Bariatric surgery continues to be a tool to help those who are struggling with obesity. Living with excessive weight can take a toll on the body, including damages to vital organs like the liver. Regardless of the surgery choice, it is important to understand the importance of being in “optimal” shape prior to the procedure. The time between the first consultation with the surgeon and surgery day should be used to help prepare the body and mind with the vast changes that will occur post-surgery. This includes the concept of a “liver shrinking diet” before surgery.
Prior to surgery, patients will need to follow a pre-operative diet, also known as a liver shrinking diet, generally between seven to fourteen days. Bariatric patients will often have an enlarged liver due their excessive weight and poor diet such as foods high in fat and sugar contents.
By carefully monitoring the patient on a very low calorie diet (VLCD), this will help shrink the liver, as some studies have shown, to minimize risks related to the surgery. Following a restrictive diet with low carbohydrate and fat intake, will help achieve weight loss by forcing the body to use up its stored fat. Our liver and stomach are very close to each other. Since the nature of weight loss surgery is altering the stomach and possibly the intestines, a smaller liver will help the surgeon have easier access to the stomach and minimize any complications.
As mentioned earlier, this liver shrinking diet will slightly vary depending on the patient’s situation as far as duration and foods allowed on the diet. Every practice will have a different approach. Some will only allow liquids, primarily meal replacement protein shakes and calorie-free liquids, while others will include protein shakes, appropriate solid foods, and calorie-free liquids.
Despite the differences, the ultimate goal is to lose weight so try not to compare with other patients as each plan is individualized.
Whether it is a seven day or two-week pre-operative liver shrinking diet, the first few days will be the most challenging phase. You will be hungry and probably irritable so be prepared. To make this temporary journey less difficult, follow these guidelines to better prepare for this diet:
- Once you receive instructions, study it thoroughly and make sure you stock up on all appropriate foods and beverages right away
- Do NOT procrastinate and prepare ahead of time
- Try different protein shakes – not all chocolate shakes are made the same (see below for more information)
- Be familiar with the foods on the list and sample if there are items you have not tried
- Although some may not be your preference of foods, you do not want to restrict yourself even more than necessary once you start
- Try to eat/drink ALL items allowed
Protein supplements will be an integral source of energy during the pre-operative diet. When choosing a protein shake, there are few things to look for before purchasing. It is recommended to sample at least a few products to see what you like and dislike. Shop around to see where you will get the best price since you will need a large quantity. Studying and comparing the nutrition facts will be useful. The following is a guideline when choosing a protein supplement:
- Calories: less than 200 calories
- Protein: at least 20 – 25 grams
- Total Carbohydrate: no more than 15 grams
- Sugar: less than 5 grams
- Total Fat (including saturated fat): less than 10% Daily Value (DV)
- Products will have lactose free label for those who are lactose intolerant
- If choosing a powder form, you can mix with water, skim or 1% milk, unsweetened soy or almond milk
- Do not add fruit or other food (such as avocado) to shake
Patients will be given a pre-operative diet prior to surgery. As mentioned before, each practice will have specific guidelines. However, the overall message is the same. You will be reducing the overall consumption of starchy carbohydrate and fatty foods. Instead, the emphasis will be on lean protein and non-starchy carbohydrate choices including appropriate protein supplements.
Patients will need to avoid caloric beverages such as alcohol, juice, soda, and sweet tea as this will also promote weight loss. Below are lists with recommendations for each major food groups as it will help you make better choices.
Protein can be found in various forms including animal-based and plant-based foods. As you prepare for bariatric surgery, it is recommended to find ways to minimize overall fat intake. Thus, choosing leaner choices is preferable. This list below offers some options.
