Question:
Does anyone know how long a pre-op liquid diet TLC's "Big Medicine" doctors require?

I think they're being deliberately evasive about it (what the younger doctor acknowledged last night as the "torture" of a liquid diet doesn't mesh well with such gauzy pleasant images as the glamorous plastic-surgery post-ops they trot out every week), but it seems to me that in one episode they said, or implied, that a liquid diet lasting several MONTHS might be required of a patient several hundred pounds overweight. I know that many surgeons require weight loss before the surgery, but several months without solid food? Has anyone heard of these, or any other surgeons, imposing this draconian requirement?    — Virginia N. (posted on June 19, 2007)


June 19, 2007
Hi Virginia, I have heard people say that they had to do a 2-3 month liquid diet, but I never did when they wanted me to do one. I told them I had already tried a liquid diet (lie) and that it did not work for me if it had, I would not be wanting gastric bypass surgery. They find out you are doing good on a liquid fast and they might not approve you for surgery unless you have already been approved and this is oone of their requirements. I am 3 1/2 years post op and 227 pounds lighter. Good Luck!! [email protected]
   — MCraig3

June 19, 2007
my old surgeon required it for some of his patients, but not all. I think it's a case by case basis. I was 412lbs at the time and wasn't required to be on a liquid diet.
   — [Deactivated Member]

June 19, 2007
I only did a liquid diet a week before surgery. (hardest thing I ever had to do but I did it!) Each surgeon is different. I noticed last night that they said "if you lose weight before surgery that will prove to us you are sincere and want to lose weight and will be successful after surgery" My surgeon's office stopped requiring that as that doesn't prove a thing. I gained about 9 lbs before surgery but have been losing at a high pace since and doing awesome on my diet. If we could have stuck to a diet before surgery, we wouldn't NEED surgery DUH! LOL...
   — crystalsno

June 19, 2007
From what i heard, it depends on your doc and what kind of surgry you are having. my friend had to do it, i dont know yet since i dont see my doc till friday. But i know that it helps make your liver smaller (which was the case on teh show) which makes the surgry easier and safer. In my opinon if it is going to help your surgry be safer, do it. Im not looking forward to it, but its part of the process. good luck KIT, mary
   — marygriego

June 19, 2007
Yes, the liquid diet is to help reduce the size of your liver, it sits just above the stomach for the surgeon. If its to large, it will be a problem for surgery. This is my understanding of the reason for liquid diet. Seems it is a health and safety issue.
   — ka11e

June 19, 2007
My surgeon requires a two weeks pre-opt liquid diet. This isn't so much about seeing if you can stick to a strict diet (although in my opinion, if you can't stay disciplined enough to follow through with a two week, or even two month diet before the surgery, you won't be able to follow your doctors strict guidelines for MONTHS after the surgery), it's more about shrinking the liver which makes the surgery much easier for both the patient and the doctor. The man on the show last night was on the liquid diet for several months prior to his surgery, even to the point of losing over 100 pounds. The doctors are well aware that this weight loss, on it's own, would have been temporary. So to say 'if I could lose the weight in the first place, I wouldn't need surgery', isn't a fair statement. Like the surgery itself, it's another step in the process and would not be a likely reason to be denied the surgery.
   — BykerGrrl

June 19, 2007
The reason why they sometimes ask this is because with being bigger our liver is also bigger and when they do the surgery if we haven't lost some weight (it all depends on your dr how much they require) the possibility of going in they could "bump" the liver and if the bump it it could start bleeding and that is when there could be sever problems, for instance if they are doing a Laproscopic surgery and the liver starts to bleed they would have to open you up and dealing with that may lead to potential infections from the incision being so big.. the thing is if the liver wasn't so big from the start they wouldn't worry about it so it is one of the choices we make with this disease we have...also with the liquid diet its usually only two weeks before hand and i haven't had my surgery yet, but i was so worried about weight loss and not getting aproved, because i have lost 35 lbs, on just trying to change the little things, like instead of a candy bar i pick up carrots or celery or when i eat i always try to eat my protien foods first and that has been my major change but it was enough to help me start the losing process.. and with the loss its perfectly fine the doctor was very happy... anything you can lose before makes it less you have to lose later, remember the first 6 months of surgery will be when we lose the majority of our weight and if we get some off before hand that just makes it a bit better for us in the long run, i don't know about you but i want so bad to be healthy for once in my life, (or as healthy as i think i should be) :) Good luck and alsways think about anything before is less latter and anything before will help the liver shrink and it will help the surgeon out a lot.. God bless you Paula... please keep us informed.. my tenative surgery is 8-13-07 :) im sooooo happy..
   — japaad

