What Zone Are You In? A Message from Allergan (Lap-Band® Manufacturer)

So, what’s the “green zone” and how do you get there from here?

The green zone is an expression that’s often used to describe where a LAP-BAND® patient is in regards to his/her hunger and eating regime. Certainly, just because a patient has had surgery doesn’t mean they can eat whatever they want or that they can maintain the same food choices they’ve made in the past. Far from it.

In order for a tool like the LAP-BAND® System to work effectively, it needs to be fine tuned. That requires multiple visits to a care provider that has the ability to adjust the band, whether that’s putting more fluid in or taking some out which as you likely already know adjusts the “fit” (or restriction) of the band. Just know that it’s a process to get there and requires assessments from a healthcare provider to get you to the “green zone”.  

Many bariatric practices require frequent “office visits” post surgery so as to monitor a patient’s progress, offer encouragement and perhaps to perform an adjustment. Many people say that a key advantage of the LAP-BAND® System over the other procedural alternatives is that it’s adjustable. And reversible too for that matter. Every LAP-BAND® System has the ability to be customized for fit, so as to bring about a sense of satisfaction (lack of hunger) to the patient after a modest and healthy meal.

Comparisons from one patient to the next in regards to who has what amount of fluid in their specific band is futile. We’re all different people inside and out. And even two people of similar size (on the outside) may not require the same amount of fluid in order to both feel satiated. So, stop asking your fellow band patients how much fluid they have in their band. Their answer won’t matter to your LAP-BAND®.

What does matter – is your hunger and getting you to your “green zone”.

Imagine a color spectrum moving from yellow to green to red. I know, the colors are not in the order we were all taught in school – but bear with me. Think of it as the colors of a stop light. Yellow means caution. Green means go, while red indicates it’s time to stop. Some would say that yellow represents “not quite there” while red indicates you may be over filled. And that leaves us with green. The best zone of the 3. It’s the “go zone”. Fully satisfied after modest meals, eating the right kinds of foods and losing weight.

Here are a few questions to help you identify within which zone you’re currently residing.

Question	Yellow	Green	Red
Are you mostly eating	Any amount of bread, pasta, rice along with proteins and vegetables	Chicken, eggs, fish, fruit, vegetables	Candy, chips, ice cream, pastries, pies, soda, soups, protein drinks
The size of your meals are	Large, full plate (10-12 inch plate)	Small/medium (half plate) with a protein and a vegetable or fruit	Small/medium (half plate of soft food)
Most meals take you	10 minutes, (you are able to eat fairly fast without paying too much attention)	15-30 minutes	60 minutes
You stop eating when	My plate is empty, but I could eat more	I feel satisfied	The band stops me and I feel uncomfortable
Your appetite is	Always hungry	Great, small meals satisfy and it lasts until it’s almost time for my next meal	Never too sure, it varies based on what I was able to eat during the previous meal
You eat this many times/day	Always, meals don’t hit the spot, and I snack no matter how hard I try not to	2-3 times/day	Unpredictable, but very hungry at times
Swallowing food for you is	Very easy, I can eat anything	Ok, if I take small bites, take my time and chew properly	Unpredictable and difficult
You regurgitate/vomit	Rarely or never, only if I swallow a large piece or fail to chew properly	Rarely or never, only if I eat too quickly, or take too big of a bite	More than 2x per week, unpredictable
At night you cough or wheeze	Never	Never	Often

Your healthcare professional may also ask you:

• ·       How often are you hungry?
• ·       What foods have you eaten recently?
• ·       What foods give you trouble?
• ·       What are your portion sizes?
• ·       What time is your first meal of the day?
• ·       What time of day is your last meal?
• ·       Do you drink liquids with your meals?
• ·       And how often do you exercise?

All of these are good questions for self reflection as well – but you’ll only get “a fill” (if needed of course) by seeing and being evaluated by a qualified professional from your bariatric surgeon’s office.

Allergan’s Executive Council of top LAP-BAND® surgeons from across the country recommends 11 visits within the first year of your surgery in order to optimize your excess weight loss results. Read that again. 11 visits within year 1. Let’s be clear though, success is not just EWL or # of pounds lost – it’s about feeling good and being healthy. And getting back to doing the things you enjoy.

The aftercare algorithm that Allergan’s experts came up with are only their recommendations. They are only for others to consider as each healthcare professional is responsible for his/her own medical decisions.  But with that said, here’s what they came up with: Follow up visits should occur at week 1, 4, 8, 12, 16, 20, 24, 30, 36, 42, 48 and then again at 24 months.

That’s 11 visits within 12 months of your surgery date. So with that said, if you’re a year out and you aren’t seeing the results you anticipated and also haven’t seen your support team several times over the course of the last 12 months, you need to ask yourself why?

And if you’re not in the “green zone”, call your bariatric surgeon’s office and ask for an appointment to discuss your options.

Important LAP-BAND^® System Safety Information

Indications: The LAP-BAND® System is indicated for weight reduction for patients with obesity, with a Body Mass Index (BMI) of at least 40 kg/m² or a BMI of at least 30 kg/m² with one or more obesity related co-morbid conditions.

It is indicated for use in adult patients who have failed more conservative weight reduction alternatives, such as supervised diet, exercise and behavior modification programs. Patients who elect to have this surgery must make the commitment to accept significant changes in their eating habits for the rest of their lives.

Contraindications: The LAP-BAND^® System is not recommended for non-adult patients, patients with conditions that may make them poor surgical candidates or increase the risk of poor results (e.g., inflammatory or cardiopulmonary diseases, GI conditions, symptoms or family history of autoimmune disease, cirrhosis), who are unwilling or unable to comply with the required dietary restrictions, who have alcohol or drug addictions, or who currently are or may be pregnant.

Warnings: The LAP-BAND^® System is a long-term implant. Explant and replacement surgery may be required. Patients who become pregnant or severely ill, or who require more extensive nutrition may require deflation of their bands. Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.

Adverse Events:  Placement of the LAP-BAND^® System is major surgery and, as with any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body. Band slippage, erosion and deflation, reflux, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required. Rapid weight loss may result in complications that may require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.

Important: For full safety information please visit www.lapband.com, talk with your doctor, or call Allergan Product Support at 1-800-624-4261.

CAUTION: Rx only.

© 2011 Allergan, Inc., Irvine CA 92612, U.S.A. ® and ™ Marks Owned by Allergan, Inc. All rights reserved.

References

1.               2009 CDC Behavioral Risk Factor Surveillance System (BRFSS) annual data.

2.               Data on file, Allergan, Inc. January 2011, Irvine, CA.                                                                                                                                                APC41PD11