Liquid Diet -- Pre op weight loss

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I was wondering if you can do the preop liquid diet longer than the surgeon has said to do it. My surgeon wants me on the liquid diet for 10 days. Can I do it longer to lose some more weight? I dont want to over do it but would also love to see if I can get some more weight off before my surgery.

Edited by Karen Merdinger

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Many bariatric programs recommend weight loss prior to surgery in hopes of reducing surgical complications and speeding recovery. Weight loss prior to surgery is beneficial because liver size is reduced. If the liver is smaller there is more room to do the surgery laparoscopically and there is more room for your diaphragm to move. So you can breathe more easily. And one more thing, your blood sugars will be easier to control. (See the summaries from two medical journal articles at the bottom of this post.)

There are a number of different pre-op liquid diets. Some liquid diets involve protein supplementation while others consist strictly of clear liquids. The length of the liquid diet depends on the type of diet involved as well as the specific goal of the diet. For example, some patients are placed on a very low calorie diet (i.e. 800 calories per day) using a program such as HMR or Optifast (protein meal replacement products) for a couple of weeks up to several months prior to surgery depending upon the amount of weight loss required.

Please always follow the advice of your surgeon as he has recommended a specific diet plan for you based on his knowledge of the diet and your health. Please speak with your surgeon if you are interested in pursuing the pre-op liquid diet longer than recommended.

Preoperative weight loss before bariatric surgery.

Benotti PN, Still CD, Wood GC, Akmal Y, King H, El Arousy H, Dancea H, Gerhard GS, Petrick A, Strodel W.

HYPOTHESIS: Preoperative weight loss reduces the frequency of surgical complications in patients undergoing bariatric surgery. DESIGN: Review of records of patients undergoing open or laparoscopic gastric bypass. SETTING: A comprehensive, multidisciplinary obesity treatment center at a tertiary referral center that serves central Pennsylvania. PATIENTS: A total of 881 patients undergoing open or laparoscopic gastric bypass from May 31, 2002, through February 24, 2006. INTERVENTION: All preoperative patients completed a 6-month multidisciplinary program that encouraged a 10% preoperative weight loss. MAIN OUTCOME MEASURES: Loss of excess body weight (EBW) and total and major complication rates. RESULTS: Of the 881 patients, 592 (67.2%) lost 5% or more EBW and 423 (48.0%) lost more than 10% EBW. Patients referred for open gastric bypass (n = 466) were generally older (P < .001), had a higher body mass index (P < .001), and were more often men (P < .001) than those undergoing laparoscopic gastric bypass (n = 415). Total and major complication rates were higher in patients undergoing open gastric bypass (P < .001 and P = .03, respectively). Univariate analysis revealed that increasing preoperative weight loss is associated with reduced complication frequencies for the entire group for total complications (P =.004) and most likely for major complications (P = .06). Controlling for age, sex, baseline body mass index, and type of surgery in a multiple logistic regression model, increased preoperative weight loss was a predictor of reduced complications for any (P =.004) and major (P = .03) complications. CONCLUSION: Preoperative weight loss is associated with fewer complications after gastric bypass surgery.

Arch Surg. 2009 Dec;144(12):1150-5.

Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery.

Still CD, Benotti P, Wood GC, Gerhard GS, Petrick A, Reed M, Strodel W.

HYPOTHESIS: Modest, preoperative weight loss will improve perioperative outcomes among high-risk, morbidly obese patients undergoing Roux-en-Y gastric bypass. DESIGN: A prospective, longitudinal assessment of characteristics and outcomes of gastric bypass patients. SETTING: All patients undergoing open or laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity or its comorbid medical problems at Geisinger Medical Center in Danville, Pennsylvania, during a 3-year period from May 31, 2002, to February 24, 2006, were included in this analysis. Patients were required to participate in a standardized multidisciplinary preoperative program that encompasses medical, psychological, nutritional, and surgical interventions and education. In addition, patients were encouraged to achieve a 10% loss of excess body weight prior to surgical intervention. RESULTS: Of the 884 subjects, 425 (48%) lost more than 10% of their excess body weight prior to the operation. After surgery (mean follow-up, 12 months), this group was more likely to achieve 70% loss of excess body weight (P < .001). Those who lost more than 5% of excess body weight prior to surgery were statistically less likely to have a length of stay of greater than 4 days (P = .03). CONCLUSIONS: This study shows that high-risk morbidly obese candidates for bariatric surgery who are able to achieve a loss of 5% to 10% excess body weight prior to surgery have a higher probability of a shorter length of hospital stay and more rapid postoperative weight loss.

Arch Surg. 2007 Oct;142(10):994-8; discussion 999.

Edited by Karen Merdinger

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