The decision to undergo any surgery, including bariatric surgery, requires careful preparation, and diet plays a crucial role in ensuring a successful outcome. This article provides guidelines for a diet focused on quick weight loss before surgery, emphasizing safety, effectiveness, and long-term health benefits. It is important to consult with your healthcare provider or a registered dietitian before making any significant dietary changes, especially when preparing for surgery.
The Importance of Pre-Operative Weight Loss
Losing weight before surgery is an important step to improve surgical outcomes and reduce the risk of complications. Excess weight can increase the risk of anesthesia-related complications, surgical site infections, and other post-operative complications. Losing weight before surgery can improve the effectiveness of anesthesia and your overall health.
Reducing Surgical Risks
Excess weight can increase the risk of complications during and after surgery, such as infections, blood clots, and breathing problems. By reducing weight, patients can significantly lower these risks.
Improving Anesthesia Effectiveness
Anesthesia is often less effective in obese patients, which can result in longer surgery times and extended recovery periods. Weight loss before surgery can improve the effectiveness of anesthesia.
Enhancing Mobility
Losing weight before surgery can improve mobility, making it easier to move around before and after the surgery.
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Understanding BMI and Weight Loss Goals
BMI, or Body Mass Index, is a measure of body fat based on a person’s weight and height. BMI is a widely used screening tool to indicate whether a person has a healthy weight or is overweight or obese. However, it’s important to note that BMI is not always an accurate measure of body fat or health, as it doesn’t take into account factors such as muscle mass, bone density, and body composition. Therefore, BMI should be used as a screening tool and not as a definitive measure of health.
BMI is a significant factor in weight loss before surgery because it provides a measure of body fat and an indication of the risk of complications during and after surgery. Additionally, BMI can help determine an appropriate weight loss goal and timeline before surgery. A healthcare provider can use BMI to determine how much weight a patient needs to lose.
In general, a weight loss goal of 5-10% of body weight is often recommended before surgery, as this has been shown to improve surgical outcomes. For example, if an individual weighs 200 pounds, a weight loss goal of 10-20 pounds may be recommended before surgery. The amount of weight loss necessary before surgery can only be determined by your bariatric surgeon based on your health, weight, and bariatric procedure. Some patients are required to lose 10 percent of their weight before weight-loss surgery is performed. For other patients, losing just 15 to 20 pounds right before surgery is enough to reduce the risk of complications.
The Pre-Surgery Diet Plan
The pre-surgery diet is vital for bariatric surgery success because it shrinks the liver, lowers surgical risks, kickstarts weight loss, and mentally prepares patients for life after surgery.
Initial Consultation and Behavior Modification
As soon as you’ve made the decision to have surgery, you should start modifying your behavior. Honestly, 90% of the success a patient achieves depends on behavior modification. The first step in healthier eating is cutting down to appropriate portion sizes and following the “MyPlate” concept. Under this formula, each plate of food is 30% non-starchy vegetables, 25% protein, 25% whole grains and 20% fruit. Another key during this phase is the importance of ingraining physical activity into your daily routine.
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About three months before surgery, you’ll begin changing your diet in consultation with a dietitian and start losing weight. The better you do in this stage, the better your chances of success after surgery. As soon as you’ve made the decision to have surgery, you should start modifying your behavior. Honestly, 90% of the success a patient achieves depends on behavior modification.
Three-Month Dietary Changes
About three months before surgery, you’ll begin changing your diet in consultation with a dietitian and start losing weight. The better you do in this stage, the better your chances of success after surgery. As soon as you’ve made the decision to have surgery, you should start modifying your behavior. Honestly, 90% of the success a patient achieves depends on behavior modification. The first step in healthier eating is cutting down to appropriate portion sizes and following the "MyPlate" concept. Under this formula, each plate of food is 30% non-starchy vegetables, 25% protein, 25% whole grains and 20% fruit. Another key during this phase is the importance of ingraining physical activity into your daily routine.
