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.

yes food is going through the band if it's not tight enough. for some reason, the doctors want us to reach restriction slowly. When you are tight enough, you will know it. You will feel full with just a few bites and won't be hungry between meals. Just call for another fill and tell them you are starving all the time.

Thank you sooooooo much for your post!!!!! I have been very stressed worrying about why I stopped losing after the initial loss and how the whole band thing works. I am still looking to find out how often I need to get a fill. I was banded on 8/15 and had my fill on 9/13 (2.6). I am still quite hungry and don't have enough restriction. I had my surgery in mexico and although the surgery went well, I don't feel like they give me enough information. Your information was exactly what I needed to read today! I know that you have made quite a few bandsters feel better!!! :confused:

I have just discovered this thread!!

What GREAT information!!! Thanks Wendell for starting it and thanks also to Dr. Watkins for adding your professional input.

I was banded on May 1st and am realizing that, as Wendell said, it is a stop and go experience (like stairs). I think that not getting too caught up in the numbers is a good idea and working on the behavior modification is huge!!

I can honestly say that the band has been helpful during those times when I feel like "stress" eating. I simply can't do that anymore or else I will end up pb'ing. Also, in the past I have always been successful with the first 25 - 30 lbs and then ALWAYS hit a wall!! My plateaus always "won" and I would revert back to my old bad behavior and forget about why I started the journey. I have never before been able to get past that point. This is where the band is going to help a LOT!!!!

It is definitely a tool that needs to be used along with behavior modification, but I can honestly say that this tool will finally be the what helps me to reach my goals.

All the best to everyone!!!

This is a great thread. It seems that Wendall has stopped posting. I hope all is well with him.

Just remember restriction will not last until you are close to goal and most of the fat pad is melted away from losing weight. Every time we lose the fat around the stomach, the band gets looser until there is no more fat around the stomach left. I have not had a fill in almost a year. I doubt I will ever need another one.

AthinnerDenise: Thanks for that information. I have a loooonng way until I will be at the point where the fat pad in my stomach is gone. My stomach is where I carry most of my weight. However, there has been good results in that area and the inches are melting away!!!

All the best!!

You're welcome. It's hard for some people to understand why some people just need a few fills and some have to keep getting them over and over. Some people get a fill and expect restriction to last, and it just doesn't work that way.

Thank you for the compliment.

Yes, before I obtained effective restriction with fill number 4, which was given 24 weeks after surgery, I thought that my Lap-Band did not work and that the entire thing was a cruel joke at my expense.

I don't know anything about the Swedish Band, but I do know that a Band that would not provide restriction when filled to capacity is exceptionally rare.

Best wishes on your journey.

Hi Wendell,

I know this post was from a year ago tomorrow, but I am feeling the exact same way. I was banded on 6/18/08 and have only had one fill, I moved out of state before my 6 weeks so I couldn't get one done in NY, and when I got to IN, I had a really hard time finding a Dr. to do my fills, so long story short, I will have my 2nd fill tomorrow and right now could eat anything! No restriction what so ever. :cool2:(

I'm just glad I wasn't the only one who thought the band wasn't working. Hope your journey is going well.

HI you all!

I just had my fourth fill..I am at 8cc's in a 9'cc band...

I am back on the liquid phase for a few days...I know I started to feel some restriction for a few days and then it was...gone..

So, I am sure this will bring me closer..I hope! I just need to follow the "rule" eat in 20 minutes etc....

TTFN, Shelley

Nice Picture Band FAN 1!

I Hope you're at your sweet spot for awhile now, Shelly!

Thanks Denise!

I hope so too, I am ready to get this weightloss journey kicking in again! I keep reminding myself of what you told me and that you did well once you hit the sweet spot...I hope that I am there! It takes time considering my surgery was May 28th! By the way, my hair has started to "shed" faster lately...4 months out is no joke on that one...LOL

I hope all is well with you...fall is such a beautiful time of year!!!

Shelley

I feel the same as you! I have never PB'd either; I can eat almost anything and I have a 9cc band with 7cc's in it. I've had 3 adjustments and not losing weight!

I am entering my second week post-op. Still on clear liquids. Start full liquids this friday. I have read some horror stories regarding fills. Has anyone had a positive experience???

Why would it have a 4 week delayed reaction if the fill tightens it right away - I am confused.

I have never had a fill take 4 weeks to take effect. I can usually tell the next day how it's going to work.

Shelly Bill left today to come down there and I so wanted to to be able to come too. I really want to be a snow bird and I am going to have to figure out how to make that happen. This weather is sucking badly here, and I know how gorgeous it is down there this time of year.

I got my 3rd on 9/23, they took out 3.5 ccs then put in 4.5 ccs. Although the barium swallow went through fine the water they gave me after the barium went down too slow so they took out .5 cc so I now have 4 ccs. I do feel more restriction/diminishing of hunger between meals, but I still think I'm eating too much during meals so I've scheduled another fill for next Tuesday. So far, I have not PB'd, or thrown up. I've only been stuck when I forgot to chew my food as well as I should have but even then, it passes relatively quickly.