Restriction: What's the deal?

I have read post after post about not having restriction. I don't get it. The lap band is really a simple concept. It won't work unless you have restriction. The band is adjustable to achieve restriction. If we don't use that feature, we are not giving the band the opportunity to do its' job the way it was designed to work. My doctor says there is no reason to go around fighting hunger and not having restriction. Go to the doctor and have an adjustment. If it is too tight, go back and get it loosened. When I needed a fill, I got one. It made no difference. It went back a week later, got the second and have been tight ever since. So, from May 12th to today, I have had good restriction for all but 2-3 weeks. My weight loss has been rapid and relatively "easy". I just can't eat very much and I am rarely hungry. I guess in some instances, it is the doctor that is shy about giving adjustments. Why? I don't understand that theory. The surgeon I chose was one of the doctors who participated in the FDA trials (he is 6 hours away versus 15 minutes across town to a less experienced one), so he has as much experience as any American doctor. Besides having the surgical experience in placing the band, the main reason I chose him was my thoughts that the experience after surgery was key to a successful weight loss program. He stresses to get an adjustment whenever you feel like you need one. I don't understand the get a fill, wait 4-6 weeks before getting another one. If you get a fill and you still have no restriction, why in the world should you wait a month for another one. That's like getting an infection at the port site but waiting a month to start antibiotics. Does you doctor stress to get filled when needed, or is he/she on the get a fill, wait a month regardless plan?

Hi Jim, I guess I am one of the lucky ones because I have restriction right off the hoot. However, if things had been different my Surgeon uses the small fills every few weeks concept. He only adds a very small amount beginning 6 weeks after banding. The patient comes in every two weeks for more until the sweet spot i**** I hope others respond with sharing how their Surgeon prefer to fill. Another thing is that some Surgeons charge an arm and a leg for fills so that may also play a part in why some people wait longer than others to have it done. If I were on the paying end, I would not be happy with small amounts every couple of weeks, I would prefer to be optimized from the beginning providing it's safe. Great job on your restriction Madame Yess

I should not talk because I dont get banded until Dec.But I found your comments intesting .My Doc stated he will do the fist fill 4 to 6 weeks and I think every 4 week later but I think I am going to ask agian.Thanks for the infor

One of the reasons to wait more than 1-2 weeks is that very often fills will "kick in" 1-2 weeks after they're given. If you get a bunch of fills a week apart, it could leave you too tight. I agree totally about having adequate restriction...but some of us don't want to be "hardly eating" as we're looking for a sensible rate of loss and to help prevent our metabolisms from slowing down too much (which makes maintaining weight loss much harder). My surgeon was also involved in the trials and she doesn't believe in just giving fills whenever we want them. She sees her banding patients once a month (we don't need to make special appointments for fills). If we need a fill (no weight loss and hunger issues), we get one. Proper restriction isn't so much gauged by how we "feel" when we eat, but has our hunger been dimmed? Do we feel full/satisfied with a reduced portion and not get hungry again for a good while? Are we losing 1-2 lbs/week on average? I've seen a lot of bandsters get filled so tight they can hardly eat at all...then they wonder why they end up with reflux and a lot of PBing and slippage... So yes, get adjustments when they're really needed, but make sure you can still eat a healthy diet...One of the contrary things about the metabolism is that it must be adequately fed or it will tank out...it's much harder to rebuild a metabolism than to keep it going... Nancy 394/299/180

One of the reasons to wait more than 1-2 weeks is that very often fills will "kick in" 1-2 weeks after they're given. If you get a bunch of fills a week apart, it could leave you too tight. I agree totally about having adequate restriction...but some of us don't want to be "hardly eating" as we're looking for a sensible rate of loss and to help prevent our metabolisms from slowing down too much (which makes maintaining weight loss much harder). My surgeon was also involved in the trials and she doesn't believe in just giving fills whenever we want them. She sees her banding patients once a month (we don't need to make special appointments for fills). If we need a fill (no weight loss and hunger issues), we get one. Proper restriction isn't so much gauged by how we "feel" when we eat, but has our hunger been dimmed? Do we feel full/satisfied with a reduced portion and not get hungry again for a good while? Are we losing 1-2 lbs/week on average? I've seen a lot of bandsters get filled so tight they can hardly eat at all...then they wonder why they end up with reflux and a lot of PBing and slippage... So yes, get adjustments when they're really needed, but make sure you can still eat a healthy diet...One of the contrary things about the metabolism is that it must be adequately fed or it will tank out...it's much harder to rebuild a metabolism than to keep it going... Nancy 394/299/180

Whoops...computer burp...sorry for double posting LOL Nancy

I agree with Nancy on this one I had a fill an everything seemed fine wasn't hungry seemed all was well about a week later I started pbing on almost eveything I ate had to go back on liquids and mushies today I was fine . but the little sucker sure seemed to tighten up after a week or so of having the fill Kathy

Jim, my doctor won't give another fill for at least a month, after I've had one. My second fill took three weeks to make itself known. If I had gone for another one, I would have been in trouble. I don't want to be so restricted that I can't eat, PB, and have reflux. It took a long time to put the weight on, I can stand to take a little time to take it off! sharon

How can it take 2 weeks or longer to get restriction after a fill? That doesn't make sense. When you add saline, the band tightens. How can it not "take effect" immediately?

Jim, no one knows WHY this happens, but it's extremely common. Some people also swell up badly after a fill so again, can't tell their actual real restriction in the first week or so afterwards. The best way to end up too tight is to stack a bunch of fills in a short time period without really giving them a try and well, a week is not a "try". Even basing it on weight loss, we don't lose at a constant rate...so it's more sensible to look at loss over a month's timeframe rather than a week's. Nancy 394/299/180