How Soon Is Too Soon For Another Fill?

Okay, my doctor's office is not too helpful when it comes to determining this.  It has been 20 pounds since my fill and I don't know if I should have one.  Some days I can eat EVERYTHING, other days, I can hardly eat eggs.  Just don't know what to make of this.

What are the weight loss intervals that everyone else seems to follow?

I can't speak for other people. My surgeon doesn't really get into number of pounds lost per fill. He asks if I am hungry between regularly scheduled meals (every 3-4 hours). He asks if I am consistently eating more than a bandster portion or, again, if after eating one (approx 1 cup), I am hungry before the next one.

If you weight loss stalls, a fill can help but it's not always the answer. Just because you've lost 20 lbs, that doesn't mean you need a fill. When I had lost 140 lbs, that would imply that I should have had 7 fills. There is no rhyme or reason to how to properly adjust your band. The opening size should be approx the size of a bic pen or a small pea.

That said, are there some foods that you could eat enormous quantities of even properly adjusted? Absolutely. If you  become an expert at chewing your food well and consistently, then you certainly can eat more than a bandster portion. The band is not necessarily supposed to be the portion control police-- many on this forum will disagree with this philosophy. Take my feedback as one person's opinion. If you cannot control your portions, if you don't measure them and then STOP eating, you are setting yourself up for challenges long term. Eating to feel full or to rely on the band to stop you from eating more than a bandster portion, means that when you get that full sensation, there will always be food left in your esophogus. That food will ever so slightly stretch your pouch. The more you do this, the more your pouch can stretch over time. This requires more food to give you that full sensation.

There are many days that I can eat MUCH more than a bandster portion. Just because I can, doesn't mean I can or should. What I use to determine if I need a fill is if I am hungry between meals when I space them out 3-4 hours and I'm making healthy (lean protein and fresh fruits or vegetables) bandster size portions. If I eat simpe starches (white bread, sugar, potatoes, white rice, pasta), they convert to sugar in the bloodstream quickly after eating and I'm hungry soon after eating. This is a "false positive" in terms of needing a fill. In that case, it's WHAT I'm eating not the band's fill level.

Hopefully, you are still losing. You are measuring portions, making healthy eating choices and incorporating more physical activity into your daily life as the weight comes off. These healthy behaviors are what you need for long term success with the band.

Hi, "peaceful" - Needing a new fill really has little to do  with weight lost.   But, if we have not lost anything for more than 4 weeks in a row, it's time take a look at SEVERAL things, and needing more fill is the LAST thing to consider, never the first.

It's important to understand that we will never lose every week or even every month - but if we are striving to improve and refine our eating, choices, exercise, and lifestyles, we WILL resume loss again. And those are the lessons that will allow us to keep the weight off this time - it's not the band at all.

WHEN we might need more fill has more to do to do with how the present fill is, and how you are doing with eating.

If you now cannot eat well on ANY days, you are not eligible for a fill. please NEVER get more fill if you are having ANY trouble with the present fill !! The too-tight days would be even worse. think about this! Never get more fill when you're having ANY trouble with the present fill. Doing so - and docs agreeing to give more - is a big part of why so many people get into band trouble.

Take a look at what you are eating.  On the days you can eat "everything", are you choosing solid protein and veggies?  The only meals that will make the band work are based on protein. Are you starting every lunch and dinner with solid protein? always stopping at 1-1.5 cups total, even if the band does not make you stop? If not, people are begging for dilations.

  If you are eating soft foods or liquid foods, don't expect the band to help . If you choose this type of meal, you'll need to SELF-limit to the 1-1.5 cups of foods that will discourage pouch and esophagus dilations. we can never eat until we are too full to eat more. That is not the primary purpose of the band. the band is meant only to dim hunger between meals - again, ONLY if we choose a good band meal) so that we can work hard on improving our eating, choices, and lifestyles. That is all we're going to be able to reply on in a few years, when the esophagus becomes accustomed to the band pressure and no longer gives reliable stop signs.

See this link for more on "When do I need more fill?" Hope this helps. Your doc should be giving you similar guidelines, and not leaving his patients out in the dark.

http://www.obesityhelp.com/forums/LapBand/4137018/When-do-I-need-more-fill-Education-document-re-post/#33781943

Sandy r

 When I start thinking about a fill, here's what I measure before I make an appt.  How much am I eating at each meal.  I measure out the recommended portion (1/2C-1C) per meal then I look to see that I'm eating protein first, veg second, if room, then fruit last & almost no carbs.  Then I see how long the meal keeps me full.  My Dr wants it to be between 4-5 hours before I have hunger again.  He also wants me to exercise at least 30 min daily and keep my calories at about 800/day (I actually keep it closer to 1000/day).  If I'm sticking to all the rules, but I'm hungry too soon, then I will get a small fill.

As far as some days are harder to eat during.  You mentioned eggs, some ppl have a big issue with chewing eggs to applesauce texture.  Are your days with issues eating with certain foods, times, times of month or anything else?

Lisa

My Dr. will allow them every 6 weeks if needed..and that's the key..I measure and weigh everything before I put it on my plate. 
I haven't had a fill since Jan 4 because I feel I'm doing fine like I am. I'm not too tight..I can eat what I am supposed to be eating with no problems, I'd rather work a little harder on my food choices than be fighting with a too tight band..
In my opinion if you are losing weight and not terribly hungry 3-4 hrs after a meal..you're probably OK where you're at as far as restriction goes..

 My doctor is the same with allowing me to have then every 6 - 8 weeks. I'm going in for my 3rd on Friday and I definitely need one. I didn't feel any difference when I got my second one and I can eat more than 1 cup.  I'm still loosing but slowly. I want to be able to eat only 1 cup and be comfortable with that for the 4 - 5 hours I'm supposed to.  My doctor and NUT also does not give me a calorie count to stick by. Instead I have a food guide with the amount I should be eating at each meal.  I know 900 calories is starvation mode for your body from another doctor I had gone to so I am trying to stick to 1000 - 1200 calories a day.  Some days I know it's more but that's ok for now. 

Fill frequency isn't based on how much weight you've lost since your last fill, it's based on how you feel about your level of restriction and how much you can (or can't) eat. If you are comfortable with the amount of restriction you have, you can keep that fill level until you begin to feel like you need a little more. If you feel like you can eat more than you should, you might want to get a little fill.