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 definately think you need at least 5cc since you are NOT loosing the weight. Why does it take so long to get in?

I think my docs way overbook themselves and are only there one day a week b/c they also have a general surgery practice. the more i read, the more i think i need better fills. thanks for the advice.

I Try to do what they suggest. Eat protein first, then veggies and fruits. STOP when you are satisfied, but never feel full. Do not drink 45 minutes before or after. I'm starting to feel not hungry since I got this advice the other day. I was eating soups first and then didn't feel good when eating...like tightness in the throat.

IT'S ONLY A TOOL AND IT'S UP TO US TO WORK WITH IT.

I recently when to a bariatric educational group run by the hospital where I had the lapband surgery. The facilitator said that the rule of abstaining from fluids 30 minutes prior to a meal has been eliminated. She said that we can now drink fluids right up until the time of the meal. The following week during my appointment for my first fill my nurse said she had never heard of this change in the 30 minute fluid rule. I am waiting to hear from her since it is confusing, conflicting information coming from the same hospital.

I have never been given a consistent reason for the 30 minutes fluid rule. I have been told everything from "it washes the food through the band and you're hungry too soon," to "it could cause you to aspirate if there's too much food in the pouch." I asked my primary care MD and he had no idea why we're told this (and he's a well-informed guy).

Wendell, you're the resident site expert on how the band works. Do you know the reason for this rule?

Scales are a tool for weight loss, but the problem is that most people who are starting out with a Band are too emotionally fragile to deal with the normal ebb and flow of fluctuating weight.

Confidence that the Band actually works for us takes time, and in my opinion, based on the hundreds of posts that I have read over the last 4 years, weighing in the post-op period is not a good idea for most people, because it leads to stress, anger and frustration due to a lack of understanding that even small fluctuations in a person's weight can wipe out what is, in reality, a good month of weight loss for the average Band patient.

So glad to see your wisdom here this morning. I am guilty of the above stated! I've had 3 fills and have been locked with the same 3 pounds up and down. I lost 46 from pre-op until first fill and then,the Mind War set in. It can be cruel and cause one to question. Hoping fourth fill will really make the 2 pounds begin to fall each week. Glad they could do surgery on the tummy, but the mind is still the mind...old habits die hard and push me to the limits. :tongue2:

great info, thanks. I just had my 2nd fill and still haven't really lost any weight. I especially found meaning in your comment about taking time to learn to trust it. Prior to reading this I'd begun to wonder if I would have been better off w/ the Bypass but now I feel a renewed sense of hope.

Please help w/this ? I am about in tears trying to figure all this out. If you chew chew chew so the food does not get stuck then it must go through to the bigger part of your stomache, in this case u can still eat alot. I have had 5 fills I can eat tons still as long as I really chew and I do eat alot. I have only lost 20 pounds in 8 months I thought I understood how this works but I am know cofused.

Barneygirl,

I think I can answer this! I have had more than 5 fills and been banded 4 months.

So i want to suggest that your band still is not tight enough. I believe the band should be tight enough that even really well chewed food should be a little restricted and fill the "stoma".

I had the EXACT symptoms you described 2 fills leading up to my last one. I felt good restriction but could easily "eat around" the band by chewing.

This last fill was like magic..at first i was scared it was too tight and it took a few days..but now im dialed in by going tighter.

I can even describe how it feels, if I drink a cold thick protein shake I can feel the band..not pain but I feel the drink pass through. That was the magic tighness for me because at that point well chewed NON Liquid food backs up a little.

To be clear..it doesnt get stuck but it takes a while to go down.

Here is another way I identify being "dialed in"... Say I eat a couple ounces of well chewed chicken. If I take a swig of water I will burp up all the water and the food along with it. Why? Because the food is still trying to go down and water has no where to go so it gets bletched up.

My guess is you dont have this experince. You probably either get stuck..or it goes down.

Soooo, my infinate wisdom is tighten that sucker up!

No doubt someone will reply back and explain why everything I said is wrong - just ignore them.

