Pre- Operative Liver Shrinking Diet (2022)

Location of liver in the body

The liver can become enlarged and contains abnormally large deposits of fat when a person is very obese. Due to its location in the body, it is in the way of the surgical area, and can cause problems for laparoscopic placement of the Lap-Band. This enlarged liver must be held out of the way by surgical instruments. An enlarged liver is more fragile than normal and will bleed easily when touched or manipulated. When the liver bleeds, it can be difficult to control and increases surgical risk. Extra care is required when the liver is enlarged, which can increase the time a patient spends under anesthesia, and prolong recovery. For the safety of the patient, if the liver is considered too large or fragile, Dr. Kuri may need to postpone or cancel the surgery until it is determined there is a reduced risk to proceed with the operation.

The Purpose of the Liver Shrinking Diet is to:

*Reduce body fat around the stomach and liver, as well as shrink the liver itself;

*Reduce surgical risk by reducing fatty triglycerides from around the liver and spleen, reduce potential surgical bleeding, and improve recovery time;

*Increase protein intake – will preserve muscle tissue and aid in recovery.

Why Do I Need to go on the Pre-Op Liver Shrinking Diet?

Patients with a Body mass index (BMI) of 45 or greater, or are at special risk due to a previous health condition, are prescribed a special diet 7 to 14 days prior to their scheduled surgery. A special diet (LSD) followed for a length of time prior to surgery, has been very effective in shrinking and firming the liver. This diet reduces the risk of potential bleeding and complications during your surgery. If you have been prescribed this special diet, it is important that you follow the instructions for the diet to improve your surgical outcome.

Please Note: This diet is not recommended to all patients undergoing Lap-Band surgery, and should only be followed if prescribed to you personally by Dr. Kuri or his staff. Although patients report losing a significant amount of weight during both the Pre-Surgery Diet and Post-Op Diet, these diets are not for the purpose of weight loss and should not continue to be followed after the prescribed time frame (unless you are asked to do so by Dr. Kuri).

It is important that you mentally prepare yourself for the challenges ahead. ( see also Getting Through the First Week of the Liver Shrinking Diet) Both the Pre-Surgical Diet (LSD) and the Post-Op Recovery Diet will be a drastic change from your previous eating habits, and will require your diligence and commitment for the diets to reach their desired effect. Although you may be tempted to splurge on all your favorite foods, this is not the time to let your health worsen.

Liver Shrinking Diet Particulars

Generally the LSD is high in protein, and low in calories and carbohydrates.

The average calorie range is between 1,200 to 1,600 calories per day;

The typical protein intake is between 70 to 120 grams a day;

The recommended carbohydrate intake is between 40 to 50 grams a day.

Which Foods are High In Carbohydrates?

The foods highest in carbs are high in starch or sugar. This includes anything made with flour or sugar, grains, foods with added sugar, and starchy vegetables such as potatoes and corn. Most processed foods are high in carbohydrates.

(Video) How to Fix Liver-Shrink Diet Problems | Bariatric Surgery | Mexico Bariatric Services

You will have a choice in how you would like to do your liver shrinking diet.

Plan A – Use protein supplements, such as protein powders, shakes, puddings and have one low carb meal a day.

Plan B – Choose regular foods that are low in carbohydrates and higher in protein.

Advantages and Disadvantages

Plan A – Results in a greater overall weight loss and is very effective at shrinking the liver. Plan A does not require as much cooking, and may be preferred by busier individuals. However this plan is the most challenging and harder to stick to. Plan A limits the patient to one solid meal a day, and uses protein supplements for additional meals. Patients also tend to have stronger cravings for carbohydrate based foods. Patients on Plan A also report being more fatigued, and have a harder time concentrating within the first five days. Plan A requires you to purchase special low carb, high protein supplements.

Plan B – Results in moderate weight loss and is effective in shrinking the liver for surgery. This plan is easier to stick to and has more balanced nutrition and provides adequate fiber. Patients experience less withdrawal symptoms and problems with focus and fatigue. Plan B requires more meal planning, shopping and cooking.

Not Sure which Plan to Follow?

Try alternating days. One day Plan A followed by one day on Plan B. Or if you are prescribed the LSD for two weeks you can start the first week with Plan B to lean you off carbohydrates the first week. Then switch to Plan A for the last push before surgery. Both plans will have sample menus to follow or you can use your own.

