Pre-Op Diet MONTHS Before Surgery?

So I'm pre-op DS with Duke. At my first appointment they put me on an intensive pre-op diet. I am only allowed 20 total carbs per day. I'm not supposed to have artificial sugar. It is also supposed to be low fat as well. I'm supposed to be on weight loss medicine, but my insurance doesn't cover any of them. The only affordable one would make my already bad anxiety worse and I'm terrified of it.

It seems awful early to be on such a strict diet when my surgery could be half a year away or more. I'm doing it. I'm terrified that they could deny my surgery based on "non compliance." I've never seen anyone put on such a strict diet so early, but I may be making a mountain out of a mole hill.

So is this normal? When did your pre-op diet start! What were you told to do?

Ridiculous. You don't even have a surgery date. Are you extremely high BMI? The ASMBS says these diets are not necessary.

Hi- My BMI was over 60 when I first saw my surgeon. He would only do a DS if I lost 50 lbs by surgery date. That was in February, I have since lost almost 50 lbs and my DS surgery is on Monday. He told me because of the inflated risk to me. I am 55 and I think the combo of high BMI and age were the determining factors. I was on low-carb until July 31 and I am currently on liquids only.

Hope that helps you understand.

Elissa

Was it described to you as a pre-op diet or a diet they want you to do to hit a certain wight to be eligible for the op?

Somewhat like Elissa I had to lose quite a bit (about 80 lbs) before my surgeon would agree to the DS in a single operation. Otherwise he would have done the VSG and then the switch later.

It kind of sounds like the Hi Protein Sparing Fast diet (something like that) that I was on.

Could it be part of an insurance requirement? Sometimes they do stupid stuff like requiring a 6 month supervised diet plan.

I didn't really think of it as a pre-op diet. My actual pre-op diet was liquids only for the 2 weeks before surgery.

So not completely crazy but you need a little more information. It can be overwhelming but get back to them and ask them to explain or exzplain again if they think they already did.

Pete

If you've got that far before your surgery, anything can happen between now and then. It's important to know what your insurance company requires, though, so you can protest unreasonable requirments such as this from the surgeon...if he does DS at all. I've not heard of any DS surgeons that make patients do such an extreme diet a year and a half from surgery.

So my surgeon is Dr. Sudan at Duke in NC. I know that he does the real DS. I did not see him at my appointment, however, since he was out of town. I saw Jennifer Norris who is a PA and I can't recall the name of the surgeon who stopped in for a few minutes to look at the scars on my stomach.

Both of them insisted that I start the diet immediately. I was told that this is a liver shrinking pre-op diet.

I know that my insurance says that I need to have 3 months (a total of 4 visits) of supervised diet prior to WLS. I'm seeing my local PCP tomorrow to start that with her office since Duke is quite a drive from my house. The reason that I said 6 months (or more) is because the 4 visits (which will likely take 4 months), getting approval for surgery from my insurance, and then Duke actually scheduling my appointment will likely take 6+ months. I'll be shocked if it is sooner (thrilled!), but I am not expecting that at all.

I do have a high BMI. I do not have any of the issues that come with it (yet). I'm lucky to not have high blood pressure, sleep apnea, diabetes, etc. Still I was never told how much weight to loose. Basically, my visit with Duke went like this.

"You want the DS?" "Yes." "Ok. You need to go on a diet. This is the one. Go low carb, 20 total carbs per day. Low fat. No artificial sweeteners. It'll be difficult, but I'll prescribe you diet pills to help." Only my insurance doesn't over diet medication, I found out. So I'm doing it without diet medicine.

Oh, my insurance also requires proof of obesity for 1 year prior to surgery. But Duke wants two years proof? I'm shocked by how difficult this all is.

I have no problem being on a diet prior to surgery. I just wasn't expecting to be put on such a strict diet. I'm afraid that I'm going to fail (like I always have, or else I wouldn't need bariatric surgery in the first place.)

They never said how much weight they are looking for me to loose. I'll e-mail them and ask if there is a specific number they are looking to see.

You will find multiple games to play and hoops to jump through. This isn't easy! Honestly this is just another form of fat shaming. You have to prove yourself worthy of losing weight. Sorry!

If you have any money, check out Esquerra/Wilhelmy in Mexicali/Alma Mater Hospital. For about 14K you could get a great DS there in just a couple weeks. Many people have gone there.

The thing that strikes me as a little strange is that I've never seen the liver reducing diet be longer than 2 weeks before surgery. All Docs can be different so that doesn't mean much. Maybe they are using it for multiple goals.

Since it is just from the Doctor's office, unless they give you specific goals you have to meet I wouldn't be worried about 100% compliance. Just do what you can, probably any progress is good enough.

The pre-surgery diets mandated by some insurance companies are kind of a joke, just their way of weeding people out that aren't serious I think.

Good luck, don't let them discourage you.

Pete

Do you have to go through Duke? I had my DS done with Dr. Bermudez at Rex in Raleigh. He was fantastic and Rex bariatric specialists are amazing! They did not make me do anything like this. I had to do a 2 week pre op liquid diet, but that was it. I do know they require weight loss if your BMI is too high but nothing extreme.