I want to re-iterate what Dr. Hekier said in an earlier post about loosening the band. I recently had a patient who had their band loosened after almost a year of frequent vomiting and PB’s at every meal. Every time they came to the office we pleaded with them to let us loosen the band, but they were so worried about re-gaining some of the 80 or so pounds that they had lost and so they refused. After giving my best puppy-eyed pleading look, we finally agreed on an unfill. And what happened? After having been at a plateau for the year the band was too tight, the patient lost 12 pounds in two weeks after the unfill.
What is the moral of this story?
The band is not meant primarily for restriction. It is not meant to be a barrier to food intake or a mechanism to induce bulimia. It is meant primarily to help control hunger and to allow for small portions to be eaten without feeling hungry afterwards, not to keep you from being able to eat anything but a small portion. This may be a subtle difference, but it’s crucial. When you’re too tight and using the band as a barrier, you’ll eat whatever will go through which usually means ice-cream & chips. Nobody in the history of the universe has EVER lost weight on a steady diet of ice-cream and chips. Never. But if you use your band to allow you to eat the kind of diet all of us wish we could stick to (protein plus a healthy side) and not be hungry, then you’ll run back for an unfill when you’re too tight ’cause you’ll realize that being too tight keeps you from eating good, fat losing foods. THE BAND SHOULDN’T KEEP YOU FROM EATING – IT ALLOWS YOU TO DIET WITHOUT SUFFERING!
24. April 2009 at 2:27 pm
That was a VERY interesting post Dr. K!
25. April 2009 at 9:22 pm
She says thank you! (She is sitting next to me reading a book.)
11. May 2009 at 10:04 pm
About 3 weeks ago I had a fill… At first there was only a little restriction, but after a few days I noticed more restriction, and after a couple more days nothing (and I mean NOTHING) would pass through my band but it was a weekend so I “toughed” it out until I could get into the office on Monday (exactly one week after my fill). Dr. Keilin unfilled about half the amount that was put in the week before and I am doing much better as far as eating goes. What people don’t realize is that when you are restricted to that point, you get dehydrated and while you think it is wonderful to see a 12 lb weight loss in one week….. you gain it all back!!!! :’( So, my body had quite a shock and now it doesn’t want to let go of any weight I am trying to shed. Don’t make the same mistake…. if you are on the fence about whether you should get a fill or examine your eating habits…. go for the latter first….at least that won’t hurt you.
11. May 2009 at 11:06 pm
I always say it is better to be too loose than too tight.
22. May 2009 at 2:14 pm
productive burps, what does that mean exactly? Should I be having them or not?
23. May 2009 at 11:25 am
In an ideal world you would never have them because you would stop eating before you overate and would still feel full after eating for several hours (without snacking) until it was time for another meal. A productive burp, or “PB”, is when you’ve taken one or two bites more than will go through the band and the contraction of your esophagus/pouch brings the extra bites back up. Kind of like throwing up, but not nearly as violent and does not involve nausea or feeling retching. More like chest pain or heartburn because you ate too much, then that pressure is relieved when you bring the food back up.
13. June 2009 at 4:35 pm
I have not thrown up. I do have HORRIBLE pain in the chest occasionally after I eat, but the food doesn’t come up. (My surgery date was 4/22 and I have had 1 fill) When I go back for my next appointment in about 2 weeks, will they fill it some more? Is it normal to NEVER throw up?
1. July 2009 at 1:06 pm
OK Now I’m throwing up! I had my second fill yesterday and I haven’t been able to keep much down – liquids yesterday or soft foods today. Will it finally get better or should I come back and have some taken out?