The 2-Week Liquid Diet
Two weeks before your surgery, you will be prescribed a strict low calorie, low carbohydrate liquid diet. It is important to follow this diet because it has been shown to reduce liver size, which allows for a faster and safer surgery. Four to five liquid meal replacements per day. The drinks must be made with products specially designed for bariatric patients, such as Bariatric Advantage.
All procedures require that you follow a liquid diet for at least two days after surgery. In the following weeks you will be prescribed a high protein diet of pureed foods, and then graduate onto a period of soft foods before resuming a normal diet. The exact timeline and nutrition guidelines will vary slightly among different procedures.
High-Protein Liquid Meal Plan
Two weeks before surgery. all surgical weight loss patients follow a Phase 2A meal plan. This high protein full liquid diet will allow you to lose body fat while preserving your muscle mass, which is the powerhouse of the body. The most important reason to following the liquid meal plan before surgery is weight loss. Weight loss before surgery will shrink the size of the liver. This allows for the surgeon to see the stomach better. Some studies of shown before surgery weight loss shortens OR times time as well. Weight loss before surgery reduces your risks of developing complications by lowering your BMI.
Read also: Weight Loss with Low-FODMAP
You should try to consume 60-80 grams of protein per day. Drink slowly or SIP, SIP, SIP. It should take you 30 minutes to drink up to 8 ounces of fluid; it is common to feel “full” after drinking only 4-6 ounces immediately after surgery. Avoid all carbonated fluids. Do not graze between meals.
Managing Hunger and Expanding Variety
Since you will not have a tool working for you, you may feel hunger. This is expected and normal. You will likely feel real physical hunger and also “head hunger.” Head hunger is the wanting to crunch or snack on certain types of foods. The reality is that your variety will be limited while following the high protein liquid plan. Your surgical weight loss dietitian has provided you with a list of acceptable liquid drinks. The variety is limited, but remember this is only for a short period of time.
Monitoring Compliance and Avoiding Overindulgence
The goal is to have weight loss. Following the liquid plan will guarantee a significant weight loss in a short period of time. It is NOT recommended to over indulge before surgery. High blood sugars the morning of surgery may result in a canceled surgery.
Nutritional Guidelines and Food Choices
Your body needs specific nutrients to heal, fight off infections, and rebuild tissues after surgery.
Emphasizing Protein Intake
Protein is like your body’s construction crew. After surgery, your body needs to repair tissues, and protein is essential for this process. Foods like chicken, fish, eggs, beans, and tofu are all great sources of protein. To be extra good, aim for lean proteins (i.e. skinless chicken, low-salt sausages). Lean proteins: Chicken, turkey, fish, tofu, beans, and legumes.
Importance of Healthy Fats, Vitamins, and Minerals
Surgery can be exhausting and your body will need extra energy to recover. Believe it or not, some fats are good for you! Vitamins and minerals can support your body’s healing process, so make sure you’re eating plenty of different fruits and vegetables. Vitamin C, found in citrus fruits, peppers and strawberries, helps with wound healing and boosts your immune system. Fruits and veggies: The more colourful, the better!
Hydration
Don’t forget about water! Staying well hydrated before surgery helps to keep your blood flowing and to ensure that your organs, muscles, and skin are in peak condition.
Foods to Avoid
This probably isn’t what you want to hear, but we’re afraid takeaways are off the menu in the lead-up to your surgery.
Sample Pre-Surgery Meal
Breakfast: Porridge oats topped with fresh berries. You could even add a handful of walnuts and a drizzle of honey if you’re feeling adventurous.
Supplements
If you struggle to get enough protein from food alone, you might want to consider a protein supplement. There is also evidence to show that taking a vitamin D supplement has benefits before surgery.
Importance of Gut Health
Your digestive system is often overlooked, but it plays a big role in recovery. Eating fibre-rich foods like vegetables, whole grains, and legumes helps keep your gut healthy and can prevent post-surgery constipation. This is a common issue after anaesthesia.
Safe Weight Loss Strategies
If your surgeon has recommended losing some weight before surgery, it’s because even a modest amount of weight loss can make a big difference in how well you recover. Carrying extra weight can increase the risk of complications during and after surgery. To lose weight safely before surgery, try to focus on a balanced diet. Control portion sizes, avoid sugary and processed foods, and stay hydrated with plenty of water.