|What is considered one serving of protein?|
|5 to 6 oz of skim of low-fat yogurt (preferably the “light” version due to its lower sugar content and “Greek” version due to its higher protein content) |
1 oz low-fat cheese
1 cup skim or low fat cottage cheese
3 oz tuna packed in water
3 oz of baked, broiled, or grilled lean protein ((skinless chicken breast, beef, pork, fish, tofu, shrimp) – do NOT fry
1 egg (limit to one daily)
1/2 cup cooked beans
Carbohydrate covers a spectrum of a variety of foods. However, the type of carbohydrate that is most concerning is the refined type, commonly referred as the “starchy” carbohydrate, such as pasta, bread, rice, and wraps, as they often dominate the daily diet. To successfully lose the necessary weight and shrink the liver, these types of foods need to be consumed very minimally. If possible, choosing a whole grain, high fiber version is better as it provides more beneficial nutrients.
|What is considered one serving of starchy carbohydrate?|
|1 slice of bread OR 2 slices of light bread |
1/2 cup of cooked cereal, pasta, or rice
1 cup ready to eat cereal
Fruits and Vegetables
Fruits and vegetables are natural sources of vitamins and minerals. However, this does not mean we can eat endless amounts of them. Some will have more carbohydrate contents than others, especially fruits and starchy vegetables (ie. potato, corn, carrots). During the liver shrinking diet, it is important to limit fruit intake to 1 serving daily while eating 2 servings of non-starchy vegetables due to its low-calorie content. When preparing vegetables, avoid cooking with fat. Instead, consider steaming, roasting and using lemon juice to add flavor.
|What is considered one serving of fruit?|
|1 “fist-sized” fruit (apple, peaches, nectarine, orange) |
1/2 large banana or 1 small banana (6 inches)
1 cup whole grapes
1 cup of whole berries (strawberries, blueberries, blackberries, or raspberries)
1 cup cubed watermelon
1/2 cup dried fruit
1/4 cup 100% fruit juice*
|What is considered one serving of vegetables?|
|1 cup of raw OR 1/2 cup of cooked leafy green vegetables |
1/2 zucchini or squash
1/2 cup broccoli or cauliflower
1/2 bell pepper
1/2 cup sliced cucumbers
1 cup chopped celery
1/2 cup cherry tomato
As a general rule, everyone should be adequately hydrated. However, it is important to know what we are consuming through our fluid intake. Many will be surprised to see how much sugar is consumed just from our beverages. The list below includes suggestions and recommendations with fluid intake.
- Drink 64 fluid ounces of water daily
- Start to limit and eliminate all carbonated and caffeinated beverages as you will need to do so post-surgery
- Avoid all caloric beverages such as juice, soda, alcohol, and sweet iced tea
The pre-operative diet will range between 1000 to 1200 calories - significantly less than what most patients consume daily. It is going to be challenging due to the restrictive nature. With help from staff and personal persistence, it is possible. This portion of the journey is usually a good indication of how successful the overall weight loss journey will be after the surgery. Below are two samples of 1000 calorie dies. Do not hesitate to ask your medical team for help if you have concerns.
|Sample A||Sample B|
|Breakfast ||Protein shake||1 egg |
1 slice of light whole grain bread
|Snack||6 oz Greek yogurt||Protein shake|
|Lunch||Protein shake |
Handful of cut up raw non-starchy vegetables (cucumber, bell peppers)
|3 oz lean protein |
2 handful of green salad
2 tablespoons of light dressing
|Snack||1 serving of fruit||1 light string cheese or 1 oz low fat cheese|
|Dinner||3 oz lean protein |
Handful of raw non-starchy vegetable or 1/2 cup of cooked non-starchy vegetable
1/2 cup cooked quinoa or brown rice
|3 oz lean protein |
1 light whole grain wrap
1 serving of fruit
|Snack||Protein shake||Protein shake|
The purpose of this structured low calorie and low carbohydrate diet is to reduce the size of your liver. This will allow your surgeon better access to your stomach and potentially decrease risk of complications and need to convert from a laparoscopic procedure to an open procedure.How long does it take for your liver to shrink before bariatric surgery? ›
Weight loss surgery diet
Sweeney, M.D., bariatric and laparoscopic surgeon with Norton Surgical Specialists who treats patients of Norton Weight Management Services. “We have you do a liver-shrinking diet for a minimum of two weeks before the procedure.”