PLAN A – Using Liquid Protein Supplements

Plan A consists of protein drinks for two meals and a protein bar or protein pudding for a snack and one solid meal per day.

Carb count for your protein drinks, including what you mix it with and protein bars and pudding should be limited to a total of 40 carbs (net carbs). Limit your one solid meal to 10 carbs, for a total of 50 net carbohydrates per day.

Liquid Protein and Protein Bars

To ensure adequate protein intake you may want to supplement your diet using a powder/liquid protein drinks. There are many on the market, you can find them at nutrition/health and vitamin stores, as well as GNC, Trader Joes, and Fresh & Easy and some local markets. Some taste good and some are downright disgusting. We suggest you sample one before you invest in a large quantity.


Many patients have reported that the brand UNJURY was among the best tasting and least expensive. It is available only online but ships very quickly. Flavors include; chocolate, strawberry sorbet, vanilla, unflavored and chicken soup.

You can choose when you would like to have your solid meal during the day (breakfast, lunch or dinner)

Your solid meal should consist of 5 to 6 ounces of lean protein and one cup of vegetables, two cups if you are using salad . You may use a small amount of butter or oil to use for cooking or flavoring your food (up to 2 tbs.).

(Video) Motivation: 7 Day Liver Shrinkage Diet

Sample Menu


Protein drink (select 15 to 20 net carbs per serving)


Protein drink/pudding 15 to 20 net carbs


2 tbs. almonds


5 ounce chicken breast with parmesan cheese, 1 cup mixed sautéed vegetables in olive oil and garlic.

Remember to drink 80 to 100 ounces of non- carb containing fluids daily.

Plan B – Your Diet Choices will be Very Limited to Low Carbohydrate Foods.

With plan B you can eat more regular foods, but your total carbohydrates should not exceed 50 net carbs. Read labels very carefully look for hidden sugars.

Low Carb. Meal

Examples of low carbohydrate foods are:

Proteins such as meat and eggs

Most vegetables (low carbohydrate)

Low sugar fruits

(Video) Pre-op diet before your VSG | Gastric Sleeve Surgery | Questions and Answers

Soy beans

Some dairy products.

Note: See Sample Low Carb Menus and recipes (1-7 )for plan B at the bottom (Tips and Resources)

See Carb Counters Cheat Sheet

Start a Journal

In order to stay within the diet parameters, you will need to keep track of your food intake. We suggest you start a food journal – This can be as simple as a spiral note pad. You just need to be able to track your carbohydrate, fiber, protein and calorie intake. Although the LSD is not part of your weight loss phase, we recommend that you don’t go over 1,600 calories. This will help to keep you well within the diet limits for carbs and protein intake.

You may have your choice of the following:

Protein (3 to 6 ounces per serving) Meat, poultry, pork

*Steak, Hamburger patty, lean, Chicken/turkey breast or thigh, pork lean cuts (pork tenderloin, ham)

*Fish/seafood- Salmon, halibut, crab, shrimp, tuna, trout, tilapia, bass, perch, etc. No breading, no fish sticks, no batter – plain only, please

*Eggs – soft boiled, hard boiled, scrambled, poached

Vegetables -You can have ½ cup of low carb vegetables or 2 cups salad greens with each meal.

Fruit -Fruit is high in carbs and can be eaten in limited amounts ½ cup total daily, if you have carbs left in your total.

Milk and Cheese -½ cup cheese, any kind, but only one serving of cheese per day.

You may use low-fat or reduced fat milk or sugar-free soy milk to mix protein drinks (read labels milk is high in carbs)

Condiments and Oils and Fats – You may add up to 2 Tbsp. total daily of the following fats/oils:

*Regular salad dressing, (The regular actually has fewer carbs than the fat-free or low cal)

*You may have 1 Tbsp. any kind tartar sauce but no ketchup or BBQ sauce

*You may use 1 Tbsp. light mayo or light Miracle Whip

*You may use butter, margarine, olive oil, or cooking spray if you wish

(Video) #1 FAQ with Prof A. Maleckas - liver shrinking diet

*You may use any spice as long as it is sugar/carb free: salt, lemon juice, dill, pepper, or onion powder, garlic salt, etc.

The best choices for fat in your diet are called mono-unsaturated fats and omega-3 fatty acid. Examples of good fats include olive and canola oils, oily fish, walnuts, almonds, peanut butter, avocado, and olives. An extra benefit is that these foods taste good.

