The Rules of Adjustable Band Surgery1. Eat three or fewer small meals per day.2. Do not eat anything between meals.3. Eat slowly and stop when no longer hungry.4. Focus on nutritious foods.5. Avoid calorie-containing liquids.6. Exercise for at least 30 minutes every day.7. Be active throughout each day.8. Always keep in contact with us. 1. Eat three or fewer small meals per dayThe Laparoscopic Adjustable Gastric Band works primarily by taking away your appetite. If it is adjusted correctly you should not feel hungry. This may take several adjustments after your first adjustment because each patient has a different setting that works best for them. You may eat up to three times a day. We don't mind if you eat just two meals per day. Many people do not feel like eating breakfast and some will miss a mid-day meal. If you don't feel inclined to eat, don't eat. If you find you are getting hungry between meals, tell us. We will probably consider adjusting the band a little tighter at your next visit.Your meals should be about ½ cup of food. This amount is the entire meal, not just one part or serving. When you are first getting accustomed to this very small amount of food you should measure the food with a ½ cup measuring cup and after several months you will know exactly how much to eat. It is very important to keep your meals limited to very small volumes. Overeating may cause the small pouch above the band to slowly dilate and the effect of the operation will be lost if this occurs. Large meals may also cause the band to slip.2. Do not eat anything between meals.You are forbidden from having snacks, biscuits with your coffee, fruit, or anything. All food must be restricted to mealtimes. One of the most frequent causes for failure of the band is snacking between meals. If you are getting hungry between meals and are tempted to have a snack, you must tell us. It is probably due to inadequate adjustment; you may need more fluid added to the band. Between meals you may only have zero-calorie liquids-water, mineral water, tea, coffee or low-calorie soft drinks. Slimfast should never be part of the band patient's intake.3. Eat slowly and stop when no longer hungry.When you have eaten enough you will no longer be hungry and signals from your stomach to your brain tell you that you do not need any more. These signals take time to be generated. Give them that time. Each meal should be stretched out over 15-20 minutes. If you eat rapidly you will already have eaten too much before you realize that you have had enough. However, do not eat beyond 30 minutes. Throw away whatever you haven't eaten at that time. That is the end of that meal and you must have nothing else until the next meal. Try to make each meal last for 15-20 minutes. Try to sense when you have had enough and stop before you feel at all uncomfortable. Use a small plate, put a small amount of food on the plate, and develop the habit of always leaving some of it uneaten.4. Focus on nutritious foods.Foods that are high in protein (e.g. meats, especially fish, eggs, dairy products, lentils, beans, nuts) and foods that are high in complex carbohydrates (e.g. vegetables, some cereals) are best. Simple sugars are worst. Be careful with foods that are high in fats as they are a dense form of calories. Be careful with fruits as they contain quite a lot of sugar.The good foods can come from all the main food groups and include vegetables, meats, eggs, cereals and dairy. There is no need to focus unduly on the particular foods in fine detail. It is not rocket science. It is simply selecting foods that are good (protein and complex carbohydrates), being careful with those that are not so good (fats, alcohol) and avoiding those that are bad (simple sugars). And take a well-balanced vitamin and mineral replacement each day.5. Avoid calorie-containing liquids. Any calorie-containing liquids will tend to flow past the restriction of the band and not give you any feeling of satiety. You are then more likely to take too much.Allowed liquids:watermineral watertea or coffee (with low-fit milk if you wish but no sugar)low-calorie soft drinks.An exception to the "no liquid calorie" rule is a glass of wine with meals, which has been shown to be good for your health and good for your weight loss when taken in a modest amount (1 or 2 glasses per week).6. Exercise for at least 30 minutes each day.This is at least as important as all of the other rules. Not only must you take in fewer calories, but you also must use up more calories. Exercise will improve your general health as well. Initially, while you are severely obese this can be difficult, but, as your weight decreases, it becomes easier. As you become fitter and healthier, you get greater enjoyment from exercise.We understand that not everybody is sports minded and exercise may be something quite new for you. Start slowly and seek to build up activity progressively. Aim to put together 30 minutes or more of moderate-intensity physical activity on most and preferably all days. Walking is ideal to start off with. As your fitness improves, you should progress to more vigorous walking and even jogging, cycling, aerobics, swimming, and light resistance training. As your weight comes down your exercise capacity will increase and your general activities during the day will increase. The more active you are the better the result will be.7. Be Active Throughout Each Day.Think of movement and activity as opportunities and not as an inconvenience. Try to be active every day in as many ways as you can. Make it a habit to walk or cycle instead of using the car. Become active in the garden and do things yourself instead of using machines. Avoid sitting down at all cost. You should see sitting down as