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CharV

3 day liquid diet

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My insurance's program requires a liquid diet for only 3 days before surgery and are not requiring patients to lose before the surgery (although its highly recommended). Since joining TT, Ive been seeing posts about people having two week liquid diets or more before surgery. Now I am tempted to start the diet sooner and be on it longer than 3 days prior to surgery to lose more and reduce liver size. What is a safe and health liquid diet?

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My insurance's program requires a liquid diet for only 3 days before surgery and are not requiring patients to lose before the surgery (although its highly recommended). Since joining TT, Ive been seeing posts about people having two week liquid diets or more before surgery. Now I am tempted to start the diet sooner and be on it longer than 3 days prior to surgery to lose more and reduce liver size. What is a safe and health liquid diet?

A three day liquid diet before weight loss surgery will do little or no good. Patients who have an "apple" shape with a very thick abdomen may benefit from preoperative weight loss, but preparation should begin many weeks or even months before surgery. The object is for the patient to lose about 2 pounds a week and gradually achieve less abdominal and liver fat mass. Crash diets may be detrimental because of fluid shifts, vitamin and mineral deficiencies, kidney damage, and potentially dangerous weakening of the patient's tissues. Most people with hip and thigh obesity do not benefit greatly from preop weight loss.

There is little solid data in the medical literature on the value of preoperative weight loss, and there is as yet no consensus on who should lose how much and which approach is best. This does not mean that there is no benefit. It just means that the few studies that have been published so far aren't consistent. Complications such as leaks, bleeding, and airway problems are very uncommon. So it is hard to accumulate enough patients in a study to show that weight loss decreases complications. On the other hand, as a surgeon, when one sees a patient with truncal obesity lose 10% of his weight over a few months, one sees that he breaths more easily, that he is more mobile, and that his abdomen is less dense. His liver is smaller. Surgical access is easier and therefore safer. It seems intuitively obvious to most of us surgeons, that surgery will be less risky and that recovery will be smoother when a patient with truncal obesity loses substantial weight. Proving it will be harder. Because of the cost of the studies and the number of patients who need to be enrolled is so large, it is doubtful that really good data will be forthcoming soon.

So discuss the issue with your surgeon and trust his or her intuition regarding the benefits you will achieve by losing weight before surgery. Your surgeon has seen hundreds of patients before, during, and after surgery, and thus will have a good feeling for the benefits that you as an individual may enjoy from preoperative weight loss.

See the recent ASMBS statement on preoperative weight loss attached below.

ASMBS Position Statement on Preoperative Supervised Weight Loss Requirements(1).pdf

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Wow...thanks Dr. Callery! Very informative!

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