Every few weeks we see a patient who had fluid removed from their Lap Band on the prior visit, and they lost weight since that time. Patients say “How can that be? I thought you need to tighten the Lap Band to lose weight, not loosen it.”
Remember remember remember: The Lap Band works best when it helps you control your hunger. If it is so tight that it stops you from eating, that is bad.
If you find significant restriction to many foods, together with symptoms or regurgitation or reflux, you are possibly too tight.
Do not rely on the tightness of Lap Band to keep yourself from eating. Rely on the lack of hunger from the Lap Band to help you.
If you are a bit too tight, you might find that you have difficulty eating many types of solid food. As a result you might be eating a lot of soft mushy foods, liquids, or crunchy fried foods. These are the foods I hear about people eating when they are too tight: soup, chili, yogurt, ice cream, shakes, potato chips, tortilla chips.
Well guess what? If you are too tight, and you are eating those foods, you aren’t going to lose weight, and in fact you’ll probably gain weight.
When you are too tight, by removing fluid from your Lap Band, you are allowing yourself to make proper food choices. So don’t be worried, don’t be surprised. For some people, taking fluid out of their Lap Band is what they need to achieve their weight loss goals.
16. March 2009 at 1:22 pm
Dr. Hekier,
Your comment about eating soft foods and gaining weight describes me to a T! I have an appt in May with you and had back surgery recently and I have gained about 5 lbs.
16. March 2009 at 4:49 pm
I recently had some fluid removed from the band due to the tightness. I was unable to eat “good” foods. There were certain times in which I could not even drink. After beind loosened, I went nuts, trying to eat what I wanted. After a trip to the office, I realized what I was doing. Now I am making better choices. Making proper food choices is important to our health. I am waiting to see if I have adjusted to the fill, and I am really trying to do better. Keeping my mind on track is just as important in this journey as the lap-band is. Thank you for your encouraging information!
16. March 2009 at 5:12 pm
Wise words. I see quite a few post bandsters where I work, and I’m a little surprised at the number that think that being barely able to swallow water is the ideal…..that’s crazy to me.
16. March 2009 at 6:08 pm
They are putting themselves, their health, and their Band at risk.
18. March 2009 at 8:24 pm
I had my surgery over a year ago and have never had a problem until recently.I had no idea that a sinus drainage would make you sick.I got to the point that I could eat nothing at all with out seeing it a second time.I’m on the 3rd round of antibiotics and am finally clearing up my sinus infection.I’ve not saw anywhere that I was being sick until Betty told me on the phone.She said to get some protein powder which I did but it had to be mixed with milk.I was in your office this week and I bought your nectar protien and I just wanted to say I love it and with having my band loosened a little I have been able to eat finally.Thank you so much.
22. March 2009 at 11:13 pm
Did you see our earlier post on sinus drainage and the Lap Band? If not, take a look:
http://blog.noscales.com/2009/01/feeling-stuck-with-sinus-drainage-and-the-lap-band.html
23. March 2009 at 1:07 pm
After reading this post, I think that my band may be too full. At the first of March I had my fourth fill because I had stopped losing weight. Since then I have been unable to eat almost anything solid. I am living on frito pies and yogurt with an occassional chicken strip. I can also keep soup and mashed potatoes down most of the time. Sometimes I can’t even drink all my water for the day because I feel too full (bloated) to drink anymore. I am losing weight but I feel that I am not eating correctly from a nutrition standpoint. I don’t have another appt until April 13. Should I come back earlier to have some removed or just wait and see what happens?
23. March 2009 at 8:27 pm
We have a patient who recently had the band changed to a larger size due to inability to eat easily even with the band empty. Once food actually went down, the patient lost 12 pounds in two weeks. I really feel this is an example of the dysfunctional and poor habits bandsters can get into when the band is too tight. Don’t be afraid to loosen it just a little so you can maintain adequate fluid intake and nutritious foods.
23. March 2009 at 8:43 pm
I had mine loosened, and I think too much was taken out.I got filled the last time I was in, but I can’t tell a difference. I gained weight last time after it was loosened and I am struggling with my weight coming back on. Any suggestions? My next appointment is the 13th of April. Thanks!
26. March 2009 at 12:24 pm
I think there are too many variables that go into what makes a good fill that we should discuss it one-on-one when you get the to office
Don’t forget to write everything down before you come so we don’t miss any questions!
12. April 2009 at 8:23 pm
I recently had a fill on March 30th and before that March 2nd. I think I am too tight. For 2 weeks I have got almost nothing down, vomiting all the time,some liquids and water, sometimes. Do you think it was too soon to get a fill? I will be in to loosen some. Thanks
13. April 2009 at 11:22 am
Remember, we can’t discuss individual issues on this site. We always say that the Lap Band works by helping you with your hunger, not with restricting your food. Every fill is different and your body can react differently each time. If a person has signs or sypmtoms of excessive restriction then we ask them to come to the office to potentially have fluid removed from the gastric band.
22. May 2009 at 2:00 pm
At 6ccs, I couldn’t keep anything down. Now I have 5 and a half ccs. Will I not be able to ever have more than 5 and a half ccs put in?
11. July 2009 at 10:59 am
i got my 3rd fill on monday (7-6-09) and yesteday (7-10-09)i had to some took out,Since i could only eat things that were VERY bad for me..and i was getting sick with every meal…i am just glad i didnt wait til my next visit to gain weight.
12. July 2009 at 3:48 pm
Yet another example of how important adjustments are. You have to get it just right. Don’t forget the follow up post from Dr. Keilin:
http://blog.noscales.com/2009/03/lapband-loosening-part-two.html
17. February 2010 at 2:22 am
In that respect is evidently a great deal to learn about this. I believe you hit remarkable great points
17. February 2010 at 4:48 pm
Thanks for your reply and keeping checking back!
1. July 2010 at 4:59 pm
Hello, im on struggle street, i got banded 3.5 years ago and fell pregnant 3 months later, i lost 18kilos in that 3 months,i had all my fill out when i fell pregnant and after 1 year after giving birth, i have since had 4 fills and 3 time ended in hospital due to dehydration and not keeping nothing down, not even sips of water. i had the camera put down yesterday and every thing came back fine, so the surgeon put 1ml back in taking it to about 4 mls, since then i have not kept nothing down. im spewing up frothy spit and have heaps of gas, i live 45minutes away from doc and am sick of having to travel back to get fluid out due to not being able to keep nothing down, i have just tried a sip of milo and i feel so sick and im just waiting on it to come up. Any help or advice would help please.jo
1. July 2010 at 9:39 pm
I’m so sorry that you’ve had such a difficult time! Reading your story, I am wondering how your doctor performs fills. Do they base their fill volume on what they see on a swallow study (xray) or do they judge how much to fill based on how you are feeling – hungry? overly tight? able to eat anything? – that sort of thing. A 1 ml fill if you’ve been having problems with over-restriction can be a little too agressive and you might need to fill very slowly in 0.1 or 0.2cc increments. There’s a possibility that you have a problem with the motility of your esophagus, i.e., the ability of your esophagus to squeeze food forward past the band into your stomach. That may well need to be checked out with a test called manometry and I recommend you speak with your surgeon about this as a possibility. I truly believe good communication between patient and doctor will produce the best possible plan. Best of luck!