an opportunity for lost activity.Try to spend as much time outdoors as possible. We tend to be more active when outdoors. Use a pedometer as a stimulus to show you how your activity level is increasing. If you are using a pedometer, aim to get beyond 10,000 steps per day-this represents a very good level of routine daily activity.8. Always keep in contact with us.We want to follow you permanently. There will never be a time when we say that the job of controlling your obesity is done and we do not need to see you anymore. There will always be a need to check your progress, monitor your health, check for nutritional deficiencies, make sure that you understand the rules, bring you up to date with new developments, and adjust the volume of fluid in the band.There is always going to be a very small loss of fluid from the band over time. For example, if you had 6 mL of fluid present (5 mL = 1 teaspoon) and we checked the volume after a 6-month period, there would probably be about 5.7 mL present. This occurs because the band is subject to the constant forces of osmosis and so a small amount of fluid is lost from the system every year. If 6 mL was the correct volume, you would be starting to get hungry and eat more with a volume of 5.7 mL. It is important for you to understand that this can happen. You must come back to see us for replacement of that small fluid loss. This is one of the main reasons that we want a maximum of 6 months between appointments.Section 7. Commonly Asked Questions about the Laparoscopic Adjustable Band [back to top] Will I vomit?There shouldn't be any vomiting. The operation places a gentle restricting on your eating. If you find yourself vomiting, then there is either something wrong with the settings of the band and it may need to be loosened or there is something wrong with your following the rules of eating and drinking.Will I be constipated?Inevitably as you eat less food, then you eat less fiber and bowel activity will decrease. This usually is not a problem but if it does so it is acceptable to take one of the bulk forming laxatives such as Metamucil with plenty of water and this should correct the problem. Should I take vitamins?Yes. You may well be taking sufficient vitamins within the food that you are able to take, but as you lose weight you have a particular need for additional vitamins and therefore we strongly recommend that you do take a multivitamin supplement. It is particularly important that the supplement has sufficient folate and iron. We will monitor specific vitamins and minerals such as vitamin B 12 and folate and iron each year after operation to see if any deficiency in these is reoccurring. If they are, specific addition of these will be recommended. What about my other medications?In general you will continue to take the medications prescribed. However, if they are in the form of a bulky tablet, it is probably best to break the tablets up to avoid any chance of them acting as a block which could lead to vomiting. Capsules should be OK as they are designed to soften and melt inside the body.What if I become pregnant?The band itself should not interfere in any way with the pregnancy. The likelihood of becoming pregnant is probably higher because, having lost weight, your periods are often more regular. Normally we will adjust the volume of fluid in the band early in the pregnancy to ensure that there is optimal nutritional intake for both yourself and the baby. Almost always this means taking fluid out for the first 12 weeks of pregnancy. After the first 12 weeks, we may elect tighten the band up and assist with slowing too rapid weight gain.Is the material of the band dangerous to me?We have no information to suggest that it is. There has been concern regarding liquid silicone in breast implants. We have been unable to show in a large number of high quality medical studies that this indeed is true. The band is made of solid silicone. It cannot leak into the tissues in the way that liquid silicone can and therefore we expect the likelihood of problems is even less. However, it could be that information of problems will become available in the future which is relevant to this question. If this occurred we would inform you of it. How long will the band last inside me?We really don't know. We have had similar products in use for in excess of ten years and they have not shown signs of failure. However we can't realistically expect a device such as this to last 40 - 50 years. We do expect that somewhere down the track there will be failure of the adjusting balloon in particular and should this occur, the band would need to be replaced. It is going to remain to be determined if and when this should be necessary. Can the band be removed?Yes. It is not our intention to ever remove it, but should it become appropriate for whatever reason, then it can be removed. If it has been placed laparoscopically, then it can be removed laparoscopically. After the band has been removed we would expect the stomach to go back to its normal configuration. What should I do when dining out?Because of the limited capacity you must restrict yourself generally to an entree (appetizers in U.S.) alone. Eat slowly while those with you overeat with two or three courses. If you are visiting friends it is probably better to advise the host or hostess that you can only eat a small amount to save embarrassment when you reject their carefully prepared food.May I drink alcohol?There is a relatively high caloric content in alcohol. It is a liquid and therefore, should be against the rules. However, there are health benefits to a very modest amount of alcohol intake every week, especially if it is wine. An occasional glass of wine is fine in the right social setting