The Elusive Sweet Spot

RUN, SPOT, RUN!

The phrase "sweet spot" pushes me into my swirling stream of consciousness, where I hear: Sore spot, hot spot, weak spot, sweet spot. Spot the dog.

Run, Spot, run!

That's what the bandster sweet spot does. It runs ahead of us, wagging its tail, taunting us, "When you catch me, you're gonna lose weight like never before! But first you gotta catch me!" And off it goes again, dangling that precious weight loss carrot just out of reach while we follow, huffing and puffing and worrying that we may never catch our errant Sweet Spot. What if we don't? Will our weight loss surgery be a waste of time and money?

Sweet spot. Just two words. Short words, endearing words, simple words, but loaded words. For such a little phrase, the sweet spot is a very big deal. But is it real? Is it even possible? I can think of other little phrases that are also big deals, and after several decades as a voting citizen of the United States of America, I have to wonder if they're just a dream. World peace. Cancer cure. Justice for all. Sweet spot.

THE ELUSIVE SWEET SPOT

The concept of a sweet spot was unknown to me until I shortly after my Lap-Band® surgery. It's not a term exclusive to bandsters. In tennis, baseball, or cricket, a swing will result in a more powerful hit if the ball strikes the racquet or bat on its "sweet spot". In the world of music recording, the sweet spot is the focal point between two speakers, where a listener is fully capable of hearing the stereo audio mix the way it was intended to be heard by the mixer.

In general terms (that might make more sense to those of us who are athletically or musically challenged), a sweet spot is a place where a combination of factors results in a maximum response for a given amount of effort. That's exactly what we're hoping for when we have weight loss surgery, isn't it? After years of useless struggle and unsuccessful dieting, we want to expend the least possible effort for maximum weight loss results.

Unfortunately, there's a trick phrase hidden in the paragraph above: a given amount of effort. It's not “no effort”. A given amount of effort…but an undefined amount. How much effort? How long, how often? Does making the sweet spot work for us take an hour a month, a week, a day?

In Bandwagon, I wrote that the sweet spot is a myth that does bandsters a great disservice because it's a mistake to think of restriction as a single point (or sweet spot) on a line. Let's pretend that you've found your sweet spot. It looks like the diagram above. Can you balance on it indefinitely, like the green triangle poised on one precarious corner? I couldn't. All it would take to knock me off that little spot is a strong breeze, and if I had to devote all my attention to keeping my balance, I wouldn’t be able to make good use of the imperfect but quite useful areas to the left and right of my sweet spot.

It’s more useful (and balanced) to think of restriction as a range, not a single point, with the sub-optimal yellow zone (not enough restriction) to the left and the sub-optimal red zone (too much restriction) to the right. According to Allergan, the band's optimal performance is in the middle “green zone,” where to greater or lesser degrees you experience early and prolonged satiety and reduced appetite and hunger.

Now let’s try thinking of restriction as a river or stream that flows along, sometimes slowly, sometimes fast, and sometimes it's quite still. If you try to catch that river water in your hands, crying, "This is it! My sweet spot!" the water will run through your fingers. If you step into the stream, your restriction is with you all the time, sometimes optimal, sometimes sub-optimal, but always there.

DOWNSTREAM WITH JEAN

Does my stream analogy sound too much like something Yoda would tell Luke Skywalker? I'll climb out of the stream now, shake off the water, and tell you about my own "sweet spot" experience.

The #1 thing I want you to know is that you can lose weight without ever catching hold of your sweet spot. I lost 100% of my excess weight (90 pounds) in my first year post-op, with far less restriction than I had later on. Except at the very beginning, when everything about banded life was a mystery to me (including the Green Zone poster at my surgeon's office), I didn't have a lot of anxiety about whether or not I'd found my sweet spot because I was losing weight without even knowing what my sweet spot looked like. I didn't have to starve myself or take diet pills or any of my rarely effective pre-op weight loss techniques. My band was most definitely helping me even though sometimes I felt as if I didn't have a band at all. As time went on, I sometimes took my band for granted, and only when I had to have unfills to treat symptoms of careless eating or overeating did I realize how much my band had in fact been doing for me. After each unfill, my appetite and my physical hunger immediately increased, which both scared and pleased me. As in many things, it was a matter of perspective. One day I whined about getting hungry 3 hours after eating and being able to eat 1 cup of food. The next day (after the unfill) I whined because I got hungry 1 hour after eating and was able to eat 2 cups of food. There's a popular saying that claims you never appreciate what you have until it's gone, and that's certainly true for me.

Hearing my story, you might want to argue that before those unfills, I had reached my sweet spot and just didn't know it. That's entirely possible. After all, how would I know what the weight loss sweet spot looked or felt like? I'd never been there, never held it in my hot little hands - I probably wouldn't recognize it any more than I'd recognize the mayor of Kansas City or the invisible line where the Eastern time zone ends and the Central time zone begins.

Of course, one of the reasons we choose WLS is to make losing weight easier. When people criticize WLS patients for "taking the easy way out", I want to laugh and then scream. Of course I chose the easier way, that's the whole danged point! But at the same time, it's not as easy as you might imagine. It's not magic! Losing weight "the hard way" hadn't worked for me, so it wasn't unreasonable of me to want my band to work perfectly right from the start. If it didn't work that way, I really can't complain (much). After all, I didn't learn how to ride a bike, multiply 9 x 7, or play the piano on my first try either. And if I'm completely honest, I'm not sure I would have been able to handle it if I arrived at my so-called sweet spot the day after my surgery or even after my first fill. One of the reasons most surgeons administer fills in small amounts over a period of weeks or months is so the patient can gradually become accustomed to the change in their body and eating, and thereby avoid unpleasant side effects and complications. If I had walked out of the hospital on September 20, 2007 with as much restriction as I had 3 years later, and with virtually no practice of band eating skills, I would've been calling my surgeon the next day, crying, "Take this thing out of me!"

Since I'm an extremely stubborn person, I needed plenty of time to adjust to everything going on in my life after surgery. In the year it took me to reach my weight goal, I learned perhaps 50% of what I needed to know to manage my weight for the rest of my life. I hadn't once heard the Sweet Spot bells chiming, but I was mighty happy with myself and my band. I had changed a lot, in my mind, heart and body. Just standing in that river of restriction, going with the flow, was such an enormous improvement over my pre-op life, all I could feel was gratitude.