Tighter Isn't Always Better
MORE, MORE, MORE
Americans love MORE: more of anything and everything. More food, more fun, and (for some of us) more fill in our bands. But striving for maximum fill in the effort to achieve maximum weight loss can be a terrible mistake.
Fat folks become obese enough to qualify for bariatric surgery because we’ve been eating more, more, more, so it’s not surprising that bandsters long for more, more, more fill. The tighter the band, the better, right?
Wrong. Here’s why: tighter doesn’t automatically yield more weight loss. It can cause eating problems, side effects and complications that none of us want. It can compromise our quality of life. It can make us miserable when all we hope for from bariatric surgery is a better life.
You’re not impressed by all that? You’re willing to risk everything in the pursuit of skinny? Then try this on for size. A tight band doesn’t guarantee weight loss. Just the opposite: it can stall your weight loss or even make you gain weight.
Do I have your full attention now? Good. Listen up and I’ll explain why tighter isn’t always better.
THE RESTRICTION FALLACY
Traditionally, the adjustable gastric band has been considered a “restrictive” weight loss surgery. Bandsters were taught to look for signs of restriction: the proofs that their bands were working. Instead of paying attention to her own eating behavior and lifestyle, the bandster waited impatiently for the flashing signs, ringing bells and slamming doors that would stop her from overeating. The idea was that the small upper stomach pouch would “restrict” food intake and result in weight loss. Sound familiar?
That was well-intentioned thinking, but it was wrong. In the past 5 or so years, band manufacturers and bariatric surgeons have come to believe that it’s a mistake to eat and eat until you set off your band’s emergency warning system, for the reasons mentioned above. Unfortunately, the re-education process is slow going, and in the meantime, the restriction fallacy lives on. Even now, approximately every third word out of a bandster’s mouth is “restriction”. It’s a catch-all term for the feelings that limit how much a bandster eats. Post-op band life tends to become a quest for enough fills to reach the Holy Land of Restriction. Next stop: Skinnyland.
Or not.
HAZARD AHEAD! THE DANGERS OF SOFT CALORIE SYNDROME
Soft Calorie Syndrome is one of the least publicized dangers of a band that’s too tight. Psychologists would call it a maladaptive behavior, that is: a nonproductive behavior that prevents you from adapting to situations, or changes in yourself or your environment, in a healthy way. It can begin as an attempt to deal with or avoid an unpleasant experience but it does not solve the original problem and eventually becomes dysfunctional. You can read more about maladaptive eating behaviors by clicking here: http://www.bariatricpal.com/page/articles.html/_/healthy-living/is-your-eating-maladaptive-r50
A bandster experiencing Soft Calorie Syndrome is responding to the unpleasant experience of eating with a band that’s too tight by eating the soft and liquid calories that slide most easily past their gatekeeper band. Instead of eating the healthy and solid foods (like dense animal protein, veggies, fruits) that provide the most satiety (both early and prolonged), that person favors easy-to-eat food that’s often junky and high in calories (for example: potato chips, ice cream, milkshakes). Even healthy foods( like yogurt, cottage cheese and, fat-free/sugar-free pudding) can fall into the soft calorie category, and they don’t provide any better satiety than the junky stuff. The net result is that you end up consuming more calories than you need because the soft stuff doesn’t provide enough early and prolonged satiety. And the result of that is a weight loss plateau, or even weight gain.
I discovered the perils of Soft Calorie Syndrome for myself when I traveled to New York City to attend a trade show when I was about 8 months post-op. I had gotten a fill the day before I left, and by the time I got to New York I had realized that my band was too tight for me to tolerate. I couldn’t eat any solid food, so I spent the next 3 days eating soft, high-calorie, low-satiety foods like creamy soups, milkshakes, and ice cream. I was just trying to survive long enough to go home and get an unfill. My maladaptive eating behavior achieved a temporary goal (comfortable survival) while sabotaging my long term goal of losing weight. In fact, I gained weight during that trip and ended up feeling disappointed in myself. I promised myself no more fills on Fridays and no more fills the day before a business trip. I called my surgeon’s every time I suspected my band was too tight and found that even tiny unfills could make all the difference in my quality of life as well as my weight loss.
