This may help you in understanding the restrictive mechanism of a Lap-Band.

The ALLERGAN protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band.

Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band.

Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 weeks after the fill. That is why the ALLERGAN protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.

7. The patient receives another fill and the process starts all over again.

Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater.

It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

I promise...it sometimes takes time to kick in. I can't begin to explain it, but for me, 7-10 days later there's usually a big difference. If you've waited a couple of weeks and are still hungry less than 3-4 hrs after a solid food MEAL...can eat more than 1 cup of SOLID FOOD, and have not lost 2 lbs. per week, you should be a good candidate for a fill. Just keep getting them till you start loosing consistently.

I think we are so impatient and read all about the very high losses we forget what the "norm" is. For example Kathy719...You've lost 20 lbs since end Nov. right? That's an average of 6.6 lbs per month so far. If you keep up the same average loss (don't worry about the big gaps if you're following the plan)...you'll loose around 60 lbs. in your first year. If you had a total of 139 lbs to loose, then you would have acheived more than 1/2 of your excess lbs. in the first year which is expected. I was told that anything more than that is the exception, not the rule.

I say you're doing fine! Don't worry about the number of fills. Remember, you are loosing fat inside as well as outside where it's visible. As you loose fat and inches, the band adjusts. That's why we need the fills. It can become loose or simply shift allowing more food to pass. Most of the surgeons only stitch the band to one part of the muscle, so the other 90% of the band can move around.

Picture our band as an innertube slid over the top part of an egg shaped balloon. If you move one side of the innertube up and down, the shape of the opening lets more air go in the top or the bottom. More space at the top means more food can fit, means you'll be hungry sooner. Poke a tiny pin hole in the balloon and innertube will be looser, letting the balloon move up and down more (lets more food slide through). Since we don't know exactly what's going on in there, it's no use trying to compare ourselves to everyone else.

I've had 14 fills and will go get another till I loose on a consistent basis. Don't be afraid to ask for what you want. You've gone through a lot to get where you are and you want results. Just don't expect more than what was outlined to you before the surgery or you'll feel like it's not working. Keep us posted, I'm sure things will turn around. Think long term!!

Great review of what is happening, you are so right the only one we have to compare ourselves to is ourself.

Thanks for the continued motivation.

Didn't mean to ramble...seems like it took me so long to catch on to all of this. As soon as I stopped feeling sorry for myself for not loosing as fast as others, I felt much better about the journey.

I had about 60-65 lbs. to loose. Start weight was 189, but at barely 5'2, it felt like a whole lot more. My goal is 130 although for my height, it's a little high. Thing is I've carried around the 60+ lbs. for 35 years. Snoring, backaches, high BP etc. all led to my being banded. Self pay but the newly found self-esteem was worth every penny so far! Banded in Salt Lake City by Dr. Hansen.

Anyone else almost to goal and having trouble with heartburn again? Haven't had any for a year, now that I'm finally getting to where I need to be, I'm taking med's to ward off the discomfort. SIGHHHHH....

I have never lost weight consistently. I lose, then I plateau for a long time, then I lose again. Some people lose 1-2 lbs every week. I have never done that.

So glad to hear that you also have to step back and see the big picture athinnerdenise! It's hard when you hear the stories of the really consistent loosers. Easier to just average it all out and ride out the plateaus I guess. I feel pretty confident I'm playing by the rules, but this has not been an easy year. What a learning experience. 60 lbs...wow! You're my inspiration! Thanks!

You are very welcome. I was so frustrated in the beginning. I lost 22 lbs the first month on the liquid post op diet. Then I didn't lose anything for a couple of months. I was ready to tear my hair out. Then I finally realized that the band wasn't going anywhere, and I had to lose more with the way my eating had changed.

I am pretty frustrated right now again. I want to lose this last 10 so badly, but I am stuck on another plateau. It's so easy to think "I might

as well eat (insert anything sweet) this because I am not losing anyway. But I know if I do that, I won't lose. I figure the scale has to move again eventually. I exercise 6 days a week.

lessofme

Thank you. I guess if you look at the over all I have lost weight and that is good. I am now gaining and losing the same 3 or 4 lbs. When I don't eat and gain it drives me nuts. After my fill, they said I could come back in a month I think I will call and ask if I can come in sooner. Right now I can eat pretty much what I want and I think it is too much. I have been thinking of doing some liquid fasting to kick start this again. Thanks for your help.

I know exactly what you mean. Losing the same 2 or 3 lbs is maddening.

There is no way I could get another fill. I wouldn't be able to eat at all

if I did that.

Wendell,

Great post w/good information. Thank you for sharing your pictures, too. You have inspired me!

Does it hurt when you get your first fill.

No, I have never had a fill hurt. Mine is over with in a couple of seconds.

Some people do have more of a problem with the dr. finding their port.

Does it hurt when you get your first fill.

They put the needle in through your scar and it does not hurt. When he (the PA) pushed down on the port to slip the needle in that stung a little but very tolerable. Very easy, don't worry.:thumbup:

They put the needle in through your scar and it does not hurt. When he (the PA) pushed down on the port to slip the needle in that stung a little but very tolerable. Very easy, don't worry.:drool:

My doctor does not go in through the scar. But, it still doesn't hurt...just like a little pin prick.

I'm a bit depressed...I got banded in June of o7...I'm 5'6" weight before was 280lbs...I've been at 261 for almost 3 months..I use an eliptical 6 days a week ...but I can still eat a plate of food and not really feel "full" had 5 fills, at moment have 5cc in my band...i feel guilty as heck, I really do...all the time, money spent on lap band and such hope to finally lose weight and here I am 8 months later...I was so excited and so was my family...but I feel like a failure..I go in for another fill this month, I am so anxious to hit that "sweet spot", but it just seems like it'll never happen.:rolleyes2: It's encouraging to hear other people lose the weight and I feel their happiness, what a wonderful feeling it must be to finally lose the weight and feel "normal"...

My band capacity is 14cc. I had it done on 2/7.The Dr did not put any fill in at time of surgery. I just had my first fill this week. Filled to 6cc. I have lost weight however have also wondered if the band is working because I have felt some restriction, I think, but if I eat really slow and chew really well, I haven't had any problems. Wendell's explanation is very encouraging.

3 weeks after my fill it started to work. My PA said it sometimes had a delayed reaction which did not make sense to me but here I am and its working. I have a fill scheduled for Tues but am not sure I need it. So far I only have 2 ccs and was banded the 26th of Nov.07. We had such bad snow I could not get in before I did but I had been stalemated since the end of Dec. Now I am going down thank goodness. So everyone hang in there if you get a fill and not sure if it is working. I do not understand how come but will ask more questions when I go in. Good luck to all:welldoneclap: