Optifast vs Ketogenic diet

Hi. I'm 300 Lbs and I?m scheduled for RNY on June 12th. I started Optifast yesterday to complete 21 days before surgery (current recommendation of my bariatric program is 1 week of Optifast for every 100 lbs). As expected both flavors score a solid 8 in my yuck scale (this doesn't mean of course that everyone will dislike it).

Here are my assumptions. There are two goals behind doing Optifast:

1. Induce Ketosis, which will in turn reduce the size of the liver especially the fatty layer around it. (this reduces the overall risk of surgery and makes it easier for the surgeon to maneuver around the liver)

2. Empty the gastrointestinal tract from solids (with the exception of course of some potential stools in the lower end of the large intestines or rectum (given that the shakes do include some fiber)

Now the thought that I'm trying to entertain here: if you can go on a moderate ketogenic diet (and by moderate I mean ~1200-1500 calories a day), and then stop solid food 72 hours before surgery, wouldn't that be as good as Optifast?

I'm an Atkins fan/expert and I do acknowledge that it's very difficult to go on Atkins for a prolonged period (otherwise I wouldn't have needed RNY in the first place). If I follow Atkins - while putting some reasonable limits on red meat and other sources of saturated fats - and then switch to Optifast 72 hours before surgery, wouldn't that produce the same results? Just much less agony and gag reflexes! Haha

What do you guys think?

Nope. Not the same. The Optifast is designed to replace entirely meals with all sorts of impacts on your body chemistry, liver, weight, digestive process...all sorts of stuff. Doctors use many things to tell if their patients are actually doing what they say they are.

The restrictions prior to surgery are surgeon specific and if you don't comply your surgeon may simply cancel your surgery. Not worth the risk.

Try some other flavors. I did Optifast several years before my RNY for 9 months solid, you can do 21 days easy! I found the soups were my favorite. Blending the shakes with ice and coffee made them WAY better, more like a Frappacino.

Best of luck to you!

~Elizabeth

If I disliked the Optifast that much, I'd try another brand. There are a million of them, and lots that have better nutritional stats than Optifast.

What I wouldn't do is start making my own plan even before I had surgery. We all got morbidly obese by coming up with our own best plan. That got us all into the OR.

So, maybe try a better brand of shake, and stick to the plan like it was your last, best chance.

I think you don't have to like the shakes, you just drink them, end of story.

We got morbidly obese by having to " like" everything we ate.

Just think ofvthem as medicine,something you just have to do. After about a week, you will likely get used to the taste and won't think a thing about it. That is the way it was for me.

You should follow the rules of the experts. At the end you will be so much happier.

Hold your nose when you drink them, then wa**** down with water; then you won't have to actually taste them. They're for your nutritional needs, get them down however you can and get it over with lol

I actually do think you are correct in your assumptions. There are programs that actually do something very similar to what you are suggesting.

However, to be clear, I don't think you should alter your center's pre-op plan.

1. They make the rules of your surgery -- you surgeon knows what works best for his/her patients and you've agreed to trust that surgeon.
2. They can, and surgeons DO, cancel surgery even on the day if they have reason to believe you've not been compliant. I was moved to first surgery of the day because two others before me were sent home. It happens.
3. NOW is the time to look at your relationship with food. Opti is not made to be a delicacy. It's meant to provide the nutrition at the lowest impact on weight. No one says, "God, you know what I could go for right now? A protein shake!" -- no one wants one to kick back, drink an Optifast shake and watch a game or have one as their birthday dinner. That's my point: now is the time to learn to find other things to make you happy and to reevaluate how you see food. That is part of the point of the pre-op diet.
4. Where does your justification for eating what you want end, and how has that worked for you so far in your life?

Look, I totally get it. The shakes suck. Three weeks feels like an eternity -- you don't like them. Tossing it back at you: it's only three weeks. Food isn't entertainment. Plug your nose, doctor them up, put a lid on your cup -- do what you have to do to be successful. Doing it your way has gotten you where you are now.

Thank you all very much for your input. As most of you suggested, I decided that the risk isn't worth it of course, so I'll just block my nostrils and swallow the damn thing.

Just as a quick clarification, I wasn't entertaining a ketogenic diet in pursuit of pleasure, I genuinely experience gag reflexes when I'm drinking the shakes.

But yeah, I've spent about 25 years of my life engineering new scary ways to maximize food pleasure, so really 3 weeks of "displeasure" ain't gonna kill me.

Thank you all for your suggestions/advice and support again!

I really liked the premade ones, as long as they were cold.

I just had my first appointment today and I asked about a liquid diet a month before surgery but they told me they don't do that.

But I think it's interesting what it does... So even though they don't suggest it. I probably will do it! ?