I know I’m not the only person who’s discovered the perils of Soft Calorie Syndrome. I also know that you’re not alone in believing that more fill is better and that unfills will slow or stall your weight loss. A few months ago I talked about this with a smart and successful bandster named Denise. When her surgeon reacted to her too-tight band by suggesting an unfill of .5 cc, her dazed and frightened face made him reassure her that she could start being re-filled in a month. The month ahead scared her, but she agreed to the unfill, and discovered that rather than returning her to Bandster Hell, it had restored sanity to her eating life. She said, “I was able to eat again. Solids went down easily. Bread was on my menu. Meals lasted me several hours. I didn’t snack because I was able to eat enough to keep me satisfied.”
When Denise went back to her surgeon a month later, he was delighted her hear her say that she didn’t even need a re-fill. She told him, “I can eat anything, but I’m not eating everything.”
And that, my friends, is what healthy eating is all about.
What a wonderful article. Something I can certainly relate to because I was in "Soft Calorie Syndrome" land for perhaps more than a year. After they removed some liquid, it took a long time to get out of that mentality, and I still have to force myself to eat real food. When I do eat, I can easily stay full for up to 6 hrs. or longer.
"She said, “I was able to eat again. Solids went down easily. bread was on my menu. Meals lasted me several hours. I didn’t snack because I was able to eat enough to keep me satisfied.” is what I'm experiencing again but it has been difficult because my mind still wavers towards the Soft calorie syndrome mentality.
Since I've been making myself eat real food, I've been taking in about 500 calories less per day because I can eat anything I want without pain. However, mentally, I still battle with it every meal 
. When everything gets stuck & eating becomes painful day after day for over a year, I suppose one's mind won't easily forget that. For example, when I'm at a restaurant, I still have the urge to find something soft that will slide down easier for fear of being stuck at a public place but that defeats the band's purpose. I'm hoping that it will pass soon but in the mean time, I continue taking each meal one at a time. Thanks again for a great article!
What a wonderful article. Something I can certainly relate to because I was in "Soft Calorie Syndrome" land for perhaps more than a year. After they removed some liquid, it took a long time to get out of that mentality, and I still have to force myself to eat real food. When I do eat, I can easily stay full for up to 6 hrs. or longer.
"She said, “I was able to eat again. Solids went down easily. bread was on my menu. Meals lasted me several hours. I didn’t snack because I was able to eat enough to keep me satisfied.” is what I'm experiencing again but it has been difficult because my mind still wavers towards the Soft calorie syndrome mentality.
Since I've been making myself eat real food, I've been taking in about 500 calories less per day because I can eat anything I want without pain. However, mentally, I still battle with it every meal
It does take a while for our minds to catch up with our bodies, doesn't it? I think you're doing all you need to do to adjust - take it one meal at a time. And promise yourself that the next time you find your band so tight that soft calories are your only option, call your surgeon ASAP!
I eat mostly all solids but when I go out to eat with family I usually have Soup or something soft. My reasoning is they all eat so fast if I try to keep up I get sick. Also I don't always have a say where we go so I tell them to make sure restaurants have soup options in case they don't have anything else for me. I don't see anything wrong with this and it is not often. I see more and more people advocating solids and it makes me really happy.
I eat mostly all solids but when I go out to eat with family I usually have Soup or something soft. My reasoning is they all eat so fast if I try to keep up I get sick. Also I don't always have a say where we go so I tell them to make sure restaurants have soup options in case they don't have anything else for me. I don't see anything wrong with this and it is not often. I see more and more people advocating solids and it makes me really happy.
