Restriction

I'm reading a lot about the "window of opportunity", the period in which you have the most restriction and lose the most weight before your stomach starts to stretch back out. How long do you have? At several years out is it possible to have restriction still, or are pretty much eating whatever you want? Did anyone never have restriction?

It's my understanding that the "window of opportunity" isn't based on physical volume restriction (especially since a well-done sleeve doesn't really stretch all that much) but on the metabolic effects of surgery. Surgery suspends (because it removes the fundus of the stomach, which is basically an endocrine organ) the normal metabolic and endocrine resistance to significantly reduced caloric intake, so your metabolism doesn't fight weight loss in the way it normally would. One your metabolic regulation has reestablished itself, the body will defend a new setpoint in the same ways it defended the old one. That doesn't mean that weight loss is impossible--you've still got the tool and the restriction it provides.

This has never been explained to me like this before. Good to know! Now I shall research this! Thank you!

Lack of restriction (barring some large medical screw up) is impossible. They remove 80% of your stomach. Your stomach is literally restricted to 20% of its previous size. It doesn't stretch out. People just start to eat the wrong things as time goes on (slider foods, lots of carbs, drinking with meals, etc).

The boost in the beginning with VSG is really due to the healing of your stomach and the fact that it takes awhile for you to get back to eating human size portions again. You will always have your restriction, it really just depends on how you use it. Eating "whatever you want" will be a good way to end up MO again.

Makes a lot of sense. Thank you!

The window of opportunity, or "honeymoon period" is about the fact that it will never be as easy to lose weight than it is in the first year after surgery. This is because motivation is highest right after surgery, hunger hormones are lowest, and restriction is the most intense it will ever be because of inflammation after surgery. Once the stomach is completely healed, it can hold more food. This is one reason why it is important to not rely on restriction for weight loss or maintenance. People *****ly on restriction tend to not lose as much as they would like and regain weight eventually.

Honey moon phase!! That's what I've heard it called before. Yes, definitely don't want to rely on restriction. I've also read there are many ways to eat around your surgery. I've already been doing a lot of self talk in that regard. Thanks for your response!

Erin is correct that it is an impossibility not to have some restriction after having ~80% of your stomach removed.

The honeymoon period is more relevant to RNYers because they've got malabsorption that only lasts about a year. For VSGers, it's more a function of the mental aspects of weight loss. Eventually your willpower might wane, you'll stop getting all the positive feedback from the people in your life. As you have a lower body weight, you need to eat fewer calories to see the same sort of weight loss you saw initially, so weight loss "slows down."

The fact of the matter is that if you stick to it and stay vigilant, you WILL reach your goal. The problem is that it's really hard to maintain constant vigilance. The surgery is awesome for fixing your stomach, but every other aspect of weight loss requires your brain to be involved. Something in your brain caused you to get to the point where you needed WLS, if you don't fix that, then you won't have sustained/lifetime success with weight loss.

I'm 3.5 years post-op, I definitely still have restriction. The problem when people say "I can eat whatever I want" is that 99% of the time "whatever I want" is slider crap that won't trigger restriction anyway. If those people stuck to dense proteins, chances are they would NOT be able to eat whatever they wanted.

Could I eat a pint of ice cream every day? Sure. I could have done that 3.5 years ago too. But, for me, I want to lose weight more than I want to eat whatever I want.

There has definitely been a lot of reinforcement from my surgical team regarding the fact this is not a magical tool. I have to have willpower too. You always give very sound and insightful advice. I truly appreciate the time everyone takes to reply to us newbies. I've learned more about my surgery from this board than my surgical team, and they are renouned for their thoroughness.

At 7 years out I still have restriction. But I can eat more than I could at one year. So somehow the sleeve settles in to the new reality. And according to my surgeon it is possible to stretch out sleeve. I had a complete lack of hunger for a couple of years and then some of it gradually returned. Thats why its important to change eating habits during the first year so you can rely on those new habits later. Habits like skipping bread or desert most of the time or chasing protein first and foremost and getting your carbs from veggies and fruits. I used to live for sugar but now I really don't though I am sure I could fall back into that. I just have a new mindset.

So its all about forming new habits. Don't wait and see if your sleeve stretches, Vow to not stretch it and decide for yourself that you are going to keep healthy habits long term. Diane S