or with your family at dinner, as long as your intake is limited to two or three times per week.Will I need plastic surgery for excess skin folds once I have lost weight?Most patients don't need plastic surgery after losing weight because the natural elasticity of skin usually takes up the slack pretty effectively. In general, about 20-30% of our patients need an operation to excise some of the excess skin around the waist. We usually wait about two years after weight loss surgery to consider removing the skin. This is typically when patients have lost a lot of their weight already.What happens if I become ill with the band in?The band operation is adjustable, which is one of its principal advantages. If an illness occurs which would make restriction of food intake inappropriate, fluid can easily be removed from the band system and nutrition would no longer be limited. After recovery from your illness, then you would be able to have the saline added back and the original restriction is restored and weight loss may resume.Will I burp after having the band placed?Not so easily. As we eat we always swallow air and normally we would bring this back up again quite unconsciously. The Laparoscopic Adjustable Gastric Banding interferes with this easy bringing up of wind. It is common in the first few weeks after the procedure for people to notice a difficulty with bloating and the feeling that they want to burp but cannot. This rarely seems to persist as a problem months later. We presume that the stomach below the band changes its shape enough to reduce the problem but for whatever reason it does not seem to continue to be troublesome. How are the adjustments done?There is no rush to perform the first adjustment as we want the band to fix itself into place where it is positioned in the operating room. We start to tighten the band 2 months after surgery. This is typically done in conjunction with an upper GI, which is a video x-ray obtained just after swallowing a barium meal.The adjustments are done in the office, but occasionally we will also use x-ray to assist in finding the port. The adjustment is typically performed in just a couple of minutes. You will be positioned on a procedure table with a pillow at the small of your back. We will sterilize your skin over the port. A fine needle is passed through the skin and into the port. A pre-determined amount of saline is added to the port. The maximum amount of fluid that the band system can hold is between 10 and 14 milliliters, and the first adjustment typically adds between 3 and 5 milliliters to the system. Different people achieve the right amount of restriction with different amounts of fluid.After the first adjustment, we typically perform adjustments every 2 weeks until you the band is in the target zone. With this setting, you will not be hungry between small meals, you will not be looking for food or constantly thinking about food, and you will be losing about 2 pounds a week early on and 1 pound a week after 6 months until your weight has become stable.We anticipate that you may need between 4 and 8 adjustments during the first year after surgery and 1 or 2 adjustments every year afterwards for the rest of life.There are several reasons that you may require more fluid in the band even though you have already had a perfect adjustment before. First, as you lose weight, fat melts away inside the band as well and so this makes for a looser fit around the upper stomach. Second, a very small amount of fluid tends to leak from the band every year and this requires a small fill every 6 months or so to keep the band opening just right.Will adjustments hurt?No, in general they do not. Some patients are more worried about the adjustment than they worry about the operation itself and this is really unnecessary. Each adjustment consists of a poke with a small caliber needle and there may be some mild discomfort as we find and push gently on the port. This usually only takes two or three minutes and does not require any local anesthetic. Adding a local anesthetic injection would add more to the pain of the adjustment than the whole adjustment by itself. You will most likely be comforted by the ease of adjustments after your first one is done.How much weight will I lose?Provided that the band is in good position and that you follow-up diligently in our clinic, in theory we can get you to whatever weight we would choose together because of the adjustable nature of the band.Ultimately, however, our main goal is focus simply on the profound benefits that weight loss will provide for your overall health. We have found that these benefits can be realized by having you lose about half of your excess weight.The weight loss is relatively slow and gentle, occurring typically over a 24 month timeframe. Our goal is for you to lose 1-2 pounds each week during the first year and 1 pound per week during the second year. More rapid weight loss than this could be associated with undesirable metabolic effects. For patients with even more weight to lose, the adjustable nature of the band allows us to carefully control weight loss over an even longer period of time. What should I do if am going to travel to a remote location?In most cases there are problems with this. While away, you will generally want to be especially careful about following the rules of eating and drinking. Take the information about your band with you so that other doctors will know what to do if there are problems. You may always have your treating doctors call us through the hospital operators at any time of day. We are always happy to discuss the problem with them before they do any intervention with accessing the port unless they are already experienced with the device.