How do you make your liver shrink for bariatric surgery? The good news is that intentional shrinkage of the liver can be controlled by consistently following a low-carbohydrate, low-calorie diet. Most bariatric surgery centers will advise new patients to follow an 800 calorie, Very Low Calorie Diet (VLCD).How can I shrink my liver for bariatric surgery? ›
As such, most bariatric surgery patients must reduce the size of their livers before they can safely have surgery. The liver shrinking diet is a low-calorie, low-fat, low-carb restrictive diet that reduces glycogen, water, and fatty deposits in the liver to make it smaller.How do I survive a liquid diet before bariatric surgery? ›
The Bariatric Pre-Op Liquid Diet Meal Plan
The pre-op liquid diet will consist of approved protein shakes, sugar-free beverages, sugar-free gelatin, sugar-free popsicles, and broth. We always recommend that our patients consume five protein shakes a day and consume at least 64 ounces of sugar-free liquids.
All patients are required to start a Liquid Diet 2 weeks before their surgery date. Following this diet will not only jump start weight loss but will also help reduce the size of your liver making the procedure easier to perform and thus more successful.How much weight can you lose on a liver reduction diet? ›
Using this diet, you should be able to lose 5 – 10 pounds during the two weeks leading up to your operation. 1. Drink at least 64 ounces (2 quarts) of fluid per day.What should I eat 2 weeks before gastric sleeve? ›
- Increase your protein consumption. Eat lean meats.
- Lower your carbohydrate consumption. Avoid breads, pasta, cereals, rice, etc.
- Eliminate Sugars. Eliminate candy, desserts, juices, sodas.
Beverages – water, fruit-infused water, i.e. water with a slice of citrus fruit. Also, drinks like Crystal Light, Mio, Fruit2O, Propel Zero are also approved. Usually, you are not allowed to have caffeine or anything carbonated while on a liver reduction diet.Can I get gastric bypass if I have fatty liver? ›
“The striking findings of this study provide strong evidence that bariatric surgery should be considered as an effective therapeutic option for patients with advanced fatty liver and obesity.”
By following a liver shrinkage diet, your body will be forced to use up the stored carbohydrate (glycogen) from the liver. The glycogen and a quantity of water will leave the liver, and therefore liver will shrink and become softer, more flexible and easier to move during surgery.How many carbs a day will shrink your liver? ›
Liver Shrinking Diet Particulars
The recommended carbohydrate intake is between 40 to 50 grams a day.
6 to 12 Months Before Surgery
Ask your primary-care provider for a referral to an accredited bariatric-surgery program. Enroll in the bariatric-surgery program, attending all required classes and meetings. Start exercising three to five times a week for 25 to 30 minutes, with your doctor's clearance.
NO diet sodas (no carbonation allowed). Start eating “dry” meals. Stop drinking fluids 30 minutes before eating and do not drink anything for 30 minutes after you eat.Do you still poop on a liquid diet? ›
It's also not uncommon to have frequent, loose stools on a full liquid diet simply because you are not consuming solids. As you begin to return to a solid food diet, your bowel movements should adjust accordingly. It is possible to lose weight on a liquid diet.Can I cheat on my bariatric pre op diet? ›
If you do break from the pre-operative diet plan, your liver will not shrink enough to make surgery safe and simple. Your bariatric surgeon would know within minutes if you cheated. During surgery, the laparoscopic camera can pick up food you may have eaten. The food could be in your stomach or intestinal tract.What can you not do before bariatric surgery? ›
How to prepare for weight loss surgery: Begin and maintain a workout routine to reach and keep your weight loss goals. Lower your daily calories to a range between 1200-1500 calories (or in a range discussed with your doctor). Avoid consuming caffeinated beverages approximately one month prior to surgery.How do you survive the pre op diet for gastric sleeve? ›
The pre-op diet for gastric sleeve surgery mainly consists of liquids such as protein shakes and other low-calorie, low-carb foods that are easily digested. The additional protein helps strengthen and protect your muscle tissue, allowing your body to burn more fat than muscle for energy.What should I do a month before bariatric surgery? ›
- Stop smoking.
- Stop drinking alcohol (any kind), as it may cause bleeding during or after surgery.
- Stop all carbonated beverages.
