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.

a lot of people here have made mention of something called a "pb", what is that?

Sorry, read though the thread a few pages and saw what it meant.

My thanks for the post as well. Granted everyone is different, are there any stats that provide estimates on fill amounts that achieve the green zone? Maybe averages or minimum cc's? Or maybe a better question would be are there recommended strategies for getting fills? I was thinking about asking my doctor for 2cc's to start with and work up from there gradually so i can learn to adjust. Any thoughts or best practices to share?

EVERYONE IS DIFFERENT . i have to have half a mil fills at a time but even that can make a big difference. all bands are different sizes and everyones bands are different.

good information. Wendell great job of explaining it.. so many people think more fills, lose faster.. it doesn't work that way.. My Dr. is conservative.. I have a 10 cc band and his first fill was 1.8 , 2nd fill was only .2 I am doing well so far on that... last visit I had lost 45 lbs total since 1/15/13 surgery..I am losing 1 -1.5 lbs per week...

I see a conflict between what Wendell stated (band cause's you to eat less because of the restriction, physically(paraphrase) and what others state (mis73) that band causes a sense of fullness which in-turn allows you to eat less! Is it one or the other? Both?

I believe it is both, with emphasis on the swallowing process causing you to feel satisfied on less food. Like Mis73, I agree that it is not a good practice to wait for the band to tell you are full (physically), because by then you are often too full. "Satisfied" is the word I see most successful bandsters use. Just my 2 cents, though!

good information. Wendell great job of explaining it.. so many people think more fills' date=' lose faster.. it doesn't work that way.. My Dr. is conservative.. I have a 10 cc band and his first fill was 1.8 , 2nd fill was only .2 I am doing well so far on that... last visit I had lost 45 lbs total since 1/15/13 surgery..I am losing 1 -1.5 lbs per week...[/quote']

So proud you are doing it the slow way! You are doing awesome.

One should never be looking to feel "full." The band should be helping you to feel satisfied with less food. You have been given a set of guidelines, 2-3 ounces of dense protein, 1/3 c veg and 1/3 c good carb. Stick to it, but make sure they are food items that you LOVE. That also helps with being satisfied and curbing the cravings. Eat what you love and only eat when hungry, do not be a clock watcher.

Hi- I just got my first full 4cc's..(thank god)

Has anyone had 4cc? Did it help? I have been hungry lately and haven't lost any weight

I love this post. I have been banded since June, 2010 and reading this has greatly helped me. I thought I would never get restriction but I finally did, and in total I lost about 98 lbs. Then I started having episodes of getting stuck or too tight. I would be very uncomfortable, couldn't keep food down and developed acid reflux. A trip to the doc's office and a slight unfill would usually do the trick. But back in May It happened again and my doctor was out of town. So I agreed to see another doctor in the office. Over my strong objection, he completely unfilled the band. I had to wait six weeks to have it refilled again on June 19th. The doctor put in 6 1/2cc, but as of today, I have no restriction and have gained 20lbs. Now. I realize that unfilling the band, at that time, may have been a reasonably sound medical decision. What I am irritated about is that this doctor would not listen to anything I had to say. I have a medical history of 1) Hypothyroidism, and 2) Diabetes. Not to mention the fact that this decision was in the middle of the freaking summer when most of us are more challenged by the foods we encounter. I needed my tool, and it was taken away from me at the worst possible time, and without me being able to even mount a defence. I will see my regular doctor in about a week, at which time I will let him know of my dissatisfaction with the matter. I hope this nest fill will send me in the right direction. If I can lose 98 lbs. I can lose 20, and your post has made this unnecessary set back a bit easier to take. Thanks

Hi- I just got my first full 4cc's..(thank god)

Has anyone had 4cc? Did it help? I have been hungry lately and haven't lost any weight

Yes I've been at 4cc's now for 10 days. And yes i still feel as if im consuming far more than i should.

My next fill/adjustment isnt until 9/27 and i cant wait!!

My nurse did say tht i shld begin to feel GREENER somewhere between 5-7.

I'll surely need & depend on this restriction to get me thru the holiday season!!

I just had my first fill this past monday and have experienced 3 pb's so far- not chewing enough!!!!! Very not fun!

but I also don't have a sense of a smaller stomach, in that if I chew well I can still eat a good amount of food- almost as much as before the band. I have 2.5 ccs in a 4cc /10cm inamed band. My weight loss has stalled since I went onto solids.

Ditto - RIGHT THERE WITH YOU! Mu husband keeps "Checking out my plate" at meal times...has even said - WHY are you eating THAT much; when in reality compared to what I use to eat - I don't think it's THAT much. However I am not eating itty bites portions. I am begining to wonder if I ever will?!?!?!?

Thank you for this post...Excellent information. I am 4 years post band and didn't know this info. This will help my husband to understand as well.

I have been reading the post and I was wondering what everyone thinks. I have 8cc's and can still eat anything and have no restriction. Doctor says that can't be possible. I'm stress eating but I tell you I am hungry all the time and can eat anything.