June 20, 2007
Hi Virginia, thanks for asking your question. You can't take a tv show and figure out what your surgeon will be thinking. My surgeon required a liquid diet for 2 days prior to surgery, maybe 3. It has been 3 1/2 years, so I forget if it was 2 or 3. She said to me is it basically because they want to loosen up the liver a little and to be sure there is no food stuck in the intestines when they are re-wiring during surgery. You are only a 47 BMI, so I can't think that you would have to endure a long period of time on a liquid diet. I read the comment that you had on your page about your possible surgeon. If the surgeon is about himself and not you, you need another surgeon. Your insurance company will pay him quite well for his services, and if he is not totally about you, dump him, and find another one. You don't need a surgeon that is concerned about himself first. You are the patient, and you need him as an advocate. If he and his staff are not advocates for you. You could be asking for trouble the rest of your life. When you call post surgery, will you get pat answers instead of real care. You technically "marry" into a relationship with your surgeon, because you will see them for the rest of your life (unless they move). Be sure you can build a relationship with his staff and him before you marry into a relationship with him. Take care. Patricia p.
   — Patricia P

June 20, 2007
My doctor told me to do a low carb diet 2 weeks before surgery so my liver would shrink. Then two weeks after surgery I had to do a liquid diet.
   — barfiep01

June 20, 2007
It is not unusual for doctors to require a weight loss before surgery the first 10-30 pounds you lose is in the area of the liver as they said I the show the liver is made a great deal smaller making the surgery safer for the patient and easier for the doctor, maybe what they do not explain well enough to people is that the part of the stomach , intestines where the stomach is cut or at the location of where the lapband placement is, is directly under the liver, a five pound liver is easier to lift than a 30 pound liver. They have a special tool to lift the liver and it has to be held up out of the way for the surgeon to do the surgery, you don't want a big ole liver and take a chance if it being cut and having a bleed. Also if you have less fat around the middle it is easier putting in the lap tools and moving around inside you a shorter time under the anesthesia. One last thing, for every 100 pounds over weight you are the risk of surgery doubles and also if a patient is 500 pounds there is a higher risk of blood clot , pulmonary problems, you have to get up and MOVE after surgery be able to breathe DEEPLY to prevent pneumonia. This is why it pays to get informed research on sites like this one and National Institute of Health or American Society for Bariatric Surgery website are too good one as well as Obesityhelp.com
   — DonnaB.

June 20, 2007
I don't know how long the Big Medicine diet is but I had to go on a liquid diet before my surgery. 4 shakes a day for two weeks, no solids. Hope this helps. Stephanie
   — stephanienagy

June 20, 2007
I did not have to do a pre op diet , I was a "lightweight" with right at 100 pounds to lose but some people are required to do one. I dont think its several months, but maybe about 2 weeks or so if you have to do one. And its not always about how much you lose but about how willing you are to stick to something. I had to do a 6 month diet for my insurance company to approve the surgery and although I think it is a stall for the insurance company, I was all for it because I was able to show my doctor my level of commitment to stick to a reduction of eating and increased exercise. My internal med doctor was an advocate of the 6 month diet and would tell me every month that in order for me to be successful with this surgery is to start changing my life before the surgery and for the rest of my life. It was very valid what he said, because it prepared me for the changes that I would go through afterwards and I was more successful because I was committed. Good luck to you, maybe your doctor will not impose a diet , or maybe your insurance company will. Angela
   — A Q.

June 21, 2007
My guess is that the people are being put on Optifast shakes or something similar *before* surgery. This type of liquid diet is considered to be a very low calorie diet (VLCD). The shakes are designed to provide all the nutrients, vitamins, and minerals necessary for health while limiting calories to 800 a day (not a typo--this is what qualifies it as a VLCD). According to what I've read, this results in a consistent and rapid loss of 3-5lbs per week. Pre-surgery weight loss may be necessary to ensure that a person does not exceed the weight limit of hospital equipment, including the operating room table. The weight loss also helps reduce the risk of operative and post-op complications. An 800 calorie liquid diet sounds horrible, but its extremely difficult to achieve that type of weight loss by watching what you eat on a low fat, low carb, or low calorie diet. I think this VLCD liquid diet is used as it is the fastest, safest way to reduce weight so that WLS can be performed. I don't think these liquid diets are being done to punish, to test, or to otherwise cause suffering.... I think they are being used to assist people... to help those who are motivated and ready for WLS but are not eligible for health and safety reasons. Best wishes.
   — mrsidknee




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