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Lap Band Fills / Adjustment Info

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Here is info will come in handy when thinking about fills/adjustments. Great information. I have seen this information before and it is really good.

How to Tell When You Are Perfectly Adjusted

You are losing 1-2 pounds per week.

If you are not losing 1-2 pounds per week:

A. You may need an eating adjustment

1. Are you eating 60 grams of Protein a day

2. Are you eating 25 grams of Fiber

3. Are you avoiding all liquid calories

a. Soup can be sign of “soft calorie syndrome”

b. Alcohol contains a lot of calories – 7 calories per gram

(1) It’s also a stomach irritant

c. fruit juice is just sugar Water

4. Are you making healthy food choices from a wide variety of


a. Are you avoiding soft foods

b. You can’t just eat what’s easy

c. cheese is glorified fat

5. Are you drinking 6-8 glasses of water a day between meals

6. Are you eating too much junk

a. chips, chocolate, nuts, ice cream, Cookies and other highly

processed junk foods are too calorically dense to be regular parts of a

healthy diet. But don’t avoid them completely to the point where you

feel deprived.

b. Stay out of fast food places

7. Are you getting in two servings of Calcium daily

8. Do you always eat the protein first

9. Then the vegetables or fruits

a. Five servings a day

b. Potatoes are NOT a vegetable

10. Is your portion size appropriate?

a. meat or fish

(1) 3 ounces – the size of a deck of cards

b. Vegetables

(1) ½ cup – the size of your fist

c. Starch

(1) If you eat the protein and the vegetables first you don’t need


(2) Avoid: rice, potatoes, Pasta

11. You might try avoiding artificial sweeteners

a. Some people think that artificial sweeteners stimulate the


b. They are HUNDREDS of times sweeter than sugar

c. They teach you to like things too sweet

d. There is no evidence that people who use them are any thinner

than people who don’t

12. Avoid most diet foods

a. Real food usually tastes better

b. Real food is more satisfying than low calorie substitutes

c. When you are only eating a tiny bit the caloric savings is not

that great

(1) Use a teaspoon of real butter instead of a tablespoon of diet


(2) The body has no way to break down artificial fats

a. They may go into permanent storage

b. Some people think liposuction is the only way to remove

hydrolyzed fats from the body

B. You may need a behavior adjustment

1. Are you eating only when you are hungry?

a. If you’re not sure drink 8 ounces of water and wait.

2. Are you eating three meals a day?

a. With maybe 1 or 2 small Snacks

3. Are you sitting down to eat?

4. Are you eating consciously?

a. No distractions, turn off the TV, put the book or newspaper

away, pay attention to your food and your companions

5. Are you eating slowly?

a. Put the fork down between bites

b. Take 20 to 30 minutes to finish a meal

c. Taking longer might cause the pouch to begin emptying

6. Are you taking small bites?

a. Tiny spoon, chopsticks, cocktail fork

7. Are you chewing well?

8. Are you drinking with your meals or too soon after your meals?

a. Practice water loading between meals

b. You won’t be thirsty if you are well hydrated before the meal

9. Are you stopping at the first sign of fullness?

a. Sometimes it’s a whisper: not hungry, had enough

b. Hard stop versus soft stop

10. Do not eat between meals. Stop grazing.

11. Do not eat when you are not hungry

C. You may need an activity adjustment

1. Are you getting in 30 minutes of physical activity at least 3

times a week?

a. Over and above what you would do in the usual course of your day

b. Could you make it 4 or 5 times a week?

c. Could you make it 45 or 60 minutes?

2. Are you taking advantage of opportunities to increase your

physical activity?

a. Taking the stairs instead of the elevators or escalators

b. Walking on the escalators instead of riding

c. Parking your car further away from the entrance

d. Getting out of the car instead of using the drive through

e. Getting off the bus one stop before your destination

f. Washing you car by hand instead of the car wash

g. Playing with your kids

D. You may need an attitude adjustment

1. Are you committed to your weight loss journey?

2. Are you totally honest with yourself about how much you are

eating and exercising?

a. Log your food and activity on ww.fitday.com for 3 days

3. Are you using food inappropriately to deal with emotional


a. Have you identified what the emotions are that drive your


b. Can you think of more appropriate ways to deal with those


c. Are you willing to seek help from a qualified counselor?

