Pre Surgery Diet Advice

Pre-Surgery Dietary Advice - The Liver Shrinkage Diet

Prior to weight loss surgery (gastric bypass or sleeve), it is essential that you follow a strict calorie controlled eating plan for at least 2 weeks. This will reduce the size of your liver, a large organ lying over the stomach, and help to reduce the risk of complications associated with the surgery.

For the eating plan to be successful, it is important that you stick to it for the length of time discussed with your surgeon and dietitian. This can range from 2 to 4 weeks. There may be a temptation to have a special/larger meal before your surgery, however, if you do this, it will reverse the hard work you have already put in.

There are 4 eating plan options which you can discuss with your dietitian to see what would work best for you.

• Restricted food portion/food group eating plan - This eating plan is designed to give you approximately 100g of carbohydrate per day. It is low in fat (although this will depend on the foods you choose) and moderate in protein. The energy plan is between 800-1000 calories (kcal) per day. You will be allowed to eat 3 x small portions of carbohydrates a day (i.e. one at each meal), 2 x small portions of protein (i.e. one at lunch and one at evening meal), 2 x pieces of fruit, 3 to 5 portions of vegetables and 2 x portions of milk/dairy. A list of portion sizes together with an example meal plan will be provided to you by your dietitian.
  
  
• Calorie controlled diet eating plan - If you are familiar with calorie counting, you can choose your own eating plan to a maximum of 800 calories per day (and 80-100g carbohydrates a day). Include fruit and vegetables and as much variety as you can. Remember to count drinks as well as food in your total calorie intake per day. You may find an app such as My Fitness Pal useful to track your intake.
  
  
• Meal replacement eating plan - On this plan you can choose to either have 3 to 4 meal replacement products per day (at 200-250 calorie each), e.g. 2 milk shakes and 1-2 soups or you can use meal replacement products combined with real food i.e. you can replace two meals with two meal replacement products and have a 450 calorie meal in the evening. Dietitians usually recommend that latter so you can still enjoy some food before starting the 4 week liquid only diet post (after) surgery.
  
  
• Milk plan - This isn’t a plan that we often recommend (due to you needing to consume liquids only for 4 weeks after surgery), but can be an option. It involves you drinking just 3 pints of milk a day (can be flavoured with sugar free options or included within teas and coffees) OR having 1 pint of milk a day and 8-10 low calorie yoghurts.

You will be provided with written information to follow and will be able to ask your dietitian questions throughout.

Please remember to weigh yourself before and after you start the liver shrinkage diet and give this information to your dietitian.

Top tips to remember:

• Spread food and drinks evenly throughout the day. Do not save up everything for later in the day.
• Drink a minimum of 2 litres of fluid every day and drink more in hot weather. This includes all fluid, e.g. milk, no added sugar squash, tea, coffee. Remember to count these as part of your total calorie intake every day.
• Drink at regular intervals throughout the day. Avoid alcohol.
• Take a daily multivitamin and mineral tablet - you may want to purchase a chewable multivitamin so you can carry on taking this for 4-6 weeks after your surgery (before moving onto tablet form)
• Try to keep busy and active throughout the day.