The Rules of Adjustable Band Surgery1. Eat three or fewer small meals per day.2. Do not eat anything between meals.3. Eat slowly and stop when no longer hungry.4. Focus on nutritious foods.5. Avoid calorie-containing liquids.6. Exercise for at least 30 minutes every day.7. Be active throughout each day.8. Always keep in contact with us.
1. Eat three or fewer small meals per dayThe Laparoscopic Adjustable Gastric Band works primarily by taking away your appetite. If it is adjusted correctly you should not feel hungry. This may take several adjustments after your first adjustment because each patient has a different setting that works best for them. You may eat up to three times a day. We don't mind if you eat just two meals per day. Many people do not feel like eating breakfast and some will miss a mid-day meal. If you don't feel inclined to eat, don't eat. If you find you are getting hungry between meals, tell us. We will probably consider adjusting the band a little tighter at your next visit.Your meals should be about ½ cup of food. This amount is the entire meal, not just one part or serving. When you are first getting accustomed to this very small amount of food you should measure the food with a ½ cup measuring cup and after several months you will know exactly how much to eat. It is very important to keep your meals limited to very small volumes. Overeating may cause the small pouch above the band to slowly dilate and the effect of the operation will be lost if this occurs. Large meals may also cause the band to slip.2. Do not eat anything between meals.You are forbidden from having snacks, biscuits with your coffee, fruit, or anything. All food must be restricted to mealtimes. One of the most frequent causes for failure of the band is snacking between meals. If you are getting hungry between meals and are tempted to have a snack, you must tell us. It is probably due to inadequate adjustment; you may need more fluid added to the band. Between meals you may only have zero-calorie liquids-water, mineral water, tea, coffee or low-calorie soft drinks. Slimfast should never be part of the band patient's intake.3. Eat slowly and stop when no longer hungry.When you have eaten enough you will no longer be hungry and signals from your stomach to your brain tell you that you do not need any more. These signals take time to be generated. Give them that time. Each meal should be stretched out over 15-20 minutes. If you eat rapidly you will already have eaten too much before you realize that you have had enough. However, do not eat beyond 30 minutes. Throw away whatever you haven't eaten at that time. That is the end of that meal and you must have nothing else until the next meal. Try to make each meal last for 15-20 minutes. Try to sense when you have had enough and stop before you feel at all uncomfortable. Use a small plate, put a small amount of food on the plate, and develop the habit of always leaving some of it uneaten.4. Focus on nutritious foods.Foods that are high in protein (e.g. meats, especially fish, eggs, dairy products, lentils, beans, nuts) and foods that are high in complex carbohydrates (e.g. vegetables, some cereals) are best. Simple sugars are worst. Be careful with foods that are high in fats as they are a dense form of calories. Be careful with fruits as they contain quite a lot of sugar.The good foods can come from all the main food groups and include vegetables, meats, eggs, cereals and dairy. There is no need to focus unduly on the particular foods in fine detail. It is not rocket science. It is simply selecting foods that are good (protein and complex carbohydrates), being careful with those that are not so good (fats, alcohol) and avoiding those that are bad (simple sugars). And take a well-balanced vitamin and mineral replacement each day.5. Avoid calorie-containing liquids. Any calorie-containing liquids will tend to flow past the restriction of the band and not give you any feeling of satiety. You are then more likely to take too much.Allowed liquids:watermineral watertea or coffee (with low-fit milk if you wish but no sugar)low-calorie soft drinks.An exception to the "no liquid calorie" rule is a glass of wine with meals, which has been shown to be good for your health and good for your weight loss when taken in a modest amount (1 or 2 glasses per week).6. Exercise for at least 30 minutes each day.This is at least as important as all of the other rules. Not only must you take in fewer calories, but you also must use up more calories. Exercise will improve your general health as well. Initially, while you are severely obese this can be difficult, but, as your weight decreases, it becomes easier. As you become fitter and healthier, you get greater enjoyment from exercise.We understand that not everybody is sports minded and exercise may be something quite new for you. Start slowly and seek to build up activity progressively. Aim to put together 30 minutes or more of moderate-intensity physical activity on most and preferably all days. Walking is ideal to start off with. As your fitness improves, you should progress to more vigorous walking and even jogging, cycling, aerobics, swimming, and light resistance training. As your weight comes down your exercise capacity will increase and your general activities during the day will increase. The more active you are the better the result will be.7. Be Active Throughout Each Day.Think of movement and activity as opportunities and not as an inconvenience. Try to be active every day in as many ways as you can. Make it a habit to walk or cycle instead of using the car. Become active in the garden and do things yourself instead of using machines. Avoid sitting down at all cost. You should see sitting down as