4. Are you attending and participating in support group meetings?

5. Have you drummed up some support from your family and friends?

6. Have you dealt with saboteurs realistically?

7. Do you have realistic expectations about the weight loss


8. Are you still obsessing about food, weight, dieting, eating?

a. Obsessive – compulsive thoughts

(1) Obsess about something else

b. Perfectionism

(1) All or none, black and white thinking

c. Patience with the pace of healthy weight loss

9. Are you acknowledging your successes with non-food rewards?

10. Have you learned how to take a compliment?

11. Are you giving up diet mentality?

a. Stop weighing yourself several times a day or every day

b. Stop dieting

c. Stop depriving yourself

d. Stop defining food as “good” and “bad”

e. Stop rewarding and punishing yourself with food

12. How do you feel about all the changes taking place?

E. You may need a band adjustment

1. You feel like you are making healthy food choices in appropriate

portion sizes but getting hungry between meals?

2. You can still eat white bread, fibrous vegetables and large


3. You are having to struggle to lose

4. You are gaining weight in spite of eating right, exercising and

having a good mind set.

F. You may need your band loosened

1. There are times when you can’t get fluids down

2. You are vomiting too much

a. How much is too much?

3. Do you have frequent reflux or heartburn at night?

a. Do not lie flat or bend over soon after eating

b. Do not eat late at night or just before bedtime

c. Rinse your pouch with a glass or water an hour before bedtime

d. Certain foods or drinks are more likely to cause reflux:

(1) Rich, spicy, fatty and fried foods

(2) Chocolate

(3) Caffeine

(4) Alcohol

(5) Some fruits and vegetables

a. Oranges, lemons, tomatoes, peppers

(6) Peppermint

a. Baking soda toothpaste

(7) Carbonated drinks

e. Eat slowly and do not eat big meals

f. If you smoke, quit smoking

g. Reduce stress

h. Exercise promotes digestion

i. Raise the head of your bed

j. Wear loose fitting clothing around your waist

k. Stress increases reflux

l. Take estrogen containing medications in the morning

m. Avoid aspirin, Aleve and ibuprofen at bedtime

(1) Tylenol is OK

n. Take an antacid (Pepcid complete) before retiring

o. Try other over-the-counter heartburn medications

p. See your health care provider

4. See your health care provider immediately (or call 911) if

a. You have a squeezing, tightness or heaviness in your chest,

especially if the discomfort spreads to your shoulder, arm or jaw or is

accompanied by shortness of breath, sweating, irregular or fast

heartbeat or nausea. These could be symptoms of a heart attack.

b. If your symptoms are triggered by exercise.

c. If your pain localizes to your right side, especially if you

also have nausea or fever

d. If you throw up vomit that looks like black sand or coffee

grounds. Or if your stool is black, deep red or looks like it has tar

in it. These are symptoms of bleeding and need immediate attention.

(Note: Pepto-Bismol or other medications with bismuth will turn your

stool black. Iron supplements can also make the stool tarry.)

e. If your pain is severe

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I have a question for you. What is the signifigance of the liquid diet after a fill? Is it OK to eat lightly if you "can"?

Thank you in advance!

It's because your stomach is a very grumpy patient and when it's been messed with, aka filled, the docs think it's a good idea to do liquids for at least the first few hours. Mine says the rest of that day, some say 2 or 3 days. Of course you'll need to follow your own physician's advice, but that is the reason - to hopefully let it rest and maybe any swelling subside before you start agitating it with solid foods again.

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Thank you so very much Miss Leatha! I don't feel much different than before he did the fill.....is that how it should feel?

