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 am one who has had questions about fills and a delayed reaction. About 3 weeks after my fill I think it started to work but I had another fill scheduled the next week and since I have 100 miles to drive I went ahead and got it. This time it work right off the bat. In fact he had me drink water with the needle still in me and removed some before he quite. Now I have to be very careful. At least I have started to loose weight again. Only thing is I have had to heave it up once to get relief and I did not think I had eaten too much but I did, and today I ate a bit much and it hurt for about and hour afterwards. So I need to be careful but my feelings are that I wanted the band to loose weight and being careful about my amounts is what it is about. Lessons learned. Laniayala I have never had your problem and think you should tell your doctor but wow you have lost the weight. Good luck.

Hi, you sound like you are at the RIGHT spot now!! Congrats! It is a tricky lesson to learn, not to sucumb to the "first bite syndrome".... its almost like you have to take this really tiny bite, chew it 20 times swallow, wait a minute or two and THEN take your second tiny bite.... This is how we are meant to eat from now on... and will avoid PB's and pain..

Good luck to you, your Weight Loss is great!

hi guys, i was banded on 2-8-08 and have already had my first fill however i still feel the same. I still feel hungry and i feel like have still have no restrictions. i am scheduled for my 2nd fill on April 9th...

Hi Lisal,

Did you too go to Post Falls and Dr. Pennings? Sure glad he is as good as he is. I did not have my first fill untill Feb. and just had my second. The snow kept me away or I would have been there sooner. Hang in there.

Hi Bergdorfblonde.

Not sure I am the right one to answer you because I am 5'9 so not in the same weight area as you, but I was banded the 27th of Nov 07. First fill in Feb and just had a second. First they put in 3 cc and 2nd 1 cc. I am once again loosing weight but I was at a stand still from the end of Dec until this last fill. Hopefull I can get a few more pounds off before I need another fill. good luck to you.

Hi, am finding this thread so informative. Was banded on Feb.11th by Dr. Pennings in Post Falls and at first had restriction but am now able to eat way to much also after reading several posts realize that I am eating too many carbs and giving in to cravings that the carbs are causing. Need a fill???? Do I just need to eat band size portions of meat and vegis but when I do feel hungry. Am in a very confused state right now LOL but do need help getting on the right track.

Thanks. Dawnie

Hi, am finding this thread so informative. Was banded on Feb.11th by Dr. Pennings in Post Falls and at first had restriction but am now able to eat way to much also after reading several posts realize that I am eating too many carbs and giving in to cravings that the carbs are causing. Need a fill???? Do I just need to eat band size portions of meat and vegis but when I do feel hungry. Am in a very confused state right now LOL but do need help getting on the right track.

Thanks. Dawnie

Hi Fellow Post Falls, Dr. Pennings patient.

I did real good the first month, then was able to eat way too much and with all the snow was unable to get to PF for a fill. I had one in Feb and it took about 3 weeks to kick in. Go figure..which was 3 cc and then another March 11 and it was 1 cc. I have now started dropping weight again. I was told to lead all meals with protien. Once you stop the white carbs the cravings go away. Also I found that to have a snack, sugar free popcycles and sugar free pudding helped. Sucking on sugar free hard candies helps too. Also gum. If I can help more just ask I would be glad to share and Good Luck to you. (Remember this is a tool, you still have to watch what you eat) ta ta:thumbup:

thank you soooo much, I thought I was nuts because I don't feel much different two weeks after surgery and my weight loss has stopped....you just made my day.

I'm just beginning my journey

sharon:)

thank you soooo much, I thought I was nuts because I don't feel much different two weeks after surgery and my weight loss has stopped....you just made my day.

I'm just beginning my journeysharon:)

You ARE just beginning your journey. Many people don't notice any difference at all until about 3 fills. It depends on how aggressive your dr. is with fills.

Just remember when you start getting them, to keep going back until you get full fast. You might start out with a fill feeling like it's different, but it won't last. It won't last until you have lost most of the fat pad around your stomach.

Hello! How long are you in the doctors office for a fill? I have no idea. Thanks! Ks

I've had 16 fills in 13 months. I'm in and out in less than 30 minutes tops. They weigh me, take BP, discuss diet then decided on a fill or not...reschedule another apt. and I'm back to work. Liquids rest of day if I've had a fill and mushies then next day. I'm a little sore for a couple of days, and swollen around my port but not too bad. Mine don't seem to take hold for at least a week, so I plan accordingly...no big get-together's or vacations a week after a fill. You get to know them pretty well :thumbup: Good luck! I was told not to worry about how many it takes, just get one if you're eating too much or hungry too often.

wow i'm surprised you even qualified for lapband wit such a low BMI...

I had carried this extra weight around for almost 30 years...tried everything possible...developed a few health problems and self-paid for the surgery. As long as I had proof of years of weight loss efforts, seemed to be no problem. Phen-phen did a number on my valves...have 3 leaks now and a couple of heart murmors. Dropping 60 lbs. can really help the BP. Cholesterol has already dropped from 171 to 136 in a year, so all considered...it's worth the $320 lbs. per lb. I've paid for my 42.5 lbs. if I avoid valve surgery :thumbup:

Oops...per pound is dropping now...guess I've paid $289 per lb. lost. Ha ha.

I was banded on Feb. 7th, 2008 and just had my 1st fill yesterday. Got 3cc's and as of now still have no restrictions in my 9 cc band. I was in and out of the dr.s offc in 10 mins. My port is fine and nothing feels any different....Dr. said wait 10 days and if still no restriction return for another 2 cc's....hoping to find my "sweet spot" soon....

The all illusive sweet spot is not all that easy to find. And it's not that easy to keep. Every time you lose weight, you're losing fat around your stomach which loosens the band. Then you need another fill.

Once you get close to goal, the fills will last a lot longer.