Please help w/this ? I am about in tears trying to figure all this out. If you chew chew chew so the food does not get stuck then it must go through to the bigger part of your stomache, in this case u can still eat alot. I have had 5 fills I can eat tons still as long as I really chew and I do eat alot. I have only lost 20 pounds in 8 months I thought I understood how this works but I am know cofused.

Barneygirl,

I think I can answer this! I have had more than 5 fills and been banded 4 months.

So i want to suggest that your band still is not tight enough. I believe the band should be tight enough that even really well chewed food should be a little restricted and fill the "stoma".

I had the EXACT symptoms you described 2 fills leading up to my last one. I felt good restriction but could easily "eat around" the band by chewing.

This last fill was like magic..at first i was scared it was too tight and it took a few days..but now im dialed in by going tighter.

I can even describe how it feels, if I drink a cold thick protein shake I can feel the band..not pain but I feel the drink pass through. That was the magic tighness for me because at that point well chewed NON Liquid food backs up a little.

To be clear..it doesnt get stuck but it takes a while to go down.

Here is another way I identify being "dialed in"... Say I eat a couple ounces of well chewed chicken. If I take a swig of water I will burp up all the water and the food along with it. Why? Because the food is still trying to go down and water has no where to go so it gets bletched up.

My guess is you dont have this experince. You probably either get stuck..or it goes down.

Soooo, my infinate wisdom is tighten that sucker up!

No doubt someone will reply back and explain why everything I said is wrong - just ignore them.

I think you got it this makes sense, I do get a fill on Thurs. well see if it helps. Thankyou.

Barneygirl,

I think I can answer this! I have had more than 5 fills and been banded 4 months.

So i want to suggest that your band still is not tight enough. I believe the band should be tight enough that even really well chewed food should be a little restricted and fill the "stoma".

I had the EXACT symptoms you described 2 fills leading up to my last one. I felt good restriction but could easily "eat around" the band by chewing.

This last fill was like magic..at first i was scared it was too tight and it took a few days..but now im dialed in by going tighter.

I can even describe how it feels, if I drink a cold thick protein shake I can feel the band..not pain but I feel the drink pass through. That was the magic tighness for me because at that point well chewed NON Liquid food backs up a little.

To be clear..it doesnt get stuck but it takes a while to go down.

Here is another way I identify being "dialed in"... Say I eat a couple ounces of well chewed chicken. If I take a swig of water I will burp up all the water and the food along with it. Why? Because the food is still trying to go down and water has no where to go so it gets bletched up.

My guess is you dont have this experince. You probably either get stuck..or it goes down.

Soooo, my infinate wisdom is tighten that sucker up!

No doubt someone will reply back and explain why everything I said is wrong - just ignore them.

I don't think you were wrong...I concur :hurray:

I agree too! I just had fill #3 and I now have 7cc's in a 14cc band. I have that exact feeling you described and I am seeing the weight come off more now. Thanks!

It is very confusing because there is a fine line between being too tight and not tight enough - I was getting fills about once a month because I could eat too much - my last one was back in June - only .25 and that did it - I can barely drink my protein shake in the morning - can only eat a small amount of food and food still gets stuck if I don't chew it enough- the thing that still confuses me is that even with all this restriction and not eating much food at all compared to what I was eating before I am losing weight so slow - only 22 lbs in a year. I had 50 to lose so I guess I shouldn't complain but I thought I would be at my goal weight by now - I must not have any metabolism and yes I do exercise a lot.

thank you for this link.....i have also been feeling demotivated about my lack of progress after my first fill on 11 august.

my problem is that i had my band fitted abroad and finding that uk doctors dont want to do fills if they have not fitted the band.

Wendell, I have had 7 fills and now have about 5.5 ccs in a 10 cc band, I don't feel any restriction. I can still eat anything I want, of course I try to limit my portions but I thought the fills were supposed to help me lose weight. I have not lost anything in the past month, although I walk 2-4 miles per day (jogging one mile of that). I did get a fill yesterday but don't feel restriction yet. Any words of wisdom?