Dr. David Provost performs weight loss surgery, including Lap-Band surgery, in Denton, TX. He has taught weight loss surgery procedures to hundreds of doctors from around the country. He also specializes in revision surgery for patients who have experienced challenges following a previous weight loss surgery procedure. In this article, Dr. Provost offers his advice and guidance to help patients who undergo Lap-Band surgery achieve long-term success awith proper follow-up care.

Frequently Asked Questions about LAP-BAND® Adjustments
By Dr. David Provost

Q: Why are adjustments important?

A: Ongoing adjustments, either adding or removing saline from your LAP-BAND System, are necessary for continued success with your LAP-BAND System.  This unique feature provides the right level of restriction for your individual needs.

Q: When do I need an adjustment?

A: It is important to remember that everyone requires a different amount of restriction and a different adjustment schedule. But, several indicators may alert you to schedule an appointment to have a LAP-BAND adjustment. Some of these include:

• No weight loss for more than four weeks
• Increased appetite
• Feeling hungry less than four hours after eating a meal
• Ability to eat more food during a meal than usual
• Increased snacking
• Ability to eat foods that you were unable to eat before (i.e. white breads, fibrous vegetables)

Q: How do I know that I have been properly adjusted?

A: You should feel an early and prolonged satiety, or fullness.  Small meals should satisfy you while maintaining a target weight loss of 1-2 pounds per week.  The LAP-BAND makes you eat less and feel full in two ways -– first, by reducing the capacity of your stomach, and second, by increasing the time it takes food to get through the digestive system.  If you follow the nutrition guidelines provided by your surgeon, when you choose your food and then chew it well, you should not feel hungry or deprived.

Q: Can I be over-adjusted?  If so, how will I know if I am?

A: Yes, there is such a thing as too much saline in your band.  Tighter is not always better!  Indicators that you may be over-adjusted include:

• Difficulty swallowing
• Unable to swallow saliva
• Foaming at the mouth
• Regurgitation
• Waking up at night coughing or vomiting
• Frequent reflux/heartburn

If you experience any of these symptoms, you should contact your surgeon’s office immediately.

Q: Why do I feel more restricted in the morning than I do at night?

A: Your esophagus muscle, like any other muscle, tightens when not being used overnight.  Your esophagus must work to push food down through the band and needs some “stretching/warming up” in the morning. Often, this results from eating a larger meal in the evening without sufficient time to empty your pouch prior to lying down for sleep.  Try making your evening meal smaller and not eating for 3-4 hours prior to bedtime.