On the night before surgery, take a long shower or bath and clean your abdomen 3 to 4 times with soap and water. Pay special attention to cleaning your belly button area-use a q-tip. DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT on the evening before surgery.
Option 1: Soup and Yogurt Diet
calories per can) Or 2 x 200 calorie portions soup per day (you must read the label). Supermarket own brand low fat, low sugar varieties (under 100 calories per pot). additional drinks.
What we see as a little weight gain, gas, or constipation, could actually point toward more serious health conditions. Excess abdominal fat has frequently been associated with liver disease, which tends to have few or no symptoms.How long does it take to shrink your stomach? ›
If you have a big meal, your stomach doesn't magically get bigger and stay that way—it shrinks back down to its previous size in about four hours or less as your food is pushed along to the small intestine, Staller says.What happens if you don't do liquid diet before gastric sleeve? ›
Your liver won't shrink enough to have surgery and will make it more difficult for the surgeon. You could have your surgery canceled (surgeons choice) Making it harder on yourself to create new healthy eating habits that you MUST adhere to after surgery.Can I eat scrambled eggs on a liquid diet? ›
Milk may be used in beverages such as eggnog*, milkshakes, malted milk, high protein milk and in cream soups. Eggs and Cheese * Do not use raw eggs, use custard, soft custard, or a commercial egg mixture that is pasteurized.
- 1 glass pulp-free fruit juice.
- 1 bowl gelatin.
- 1 cup of coffee or tea, without dairy products.
- Sugar or honey, if desired.
- Red meat that's tough or dry.
- Greasy, high fat foods.
- Heavily seasoned or spicy foods.
- Sugar alcohols, such as erythritol, glycerol, mannitol, sorbitol and xylitol.
- Foods reheated in the microwave.
In the second month, some people lose 20% of their excess weight.Can I eat eggs 1 week after gastric sleeve? ›
You'll eat a soft diet between weeks three and four after surgery. During this phase, you'll continue to prioritize protein, but you'll be able to get the nutrient from foods including scrambled eggs, hummus, and tuna/chicken salad with low fat mayo.Why do you have to stop caffeine before bariatric surgery? ›
Avoid caffeine or carbonation
Caffeine causes dehydration and acts as an appetite stimulant. Carbonation can cause increased bloating and discomfort, especially after gastric bypass surgery.
When your body digests caffeine, it makes a chemical called paraxanthine that slows the growth of the scar tissue involved in fibrosis. That may help fight liver cancer, alcohol-related cirrhosis, non-alcohol-related fatty liver disease, and hepatitis C.Can you have bariatric surgery with liver disease? ›
Results:: Bariatric surgery is safe and effective in individuals with chronic liver disease without clinical decompensation or significant portal hypertension.What causes liver failure after bariatric surgery? ›
Liver insufficiency has been described after malabsorptive bariatric procedures, such as the Scopinaro procedures. Bacterial overgrowth with the production of hepatotoxic macromolecules was considered the main cause.Will gastric sleeve help with fatty liver? ›
Roux-en-Y gastric bypass and sleeve gastrectomy are equally effective at reducing hepatic steatosis, with an almost complete clearance of liver fat 1 year after the surgical procedures, according to data from a single-center study.Can you drink ginger ale on a clear liquid diet? ›
Acceptable clear liquids include: water, tea, Apple juice, Ginger ale, Sprite, 7UP, Gatorade, Powerade, Vitamin Water, Crystal Light. Black coffee is considered a clear liquid. However, milk and cream are not considered clear liquid and please do not add them to your coffee. Please be sure to avoid any red liquids.How many days can you stay on a liquid diet? ›
A clear liquid diet is not adequate in calories and nutrients. It should not be followed for more than five days unless supplemented by high-protein gelatin or other low residue supplements.What is the 3 day liquid diet? ›
A juice cleanses, also known as a juice fast, is a detox diet that consists of drinking vegetable and fruit juices for a short period of time (1-3 days). No solid foods are consumed, only liquids (raw juices and water).How long is pre op diet for gastric sleeve? ›
Pre-Op Gastric Sleeve Diet: 2-3 Days Before Surgery
Restrict your food intake to water, broth, gelatins, and low-calorie sports drinks (no sodas). You'll need to cut out consumption entirely starting at midnight on the day of your surgery – even water.