an opportunity for lost activity.Try to spend as much time outdoors as possible. We tend to be more active when outdoors. Use a pedometer as a stimulus to show you how your activity level is increasing. If you are using a pedometer, aim to get beyond 10,000 steps per day-this represents a very good level of routine daily activity.8. Always keep in contact with us.We want to follow you permanently. There will never be a time when we say that the job of controlling your obesity is done and we do not need to see you anymore. There will always be a need to check your progress, monitor your health, check for nutritional deficiencies, make sure that you understand the rules, bring you up to date with new developments, and adjust the volume of fluid in the band.There is always going to be a very small loss of fluid from the band over time. For example, if you had 6 mL of fluid present (5 mL = 1 teaspoon) and we checked the volume after a 6-month period, there would probably be about 5.7 mL present. This occurs because the band is subject to the constant forces of osmosis and so a small amount of fluid is lost from the system every year. If 6 mL was the correct volume, you would be starting to get hungry and eat more with a volume of 5.7 mL. It is important for you to understand that this can happen. You must come back to see us for replacement of that small fluid loss. This is one of the main reasons that we want a maximum of 6 months between appointments.Section 7. Commonly Asked Questions about the Laparoscopic Adjustable Band [back to top] Will I vomit?There shouldn't be any vomiting. The operation places a gentle restricting on your eating. If you find yourself vomiting, then there is either something wrong with the settings of the band and it may need to be loosened or there is something wrong with your following the rules of eating and drinking.Will I be constipated?Inevitably as you eat less food, then you eat less fiber and bowel activity will decrease. This usually is not a problem but if it does so it is acceptable to take one of the bulk forming laxatives such as Metamucil with plenty of water and this should correct the problem. Should I take vitamins?Yes. You may well be taking sufficient vitamins within the food that you are able to take, but as you lose weight you have a particular need for additional vitamins and therefore we strongly recommend that you do take a multivitamin supplement. It is particularly important that the supplement has sufficient folate and iron. We will monitor specific vitamins and minerals such as vitamin B 12 and folate and iron each year after operation to see if any deficiency in these is reoccurring. If they are, specific addition of these will be recommended. What about my other medications?In general you will continue to take the medications prescribed. However, if they are in the form of a bulky tablet, it is probably best to break the tablets up to avoid any chance of them acting as a block which could lead to vomiting. Capsules should be OK as they are designed to soften and melt inside the body.What if I become pregnant?The band itself should not interfere in any way with the pregnancy. The likelihood of becoming pregnant is probably higher because, having lost weight, your periods are often more regular. Normally we will adjust the volume of fluid in the band early in the pregnancy to ensure that there is optimal nutritional intake for both yourself and the baby. Almost always this means taking fluid out for the first 12 weeks of pregnancy. After the first 12 weeks, we may elect tighten the band up and assist with slowing too rapid weight gain.Is the material of the band dangerous to me?We have no information to suggest that it is. There has been concern regarding liquid silicone in breast implants. We have been unable to show in a large number of high quality medical studies that this indeed is true. The band is made of solid silicone. It cannot leak into the tissues in the way that liquid silicone can and therefore we expect the likelihood of problems is even less. However, it could be that information of problems will become available in the future which is relevant to this question. If this occurred we would inform you of it. How long will the band last inside me?We really don't know. We have had similar products in use for in excess of ten years and they have not shown signs of failure. However we can't realistically expect a device such as this to last 40 - 50 years. We do expect that somewhere down the track there will be failure of the adjusting balloon in particular and should this occur, the band would need to be replaced. It is going to remain to be determined if and when this should be necessary. Can the band be removed?Yes. It is not our intention to ever remove it, but should it become appropriate for whatever reason, then it can be removed. If it has been placed laparoscopically, then it can be removed laparoscopically. After the band has been removed we would expect the stomach to go back to its normal configuration. What should I do when dining out?Because of the limited capacity you must restrict yourself generally to an entree (appetizers in U.S.) alone. Eat slowly while those with you overeat with two or three courses. If you are visiting friends it is probably better to advise the host or hostess that you can only eat a small amount to save embarrassment when you reject their carefully prepared food.May I drink alcohol?There is a relatively high caloric content in alcohol. It is a liquid and therefore, should be against the rules. However, there are health benefits to a very modest amount of alcohol intake every week, especially if it is wine. An occasional glass of wine is fine in the right social setting