No, nothing wrong with ordering soup when you're in a situation like you've described. I learned to order soup whenever I took my elderly mother out to eat. Much as I loved her, she was so needy and demanding that I couldn't possibly pay enough attention to my own meal to avoid eating problems. It's when soup becomes a daily routine that I begin to worry.
I agree totally. I don't want my band to be so tight I can't eat anything worth eating. I still love food and want to enjoy at least what I can eat.
Sometimes I scratch my head and wonder if I am doing this right....
Right in what sense?
You've lost 159 pounds!
Satiety throws me for a loop sometimes. For someone who has been a binge eater all their life it is a difficult concept at times. What I can say is I don’t crave food anymore and I can typically stop when I am satisfied but at times I wonder if I am eating too much or too little. I like to think I am eating just enough to be satisfied but then I have my days where I will actually skip a meal either because I am just not hungry or I get so involved with work that I just forget. Then I get into my own head whether or not I am sabotaging myself somehow. I also have had my moments where I think ‘crap, I should not have taken that last bite’.
Twice last week and again today I had Breakfast at 6:30 and then ended up working through lunch to then realize it is now 4:30 and too late for lunch as dinner time is right around the corner…
I guess I am just over-thinking it all…
Satiety throws me for a loop sometimes. For someone who has been a binge eater all their life it is a difficult concept at times. What I can say is I don’t crave food anymore and I can typically stop when I am satisfied but at times I wonder if I am eating too much or too little. I like to think I am eating just enough to be satisfied but then I have my days where I will actually skip a meal either because I am just not hungry or I get so involved with work that I just forget. Then I get into my own head whether or not I am sabotaging myself somehow. I also have had my moments where I think ‘crap, I should not have taken that last bite’.
Twice last week and again today I had Breakfast at 6:30 and then ended up working through lunch to then realize it is now 4:30 and too late for lunch as dinner time is right around the corner…
I guess I am just over-thinking it all…
Sounds to me like you're doing fine. I also tend to overthink and overanalyze, but I think it's good that you're aware of the adjustment process. and I think that people who expect to change their eating behavior overnight are facing a much tougher journey.
jim can i add something....i eat when i am hungry..
if i am not hungry (at lunch) i dont eat....if i am not hungry at dinner, i dont eat
i think of a baby....they eat when hungry and then turn their head when full.....
you have done well....but i can read myself in your words.
jim can i add something....i eat when i am hungry..if i am not hungry (at lunch) i dont eat....if i am not hungry at dinner' date=' i dont eat
i think of a baby....they eat when hungry and then turn their head when full.....
you have one well....but i can read myself in your words.[/quote']
I wish I could be like that but I find there are many times I am not really hungry but I can tell my body needs me to eat. I am pretty sure it as to do with my meds and how they metabolize. It is very easy to over think. Learning what my body needs is a whole new chapter for me.
jim can i add something....i eat when i am hungry..
if i am not hungry (at lunch) i dont eat....if i am not hungry at dinner, i dont eat
i think of a baby....they eat when hungry and then turn their head when full.....
you have done well....but i can read myself in your words.
I do that often times as well but then I worry about whether or not I am getting a good amount of calories in to keep weight loss going. At some point if you don't eat and start skipping meals it can also put you in a stall and eventually you start to lose muscle instead of fat..at least that's how I understand it.
I do that often times as well but then I worry about whether or not I am getting a good amount of calories in to keep weight loss going. At some point if you don't eat and start skipping meals it can also put you in a stall and eventually you start to lose muscle instead of fat..at least that's how I understand it.
that is 100% correct.
so when i do eat (i make sure i am getting the Protein, veggie stuff in me) and i do drink my shake (like you in the a.m.) i like knowing i have that jump on the Protein and I LOVE my shake so i dont mind
the way i see it, my bod has some extra (fat) on me and if it needs to borrow some from my a ss area or thighs, be my guest
Great article Jean as always! I appreciate your insite and posts.
2muchfun 8,927
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I've got the book and I'll take a look.
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