Fasting Guidelines Before Surgery
In addition to dietary focus before surgery, there’s another important aspect of pre-surgery preparation to consider: fasting. When you undergo anaesthesia, your body’s natural reflexes are suppressed. These include the reflex that prevents food or liquid from coming back up from your stomach and entering your lungs. This can lead to a serious complication called aspiration, which occurs when food or liquids enter your lungs. Sticking to the fasting guidelines is critical. If you accidentally eat or drink something past the cut-off time, you’ll need to inform your surgical team right away.
Your healthcare team will provide you with specific instructions based on the type of surgery and anaesthesia you receive.
General Fasting Guidelines
- Usually, you will be asked to stop eating solid foods 8 hours before surgery. This includes any heavy or solid meals, snacks or even chewing gum.
- Most guidelines allow you to drink clear fluids (such as water, black coffee, or tea without milk) up until 2 hours before your surgery. Clear liquids leave your stomach more quickly and are less risky in terms of aspiration.
- Avoid milk and any dairy products like yogurt or smoothies in the 6-8 hours before surgery.
- Avoid alcohol for at least 24 hours before surgery. Ideally though, you should try to cut back or stop drinking completely in the 3-5 days leading up to your procedure.
Prepping Your Body Nutritionally
Ideally, you want to start prepping your body nutritionally as soon as you know about your surgery. Two to four weeks before your surgery is a great window to focus on improving your diet. By fuelling your body with the right foods, you can give yourself the best chance for a speedy recovery. You’re also more likely to experience fewer complications when on the other side of your surgery. Don’t use certain over-the-counter medications and prescription medications.
Very-Low-Calorie Diets (VLCDs) and Low-Calorie Diets (LCDs)
VLCDs are designed to promote rapid weight loss by creating a significant calorie deficit. These diets often involve replacing meals with low-calorie shakes, soups, or bars, and may also include some whole foods. VLCDs are typically recommended for individuals who are severely obese or have significant weight-related health problems, such as type 2 diabetes or high blood pressure. They are typically used for short periods of time, ranging from a few weeks to a few months, and are supervised by a healthcare provider.
While VLCDs can be effective for rapid weight loss, they are also associated with some potential risks and drawbacks. Some of these risks include nutrient deficiencies, gallstones, and dehydration.
Most VLCDs use meal replacements, such as formulas, soups, shakes, and bars instead of regular meals. This helps ensure that you get all of the nutrients you need each day. A VLCD is only recommended for adults who have obesity and need to lose weight for health reasons. These diets are often used before weight-loss surgery. You should only use a VLCD with the help of your provider. Most experts do not recommend using a VLCD for more than 12 weeks.
These diets usually allow about 1,200 to 1,500 calories a day for women and 1,500 to 1,800 calories a day for men. An LCD is a better choice than a VLCD for most people who want to lose weight quickly. But you should still be supervised by your provider. You will not lose weight as fast with an LCD, but you can lose just as much weight with a VLCD. An LCD may use a mix of meal replacements and regular food. This makes it easier to follow than a VLCD.
Alternative Diet Strategies
Time-Restricted Eating
This diet strategy is becoming more popular. It is often compared to fasting, but the two strategies are slightly different. Time-restricted eating limits the number of hours per day that you can eat. A popular strategy is the 16:8. For this diet, you have to eat all of your meals during an 8 hour period, for example, 10 am to 6 pm. The rest of the time you cannot eat anything. There are some studies that this method can cause rapid weight loss, but there is little information so far about whether the weight loss is sustained.
Fasting
Fasting is an ancient form of caloric restriction. It has become more popular recently. This is partly because some animal and human studies have shown benefits to fasting for people with diabetes and obesity. There are many different fasting regimens and it is unclear which may be the best. One of the most popular is the 5:2 system. This involves 2 days a week of fasting or VLCD and 5 days a week of eating your normal diet. Diets that incorporate fasting can cause rapid weight loss.
