Pre Surgery Liquid Diet is MORE carbs than I eat now.

My RNY is January 4th. I am allergic to aspartame. So instead of doing Optifast, I'm taking Slim Time. I got my shipment and the macros are: 230 cals - 8g fat, 19g carbs, 22g protein. I am supposed to have 4 packages per day. I do not get to eat salad anything. I'm just allowed sugar free flavorings for my shakes, plus sugar free jello, decaf coffee, low cal water flavoring. I am currently low carb, nearly keto and eat about 60 grams of carbs per day. Funny how it is more carbs than I eat now.

For those who did the actual optifast, what are the macros?

Just FYI, OH reads the greater than and less than symbols as HTML, so if you try to type "less than" something, with the less than symbol, the rest of your post will get cut off.

You have to remember that most pre- and post-op diet guidelines are not extremely low carb like you are doing currently. Pre-surgery the emphasis is getting your liver smaller...post-op it focuses on protein to aid in healing and keep you full longer. My program didn't even give me a carb guideline, but I knew I was supposed to eat lower carb veggies. Essentially the focus was 60g protein and 64 oz fluids post-op, and if there was room for something else, great.

If you're going to follow your program's guidelines, then follow them. After surgery, you're not going to have to worry about carbs for a while because it's going to take everything you've got to get your protein and liquids in. After your healing phases are over and you're back to being able to eat, more or less, what you want, then you can refocus on your super low carbs. You're probably going to be there anyway.

Pre-op it's most important to do what your surgeon wants you to do, in order to get your liver prepared. If you have issues, then talk to your surgeon and see if there are other options. Personally, I used a zero carb unflavored protein powder and made my own shakes. I'm assuming you're in Canada based on the fact that I see most of those programs require Optifast pre-surgery. Other than Optifast, your pre-surg diet is the same as mine was for 2 weeks. I used Isopure Zero Carb Unflavored powder.

P.S. Here is the nutrition label for Optifast 800 Ready to Drink shakes:

My surgeon's nutritionist recommended a protein drink pre and post op that had way too many carbs. I just drank my own protein drinks and didn't tell them. Still lost weight pre-op. Also the more I read the more the "liver shrinking" diet is a bunch of bunk. The ASMBS actually now say the two week liquid diet doesn't work and don't recommend it. Takes more than 2 short weeks to shrink your liver.

Do you have a link to the ASMBS data you mentioned?

No I'm sorry. I thought I read it somewhere but I'm not sure where

How did you meet your nutritional needs through making your own protein shakes? Looking at the labels of Slim Time and Optifast, they are supplemented with vitamins/minerals and contain approximately 20% per serving for most of the vitamin/minerals needed.

I started my post op vitamin routine before surgery to get my levels up. Used Optimum Nutrition gold standard protein powder.

Ok. Thanks for clarifying.

I did more than two weeks on the liquid pre-op diet (Cleveland Clinic -- specialized bariatric endocrinology diet) -- and was required to have less that 180 calories per shake, less than 10 carbs, and at least 19 grams of protein. I was allowed 4 to 5 shakes per day.

I used Syntax Nectar shakes for most of the time -- some mixed with water with a fruity Crystal Light flavor that coordinated with the flavor (i.e. Syntax Nectar Fuzzy Navel + 1 cup water with half packet of classic orange Crystal Light = 105 calories, 0 carbs, 23 protein); and others with unsweetened almond milk (30 calories per cup) for the milkshake type flavors (i.e. Syntrax Chocolate Truffle + 1 cup almond milk = 130 calories, 1 g. carb, 24 protein). For convenience, I also used ready-made Premier Protein shakes sometimes (160 calories, 5 carbs, 30 protein).

Every pre-op diet is different. You will find huge variations in what surgeons require. It does seem like that's a lot of carbs to take in via shakes, but that's probably just because it's different than what I did. That doesn't make it right or wrong. If you trust your surgeon, then I'd trust that he/she knows what is best for his/her patients pre-op. I have seen people here who had food funerals up until surgery because they had no pre-op diet requirement -- who've done okay, too.

I personally believe the pre-op diet was a huge benefit to me -- for my own personal reasons -- beyond just the liver shrinking aspect -- but that is just my personal experience. I don't know if it helps, but after surgery, I have lost 220 lbs and maintained that loss by staying under 30 grams of carbs during the loss stage, and under 45-50 in maintenance.