Foods you cannot Eat During the LSD Include:

Food you can’t eat on the Liver Shrinking Diet

High sugar foods (candy, baked goods, high sugar cereal)

High carbohydrate foods (including bread and pasta, rice, crackers)

Fatty meats, Fried foods, Whole milk products (regular cheese, regular yogurt and ice cream included), High calorie beverages (including regular soda, coffee drinks, sweet tea and alcoholic beverages)

Watch out for things that you would normally not consider food! Chewing gum (no-cal gum is fine), breath mints, cough syrup, hard candy, and cough drops nearly all have sugar.

Tips and Resources

Low Carb Menu #1 – Liver Shrinking Diet Plan B

Low Carb Menu #2 – Liver Shrinking Diet Plan B

Low Carb Menu #3 – Liver Shrinking Diet Plan B

Low Carb Menu #4 – Liver Shrinking Diet Plan B

Low Carb Menu #5 – Liver Shrinking Diet Plan B

Low Carb Menu #6 – Liver Shrinking Diet Plan B

Low Carb Menu #7 – Liver Shrinking Diet Plan B

Quick and Easy Low-Carb Snacks for Liver Shrinking Diet

(Video) Importance of the 2-Week Pre-Op Liquid Diet (2019)

Getting through the first week

Carb counters “cheat sheet”

Sugar Has Many Disguises


What if I cheat on my liver shrinking diet? ›

If you cheat on your liver shrinking diet and your liver does not reduce an adequate amount, you may be risking your own safety or the surgeon may reschedule the surgery. The surgeon will know right away at the start of surgery if you have followed your liver shrinking diet or not.

How can I reduce my liver size before surgery? ›

Open surgery means a larger abdominal scar, which results in longer recovery and increased risks. To reduce the size of the liver, it is necessary to follow a diet that is low in carbohydrate, low in fat and moderate in protein. Foods high in carbohydrate include sugars and starch food.

How long does it take to shrink your liver on a liquid diet? ›

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.

How important is the liver shrinking diet before bariatric 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. This diet also forces your body to use up its fat reserves, which helps you lose weight before the surgery and ensures the procedure goes smoothly.

Can I cheat on my pre-op diet? ›

It's not a good idea to cheat on your pre-op diet before surgery. Although many patients struggle with this leg of the journey, they're also grateful for it. The risks associated with cheating on your pre-op diet include: Your surgery could be canceled depending on the discernment of your surgeon.

What happens if you dont do the 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. Increase risk of complications during and after surgery.

How many carbs will shrink your liver? ›

Liver Shrinking Diet Particulars

The average calorie range is between 1,200 to 1,600 calories per day; The typical protein intake is between 70 to 120 grams a day; The recommended carbohydrate intake is between 40 to 50 grams a day.

Does fasting shrink liver? ›

Fasting resulted in a significantly reduced liver mass but only had a minimal effect on bodyweight. The effects on the liver by 30 days of fasting were not reversed by subsequent ad libitum refeeding for 30 days.

Can you shrink an enlarged liver? ›

If it's the result of chronic liver disease, it can potentially be reversed and in some cases cured with lifestyle changes. For example: If you have alcohol use disorder, get help to quit drinking alcohol. If you have non-alcohol-associated fatty liver disease, losing 10% of your weight can help.

Is peanut butter good for your liver? ›

Due to its high content of antioxidants and vitamins, peanut butter can improve antioxidant activity in the liver and promote its health. Peanut butter is a balanced source of protein that serves especially important to liver patients, as they have many dietary restrictions.

Do you lose weight on liver shrinking diet? ›

It is quite possible that you will lose a lot of weight following the liver shrinkage diet but it will mainly be water loss. This diet usually allows between 800 to 1000kcal a day. By reducing the size of the liver, the operating time for laparoscopic surgery is shortened and the procedure is safer.

How much weight can you lose on a pre op bariatric diet? ›

Typically, most patients will lose around 10 to 15 pounds while on the pre-op diet. It helps to jump-start your future diet and lifestyle as you get used to eating more low carbohydrates, fat, and calories and high in protein, vitamins, and nutrients.

How long can you do a liquid diet? ›

Malnutrition: It's safe to limit calories and nutrition for short periods, but you risk malnutrition if you stay on the clear liquid diet for more than five days. Healthcare providers will rarely recommend this. If they do, they will prescribe supplements to enhance your nutrition.