Well, sometimes you don't really get the full effect of a fill for several days, even weeks, I've heard. Usually, I can tell some subtle difference right away. Some people get severe swelling, then eventually settle down. Everyone is unique, but my doc tells me if I don't feel restriction by 2-4 weeks, I need to come back.

I got my fill on Tuesday. I did liquids/soft foods the rest of the day. Then tried it out with chicken breast the following day. It was apparent right away that I had more restriction than before. I can never tell much until I really test it with solid Proteins. I really hope yours is different. That's a long way to have to go for a fill. Good luck!

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Guest Rhonda

Can I get information on Texas Doctors for fills? I was banded in Tj, Mexico.

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I am getting my band shortly, how is it you lose weight the first six weeks if the band is not filled when inserted? And once it is filled, how do they know how much to fill it with. and will I be really hungry for the first 6 weeks before the fill and trying to diet/

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All of these questions are discussed at length many times over on this board. Read, read, read all you can before you undergo surgery. There is much to learn.

To answer this question. The first 6 weeks is meant for healing. It is not even meant for weight loss. At this time your tummy will be very grouchy and the doc will want you to take in only fluids or soft foods. This allows the tummy to rest and not have to churn and grind to digest solids. While the tummy is resting and not having to work as it normally would, there will be scar tissue that develops around the band which will help to anchor it in place. This is your one real defense against slippage later down the road. If a person begins eating solids too soon, they are putting themselves at danger of not allowing this 'anchoring' to take place as intended. Hence, possible slippage later on.

Some people DO get hungry. But, more than that, they hear their stomach growl which they THINK is a clear sign of hunger and this is not really always the case. It may just be digestion taking place or small intestine doing it's job. We have to re-learn alot, but you'll THINK you are hungry, even though you may have loads and loads of storage already on board. (I know I did.) This is where new habits need to come into play. Learning that you can do something else, besides eating. Learning that sometimes your thirsty when you THINK you are hungry. Learning to actually talk to your dinner partners instead of focusing on the food. Learning to put your plate away and go for a walk instead of eating more.

As for fills. Some docs are more aggressive than others. Some prefer to 'sneak up' on the fills by using small increments at a time. Some use flouro and fill you to completely blocked closed, then they back off enough to see barium coming through. It all depends on the doctors. Most people tend to get a couple of fills before they can really tell they have restriction. Some take more, some take less. Some have restriction right outa surgery and have great weight-loss right up front. One can never tell which one you'll be until you actually get there.

I hope this helps.

Please feel free to browse all the threads here, old and new. There is so much knowledge and experience just free for the taking. :D Good luck with your surgery!

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thank you so much, you seem to have so much knowledge. Were you banded in the U.S or internationally? I am going to Mexico. My doctor is Dr. De La Garza, I found his site on litenfree.com. I have tried to do the best research I could and he seems to be very good. I also, have not heard any negatives about him. I'm afraid of scammers.

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thank you so much, you seem to have so much knowledge. Were you banded in the U.S or internationally? I am going to Mexico. My doctor is Dr. De La Garza, I found his site on litenfree.com. I have tried to do the best research I could and he seems to be very good. I also, have not heard any negatives about him. I'm afraid of scammers.

Don't worry about Dr. De La Garza. I had my lap band done by him on Dec. 2nd, 2004, and I just got back from my first fill with him. I would say he is one that is more aggressive about fills.

As for fills I just got my first. Boy can I tell a difference. My doctor said to eat liquid or pureed for a few days. He is right. I am having trouble even drinking my Protein drink. I have to go super slow. It takes me about 20 minutes to drink my 8 oz. Protein Drink. I think my stomach my have gotten a little swollen after the fill, I know that will get better in a few days.

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How often do most of you get your fills? I got my first one Dec 27,2004 and I am scheduled for another fill Feb 27,2005 but really dont think I need it, have some of you waited longer? Also have any of you tryed to drink a carbonated beverage? I really wanted to have a glass of Champain on New Years but was afraid any responses would be great!


Dr. Rumbaut

Lost 25 lbs

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