Restriction Riddles
RESTRICTION RIDDLES
Restriction is the holy grail of bandsters, but even when you find it, it may not cooperate with you all day every day. Its fickle nature may allow you to eat one food on Tuesday but not on Wednesday. It may not show up until 2 weeks after a fill, or it may disappear 2 weeks after a fill. You end up puzzling over riddles like delayed restriction, disappearing restriction, and/or variable restriction.
DELAYED RESTRICTION
Although the fluid injected into the port during a fill travels immediately to the band, it can take several weeks for you to notice an increase in restriction. This may be because you spend a few days after a fill progressing from liquids to purees to soft to solid food, and then you're extra careful when eating: on the alert for more restriction. When we relax this vigilance, careless eating will eventually remind us (again) that we have a band with more fill in it.
Delayed restriction is frustrating, I admit. You get a fill and want instant results. But all you can do is pay close attention to your body's signals as it adjusts to the tighter fit of the band.
It is pointless to try to judge your restriction in the two to three days immediately after a fill, when you're on a liquid or pureed diet, because optimal restriction is experienced when you're eating solid foods.
DISAPPEARING RESTRICTION
At times during my weight loss surgery journey, I have asked myself, "Where the heck did my restriction go? Did thieves sneak in during the night and steal it?" In addition to thieves and elves, the following things can make your restriction seem to disappear overnight:
1. A few days to a week after a fill, the swelling and irritation caused by the fill calms down and the fit of your band feels looser.
2. In the first few weeks after a fill, you re-learn your band eating skills and unconsciously adjust to the new fill level so that you experience fewer negative symptoms.
3. As you lose weight after a fill, the visceral fat around your stomach shrinks, so the fit of your band doesn't feel as tight.
4. The position of your band against your stomach subtly changes due to normal body processes (see below).
5. Your band loses fluid due to evaporation, leakage, or inadvertent removal during a fill.
Please note that in #1 and #3 above, I said that the fit of the band feels looser or tighter. The band itself does not loosen or tighten by itself. Only a fill, unfill, or manufacturing defect can do that. The band is not like a rubber band that stretches out over time and eventually snaps.
WHY IS RESTRICTION SO VARIABLE?
Sooner or later, every bandster discovers that the band is a fickle mistress. In the course of a week, it can feel too loose, too tight, or just right (kind of like Goldilocks and the Three Bears). The food that worked fine on Monday may get stuck on Tuesday. On Wednesday you can hardly eat at all, and on Thursday you could eat an entire wedding banquet all by yourself. Friday you're back to Square One.
These variations are maddening but fairly normal. The stomach is living tissue that expands and contracts to aid digestion. It's affected by weight loss, the time of day (morning tightness is common), the time of month or fluid retention, medications, illness, dehydration and stress. The pressure of the band against the stomach can cause the stomach wall to thin out, so the band feels looser. And although the band and the stomach are sutured together, the position of the band can shift enough to affect your experience of restriction.
Remember: the #1 factor affecting the amount of food you can eat is what type of food you eat. You will feel more restriction when you eat solid food (like animal protein), less when you eat soft food (even healthy stuff like yogurt and cottage cheese), and virtually none when you drink liquids (even healthy ones like protein drinks).