What happens if you don't follow post op diet for gastric sleeve? ›

Adjustable Gastric Band: What Happens If You Don't Follow Your New Diet. Adjustable gastric band surgery restricts the size of the opening to your stomach. This decreases the amount of food you can take in. After this surgery, you are likely to lose a lot of weight, as long as you follow instructions.

Why are bariatric surgery patients placed on very strict diets before the surgery? ›

This is the purpose for following a pre-surgery diet: Reduce body fat: Reducing fat in the abdomen and liver increases patient safety. Preserve and protect muscle tissue: Increasing protein keeps the body from using muscle tissue as an energy source on a reduced-calorie diet.

How long before gastric sleeve surgery should I stop eating? ›

DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT on the evening before surgery. You may take those medications approved by anesthesia with a sip of water as needed. DIET PLAN 1 DAY BEFORE SURGERY: On the morning of the day before your surgery, you will need to start a clear liquid diet.

Is coffee good for your liver? ›

Coffee also lowers the risk of other liver conditions including fibrosis (scar tissue that builds up within the liver) and cirrhosis. Drinking coffee can slow the progression of liver disease in some patients. Beneficial effects have been found however the coffee is prepared – filtered, instant and espresso.

What can I eat on a liver shrinking diet? ›

Daily intake:
  • 3 pints of skimmed OR semi skimmed milk OR lacto-free OR soya milk per day. ...
  • 2 x 125g low-fat plain or natural yogurt or 0% fat yogurt per day. ...
  • An additional minimum of 2litres of fluid per day (i.e. water, calorie free or low calorie squash/flavoured water, tea/coffee, fruit/herbal teas)

Can fasting repair liver damage? ›

Larance Lab research

“We know that fasting can be an effective intervention to treat disease and improve liver health.

What size is considered an enlarged liver? ›

Hepatomegaly is a condition in which the liver is enlarged, generally greater than 15 centimeters in the midclavicular line. However, normal liver size varies by person depending on the person's sex, age, height, weight, and body size.

What are the 3 signs of a fatty liver? ›

  • Abdominal swelling (ascites)
  • Enlarged blood vessels just beneath the skin's surface.
  • Enlarged spleen.
  • Red palms.
  • Yellowing of the skin and eyes (jaundice)
Sep 22, 2021

Does a fatty liver make your stomach bigger? ›

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.

What can I eat on a liver shrinking diet? ›

Daily intake:
  • 3 pints of skimmed OR semi skimmed milk OR lacto-free OR soya milk per day. ...
  • 2 x 125g low-fat plain or natural yogurt or 0% fat yogurt per day. ...
  • An additional minimum of 2litres of fluid per day (i.e. water, calorie free or low calorie squash/flavoured water, tea/coffee, fruit/herbal teas)

How can I detox my liver in 3 days? ›

The 3-day detox juice cleanse involves consuming only blended juices and water for 3 days.
In general, the following steps are taken in a specific order:
  1. Morning detox tea.
  2. Breakfast drink.
  3. Supplements.
  4. Lunch drink.
  5. Supplements (multivitamins, omega-3 fatty acids, and probiotics)
  6. Snack drink.
  7. Dinner drink.
  8. Detox ultra-bath.
Mar 8, 2022

Can you drink coffee on liver shrinking diet? ›

As an alternative to dairy you may use sweetened non-organic soya milk in the same quantities as above. Plus unlimited water, tea, coffee, low calorie squash, low calorie fizzy drinks. Please note that alcohol is NOT allowed while you are following any of the 2-week pre-op diet options.

What is the normal size of liver? ›

By percussion, the mean liver size is 7 cm for women and 10.5 cm for men (Table 94.1). A liver span 2 to 3 cm larger or smaller than these values is considered abnormal. The liver weighs 1200 to 1400 g in the adult woman and 1400 to 1500 g in the adult man.


1. Pre-op Diet (Bariatrics)
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2. Explained: Liver Shrink Diet (Pre-Op) | Mexico Bariatric Services
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3. What You Need to Know About the Liver Shrink Diet (Pre Bariatric Diet Explained)
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4. Pre gastric bypass liver shrinking diet
5. Fatty Liver | Gastric Sleeve Surgery | Questions and Answers
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6. LIQUID DIET | Feeling Out of Energy with the Bariatric Surgery Pre-Op Diet
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