Six-month Study to Compare the Effects of Volume- and Pressure-Guided Adjustments on Weight Loss and Satiety

Inclusion Criteria: * Able to comprehend, follow and give informed consent. * Be at least 18 years of age at time of trial enrollment. * Had a pre-implantation BMI between 35 and 55 kg/m2. * Have received a SAGB VC implant 1) 30-60 days (and not undergone first band adjustment yet)prior to the date of enrollment. * Willingness to be randomized to intraband-based or conventional adjustments * Willingness to consent to monthly visits and possible measurements of intraband pressure (requiring access to the injection port). * Willingness to undergo up to 7 band adjustments within the 6-month period of the study. * Able to sit approximately at a 90 degree-angle, from the floor, for IBP measurements. * Willingness to return to office visits around the same time of the first in-study adjustment (plus or minus 2 hours) * Willingness to consent to a limited UGI series if the investigator suspects the presence of a band-related complication or if the intraband pressure recordings deviate from expected. * Willingness to refrain from taking medications or supplements indicated for or known to induce weight loss. Exclusion Criteria: * Females currently known to be pregnant. * Ongoing or unresolved band perforation or band leakage. * Ongoing (unresolved) slippage, erosion, or pouch dilation. * Documented esophageal dysmotility/dyskinesia. * Ongoing (unresolved) port obstruction or tube kinking. * Current injection port infection. * History of band revision or replacement. * Previously documented or ongoing esophageal dilatation. * Any condition that, in the opinion of the Investigator, may jeopardize the subject's well-being or the soundness of this study. * Current use of medications or supplements indicated for or known to induce weight loss at any point during the study.