.

“I went to Cancun last July, and I was able to go horseback riding without hurting the horse,” jokes Hill.

She’s also discovered something else.

“I’m actually petite,” Hill says excitedly. “I can buy stylish clothes. Before surgery, I just bought clothes that fit me. Now I can buy clothes that look good on me.”

When she’s shopping, Hill says, people make eye contact with her more often and wait on her right away. When she was obese, Hill says, she felt almost invisible, and even though she didn’t want to believe it, people ignored her.

“Men actually flirt with me; it cracks me up, but freaks out my daughters,” says Hill. “I have a boyfriend with a Harley. I love riding on the back of [his bike].”

The weight loss has also inspired Hill to take acting classes, and she’s even appeared as an extra in several movies. Earlier this year, she attended her first Boston Red Sox game and was elated to discover that she could fit into the seats.
Best of all, Hill says, she has a lot more energy and self-confidence, and she’s healthier. She says the surgery is the best thing she’s done for herself.

“I am so happy with the way I look and feel,” says Hill, “I never want to go back to the way I looked before. It sounds very superficial, but it’s the truth.”