‘Fill my band, I need more restriction’

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This is something our nurses often hear in the clinic. It usually leads to a long conversation about eating habits, how the band is supposed to work and that an adjustment isn’t needed at this time.

This can be a very difficult conversation because many patients will tend to link their adjustment to weight loss and if they are not losing weight at the rate they were or that they hoped to, naturally they will want a tighter band. Rarely is this the right course of action though. The band is a great ‘servant’ but only when patients learn the right eating habits alongside it, for some patients this takes several months and perseverance. During this time its unwise to over tighten the band.

The band requires a change in eating habits, including changes to the textures of the food eaten, eating smaller morsels (not mouthfuls) and eating slowly. We can’t establish what is the right fill volume for you until you are following the right eating habits. It’s for this reason that we may deny adjustments for a short period and encourage patients to complete a food diary while the new eating habits are ingrained.

If a patient is not eating the right textured foods, an adjustment is not going to help and could encourage the wrong behaviour. When having a band you should plan on needing 3-6 band adjustments over a 6-12 month period to reach the right level of restriction, you may be lucky and require fewer but seldom more than is required.  

So, if your band fill nurse is ‘refusing’ to adjust your band, its because you don’t need one and they are acting in your best interests long term.  

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Rishi Singhal

Rishi is an expert bariatric surgeon based in the West Midlands and also Medical Director at Healthier Weight

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