Pre-Operative Liquid Diet

Pre-Op Diet for Weight Loss Surgery

Pre-op operative weight loss is desirable to decrease the risk of complications for our patients scheduled for weight loss surgery.  Weight loss before sugar reduces the risk of conversion from laparoscopic surgery to an open procedure.  Pre-operative weight loss also reduces the severity of co-morbidities, reduces operating room and recovery time.  To be specific:

• Reduces liver size and intra-abdominal fat
• Improves visual field
• Reduces co-morbidities
• Increases patient’s understanding of post-op requirements
• Reduces operating time
• Reduces post-operative risks

It is very important that you adhere to the pre-op diet that your surgeon is recommending for you.  Situations have occurred where patient’s surgery was cancelled due to non-compliance with the pre-op diet.  Please understand this can occur to you if you do not follow the guidelines.  If you find yourself struggling with the guidelines, please call the office for support and guidance.

Bariatric Advantage

Our program recommends Bariatric Advantage meal Replacements for our pre-op surgery patients.  Bariatric Advantage provides a complete line of nutritional supplements that have been specifically formulated to meet the unique demands of both the pre-operative bariatric surgical candidate, as well as the post-operative bariatric surgical patient.

The Bariatric Advantage High Protein Meal Replacement comes in an economic 24-serving tub with a measured scoop to make an accurate dispensing easy.  Each 140 calorie serving provides a full 27 grams of protein, with only 7 grams of carbohydrate (of which 5 grams are fiber, and only 1 gram is sugar) and 4 grams of fat.  Meal replacements come in a great variety of flavors – chocolate, vanilla, strawberry, banana and unflavored.

Pre-Operative Protocol

In order to lose weight pre-operatively, the meal replacements and control bars are recommended for every patient.

            1.  3-5 shakes per day   2.  64- 96 ounces of water    3.  700-900 calories per day

*** Please remember clear liquids only the day before surgery***

The first 48 hours on a liquid diet is the most challenging.  You will be very hungry until your body induces ketosis.  Ketosis occurs when the amount of carbohydrate fuel (fuel that is needed to run the body) drips below a critical level, forcing the body to turn first to protein and then to fat reserves to do the work carbohydrates normally do.

You will experience a sensation of improved well-being and absence of bothersome hunger in the second or third day of a fast.  This feeling is due to a chain of reactions set off by the release of ketones.  Ketones inhibit the release of insulin and the stress hormones.  As a result, the blood sugar becomes more stable and hunger is calmed.  Anxiety is reduced.  You must drink 64-96 ounces of water daily to remove the waste products in the blood stream.

Side effects of a liquid drink diet:

• Dizzy, dry mouth, “ketosis breath”, headache, fatigue and bowel changes

Directions, Recipes and Hints

Basic ingredients to add to any shake:
Ice cubes
Fruit(s)
Flaxseed oil
Splenda
Sugar-free flavorings, syrups
Base – skim milk, water or soymilk*****IF YOU USE AS A BASE, DO NOT ADD FRUIT TO YOUR RECIPE

Basic Blending Instructions:

• Pour cold skim milk or cold water into a blender.  Begin mixing on a low speed.
• Slowly add the Bariatric Advantage Meal Replacement, while blender is mixing for about 15 seconds.
• Add ice cubes, replace lid and blend until smooth.

Shaker Directions:     

• Pour cold skim milk or cold water into shaker.
• Slowly add the Bariatric Advantage Meal Replacement.
• Add small ice cubes if desired.
• Replace lid and shake until smooth.

Hints:

• To increase sweetness, add Splenda, Stevia or sugar-free syrups
• To decrease sweetness, increase milk or water
• Frozen fruits make the shakes creamier
• For thicker consistency add sugar-free yogurt
• You may freeze the shakes for an ice cream consistency.  Do not allow the shake to thaw.  It must be eaten frozen.
• If you are using frozen fruit, you may or may not need to add ice cubes.
• When adding Control Bars to the shake, be sure to cut into small pieces before adding to the blender.
• Remember, you can interchange skim milk (91 calories), water or light soymilk (80 calories) in any of the recipes - - BUT DO NOT ADD FRUIT IN ADDITION TO THIS - - TOO MANY CARBOHYDRATES WILL PREVENT KETOSIS –CHOOSE EITHER MILK OR FRUIT.

Recipes

Please use these recipes as suggestions.  The consistency of the shakes will depend on the fluid added.  You may want to increase or decrease fluids, depending on your likes and dislikes.  You may be creative and make recipes of your own.  Remember, the key is to adhere to the guidelines and again, please do not forget to call the office, should you need additional information and support.

Mocha Shake                                                Pineapple Blast
4 ice cubes                                                    4 ice cubes
1 tbsp. milk                                                    6 oz. water
6 oz. coffee                                                    2 scoops vanilla meal replacement powder
2 scoops chocolate meal replacement             1/3 cup pineapple chunks
Additional Calories:  11                                  Additional Calories:  60
Additional Carbohydrate:  1.5                         Additional Carbohydrate:  15 grams
Additional Fat:  0.1 grams                              Additional Fat:  0.1 grams
Total Calories:  161 Calories                           Total Calories:  210 Calories

Frozen Chocolate Banana                          Pina Colada
8 oz. water                                                   6 oz. water
4 to 5 ice cubes                                            4 ice cubes
½ medium banana                                        2 scoops vanilla meal replacement powder
2 scoops chocolate meal replacement           1/3 pineapple chunks
powder                                                        1 tsp. sugar free coconut extract
Additional Calories:  60                                Additional Calories:  60
Additional Carbohydrates:  15 grams             Additional Carbohydrates:  15 grams
Additional Fat:  0.2 grams                            Additional fat:  0.1 grams
Total Calories:  230 Calories                         Total Calories:  210 Calories

Chocolate Strawberry Shake                      Orange Creamsicle
2 scoops of chocolate meal replacement         2 scoops of vanilla meal replacement
powder                                                         6 ounces of water
6 ounces of water                                          4 to 6 ice cubes
4 to 6 ice cubes                                            1 small orange (size of tennis ball)
6 small strawberries
Additional Calories:  60                                 Additional Calories:  60
Additional Carbohydrate:  15 grams              Additional Carbohydrate:  15 grams
Additional Fat:  0                                         Additional Fat:  0
Total Calories:  210                                      Total Calories:  210

Raspberry Chocolate                                   Blueberry Blaster
2 scoops of chocolate meal replacement         2 scoops of vanilla meal replacement powder
6 ounces water                                             6 ounces water
6 ice cubes                                                  6 ice cubes
¾ cup fresh raspberries                                 ¾ cup blueberries
Additional Calories:  60                                  Additional Calories:  60
Additional Carbohydrate:  15 grams              Additional Carbohydrate:  15 grams
Additional Fat:  0.1 grams                             Additional Fat:  0.1 grams
Total Calories:  210 Calories                          Total Calories:  210 Calories