or with your family at dinner, as long as your intake is limited to two or three times per week.Will I need plastic surgery for excess skin folds once I have lost weight?Most patients don't need plastic surgery after losing weight because the natural elasticity of skin usually takes up the slack pretty effectively. In general, about 20-30% of our patients need an operation to excise some of the excess skin around the waist. We usually wait about two years after weight loss surgery to consider removing the skin. This is typically when patients have lost a lot of their weight already.What happens if I become ill with the band in?The band operation is adjustable, which is one of its principal advantages. If an illness occurs which would make restriction of food intake inappropriate, fluid can easily be removed from the band system and nutrition would no longer be limited. After recovery from your illness, then you would be able to have the saline added back and the original restriction is restored and weight loss may resume.Will I burp after having the band placed?Not so easily. As we eat we always swallow air and normally we would bring this back up again quite unconsciously. The Laparoscopic Adjustable Gastric Banding interferes with this easy bringing up of wind. It is common in the first few weeks after the procedure for people to notice a difficulty with bloating and the feeling that they want to burp but cannot. This rarely seems to persist as a problem months later. We presume that the stomach below the band changes its shape enough to reduce the problem but for whatever reason it does not seem to continue to be troublesome. How are the adjustments done?There is no rush to perform the first adjustment as we want the band to fix itself into place where it is positioned in the operating room. We start to tighten the band 2 months after surgery. This is typically done in conjunction with an upper GI, which is a video x-ray obtained just after swallowing a barium meal.The adjustments are done in the office, but occasionally we will also use x-ray to assist in finding the port. The adjustment is typically performed in just a couple of minutes. You will be positioned on a procedure table with a pillow at the small of your back. We will sterilize your skin over the port. A fine needle is passed through the skin and into the port. A pre-determined amount of saline is added to the port. The maximum amount of fluid that the band system can hold is between 10 and 14 milliliters, and the first adjustment typically adds between 3 and 5 milliliters to the system. Different people achieve the right amount of restriction with different amounts of fluid.After the first adjustment, we typically perform adjustments every 2 weeks until you the band is in the target zone. With this setting, you will not be hungry between small meals, you will not be looking for food or constantly thinking about food, and you will be losing about 2 pounds a week early on and 1 pound a week after 6 months until your weight has become stable.We anticipate that you may need between 4 and 8 adjustments during the first year after surgery and 1 or 2 adjustments every year afterwards for the rest of life.There are several reasons that you may require more fluid in the band even though you have already had a perfect adjustment before. First, as you lose weight, fat melts away inside the band as well and so this makes for a looser fit around the upper stomach. Second, a very small amount of fluid tends to leak from the band every year and this requires a small fill every 6 months or so to keep the band opening just right.Will adjustments hurt?No, in general they do not. Some patients are more worried about the adjustment than they worry about the operation itself and this is really unnecessary. Each adjustment consists of a poke with a small caliber needle and there may be some mild discomfort as we find and push gently on the port. This usually only takes two or three minutes and does not require any local anesthetic. Adding a local anesthetic injection would add more to the pain of the adjustment than the whole adjustment by itself. You will most likely be comforted by the ease of adjustments after your first one is done.How much weight will I lose?Provided that the band is in good position and that you follow-up diligently in our clinic, in theory we can get you to whatever weight we would choose together because of the adjustable nature of the band.Ultimately, however, our main goal is focus simply on the profound benefits that weight loss will provide for your overall health. We have found that these benefits can be realized by having you lose about half of your excess weight.The weight loss is relatively slow and gentle, occurring typically over a 24 month timeframe. Our goal is for you to lose 1-2 pounds each week during the first year and 1 pound per week during the second year. More rapid weight loss than this could be associated with undesirable metabolic effects. For patients with even more weight to lose, the adjustable nature of the band allows us to carefully control weight loss over an even longer period of time. What should I do if am going to travel to a remote location?In most cases there are problems with this. While away, you will generally want to be especially careful about following the rules of eating and drinking. Take the information about your band with you so that other doctors will know what to do if there are problems. You may always have your treating doctors call us through the hospital operators at any time of day. We are always happy to discuss the problem with them before they do any intervention with accessing the port unless they are already experienced with the device.