Yes. Liver is a keto powerhouse. While the carb amounts change slightly between animals, livers are high in protein, have an incredible amount of minerals and vitamins, and have very few carbs.How much weight should I have lost 4 weeks after gastric bypass? ›
Generally, gastric bypass and sleeve patients lose up to 3lb (1.5kg) per week in the initial stages after surgery. This tends to slow to 1-2lb (0.5kg to 1kg) per week by six months following surgery. 55-70% of your excess weight with a gastric bypass. 55-60% of your excess weight with a gastric sleeve.
Most gastric bypass surgery is laparoscopic, which means the surgeon makes small cuts. That makes for shorter recovery time. Most people stay in the hospital for 2 to 3 days, and get back to normal activities in 3 to 5 weeks.How much weight should I have lost 5 months after gastric sleeve? ›
This quick weight loss is attributed to a change in eating habits and the loss of water weight. After that, weight loss should remain consistent. On average people can expect to lose around two to four pounds a week, or eight to 16 pounds a month, for the first six to 12 months following their gastric sleeve surgery.How long does it take to shrink your liver for bariatric surgery? ›
Weight loss surgery diet
“We have you do a liver-shrinking diet for a minimum of two weeks before the procedure.”
However, low calorie diet is the preferable method to reduce liver volume, considering the level of evidence and practical applicability. On average, low calorie diets reduce liver size by 2.4 % per week; therefore, we would recommend a low calorie diet of at least 4 weeks prior to surgery.Is soda worse than alcohol for liver? ›
When you choose a sugary soda instead of alcohol every day, you may think you're doing your liver a favor. But that daily soft drink can be harmful, especially to your liver — as damaging as alcohol can be. Once it reaches the liver, the sugar in beverages can get converted into fat that's stored in liver cells.Do you have to do the liver shrinking diet? ›
If you do not follow the liver shrinkage diet and your liver has not shrunk, surgery may be deemed unsafe and the surgeon may cancel the surgery on the day.What is the best way to prepare for bariatric surgery? ›
How to prepare for weight loss surgery: Begin and maintain a workout routine to reach and keep your weight loss goals. Lower your daily calories to a range between 1200-1500 calories (or in a range discussed with your doctor). Avoid consuming caffeinated beverages approximately one month prior to surgery.Can I eat salad on a liver shrinking diet? ›
60g/2oz cheese (2 x matchbox size) • 8 thin packet slices of ham, chicken or turkey • 1 small chicken breast without skin • 4 rashers grilled back bacon • 100g/4oz (small portion) meat • 100g/4oz tinned fish • 100g/4oz tofu • Plus you can have plenty of vegetables/salad (low fat dressing).What can disqualify you from bariatric surgery? ›
- Drug and/or alcohol addiction.
- Age under 16 or over 75.
- History of heart disease or severe lung problems. ...
- Chronic pancreatitis (or have a history of this).
- Cirrhosis of the liver.
- Autoimmune disease such as systemic lupus erthyematosus.
- Blood disorder which increases your risk of heavy bleeding.
Foods to Avoid After Bariatric Surgery
Greasy, high fat foods. Heavily seasoned or spicy foods.
- Supportive Pillows. After surgery, you might not be able to sleep as comfortably on your side if that's what you typically prefer. ...
- Comfortable clothes. ...
- Water. ...
- Help. ...
- Quick and easy meals. ...
- Hand sanitizer. ...
Typically, we recommend that patients wait between 1-2 weeks (for Lap-Band procedures) to 2-4 weeks (for stapled procedures such as gastric sleeve or bypass) before returning to their jobs.Does a fatty liver cause belly fat? ›
We conclude that fat infiltration of the liver is well correlated with amount of abdominal fat. Fatty liver tends to be more strongly associated with VF compared to SF. In other words, if a non-obese patient exhibits fatty liver, the patient may in fact have visceral obesity.