When a Fill Adjustment is Needed?
- When I don’t lose weight for 2 weeks
- When I don´t lose sizes for 2 weeks
- When I regain weight
- When I’m hungry after eating 2 hours earlier
It is very important to know that fill adjustments are different in every patient due to age, size, metabolism, physical activity and quantity of calories intake. Fill adjustments are required within 3 to 5 weeks during the first year to lose 80% of the overweight, though it is not necessary to visit your surgeon every time you need one.
What is a fill adjustment or band adjustment?
When the Lap Band is an adjustable device. It can be “filled” to achieve the level of restriction
- Feel hungry hours after meal
- Dont lose any pound in weeks
- Dont lose any size in weeks
- If you regain one pound
Do I need a fill (band adjustment) ?
A properly adjusted band should restrict your eating to about a third of your pre-surgical intake. If you can eat more than a third, you may need a fill. Remember, you must be eating only solid foods since the band is designed to restrict only solids. If you are eating mostly soft or liquid foods, we cannot evaluate the need for a fill since these foods will easily pass through the band even when properly restricted. After about a year, some patients find while they are eating only a third of their volume, selecting their food wisely and eating only solid foods, but still not loosing weight. This may also mean they require a small adjustment to “fine tune” their band to resume weight loss.
How much is right for me?
If everybody wore the same shoe size, then just one adjustment might also be right for everyone. The precise fill can only be determined for each individual at that moment in time. This means, if your fill volume (1 to 3 mls) results in the perfect restriction, this may not be the case several weeks or months later. A number of things determine the right fill such as your weight, (the more you weigh, the thicker your stomach is). As you lose weight and your stomach gets thinner, you may need a tighter adjustment. The adaptation of your esophagus and stomach also play a role in restriction. Sometimes when air is caught in your band (when your band is new), the amount of fill may vary after a couple of weeks. Thus the liquid does not seep out, but air will diminish the total fill volume.
What to expect
We perform fills under X-ray at our center. This will permit us to visualize the size of the fill and the level of tightness produced when we inflate the band. We do this by accessing the port under the skin with a thin needle. This is a quick and painless procedure. Once the port is accessed, we ask the patient to swallow the liquid barium that shows up under x-ray. You will marvel at seeing how the barium goes down your esophagus and then stops at the band. You will then see how your upper pouch (new stomach) fills, pauses, then slowly goes through and pasted the band. We measure how long it takes the barium to pass, which is how we determine we have the correct tightness giving you the amount of restriction, necessary for weight loss. The whole procedure takes only a few minutes.
We will expect you to be on liquids for hol week in order for you and your body to get used to your new fill. Some people will try eating solid food while driving or flying back home, they will have food get stuck, then it becomes a medical emergency to remove liquid from the band.