Importance of Professional Guidance
Consulting with a healthcare provider is an important step in any weight loss journey, especially before surgery. During a consultation, a healthcare provider may perform a physical exam, review medical history and medications, and discuss weight loss goals and expectations. The healthcare provider may also recommend specific dietary changes, such as reducing calorie intake or avoiding certain foods or food groups.
Additional Strategies for Weight Loss
Setting Realistic Goals
Motivation: Goals that are challenging but achievable can help you to stay motivated and focused on the weight loss journey. Avoiding frustration: Unrealistic goals can lead to frustration and disappointment, which can make it difficult to stay motivated and committed to the weight loss journey.
Monitoring Calorie Intake
Monitoring calorie intake is an important aspect of losing weight before surgery. When you consume more calories than you burn, the excess calories are stored as fat, leading to weight gain. Monitoring calorie intake involves tracking the number of calories consumed each day and comparing it to the recommended daily calorie intake. This can be done using a food journal or a calorie tracking app.
Track calorie intake accurately: Record all foods and beverages consumed, including portion sizes and ingredients. Be aware of hidden calories: Many foods and beverages contain hidden calories, such as added sugar, oils, or sauces.
Eating a Healthy Diet
Eating a healthy diet is an important part of losing weight before surgery. A healthy diet provides the body with the nutrients it needs while promoting weight loss through a calorie deficit. Eat plenty of fruits and vegetables: Fruits and vegetables are packed with vitamins, minerals, and fiber. Choose whole grains: Whole grains are a good source of fiber and other nutrients. Limit processed foods: Processed foods are often high in calories, unhealthy fats, and added sugars. Drink plenty of water: Drinking plenty of water can help to keep you hydrated and promote weight loss. Practice portion control: Portion control is important for weight loss.
Regular Exercise
Regular exercise is an important part of losing weight before surgery. Exercise can help to burn calories, build muscle, and improve overall health and well-being. Mix it up: Incorporate a variety of types of exercise, such as cardio, strength training, and flexibility exercises. Find activities you enjoy: Choose activities that you enjoy and are sustainable in the long term. Set goals: Set goals for your exercise routine, such as increasing the duration or intensity of your workouts. Be consistent: Consistency is key when it comes to exercise. Strength training: Strength training exercises can help to build muscle and increase metabolism. High-intensity interval training (HIIT): HIIT is a type of cardio exercise that involves short bursts of high-intensity exercise followed by periods of rest.
Staying Hydrated
Staying hydrated is an important part of losing weight before surgery. Drinking plenty of water can help to keep you feeling full and promote weight loss by increasing metabolism. Drink plenty of water: Drinking water is the best way to stay hydrated. Avoid sugary drinks: Sugary drinks, such as soda or sweetened coffee drinks, can add unnecessary calories and contribute to weight gain. Limit alcohol: Alcohol can be dehydrating and adds extra calories. Eat hydrating foods: Many fruits and vegetables have high water content, which can also help to keep you hydrated.
Potential Risks of Rapid Weight Loss
People who lose weight very quickly are much more likely to regain the weight over time than people who lose weight slowly through less drastic diet changes and physical activity. The weight loss is a bigger stress for the body, and the hormonal response to the weight loss is much stronger.
Losing more than 1 or 2 lb (0.5 to 1 kg) a week is not safe for most people. It can cause you to lose muscle, water, and bone density. Rapid weight loss can also cause some side effects including:
- Gallstones
- Gout
- Fatigue
- Constipation
- Diarrhea
- Nausea
People who lose weight quickly are also more likely to gain back the weight quickly. This can lead to other health problems.
Rapid Weight Loss Diets
Rapid weight loss diet is a type of diet in which you lose more than 2 pounds (lb) or 1 kilogram (kg) a week over several weeks. To lose weight this quickly you must eat very few calories. These diets are most often chosen by people with obesity who want to lose weight quickly. These diets are less commonly recommended by health care providers. People on these diets should be followed closely by their provider. Rapid weight loss may not be safe for some people to do on their own. These diets are only to be used for a short time and are usually not recommended for more than several weeks.
Rapid weight loss is more about cutting calories than exercising. Talk with your provider about what type of exercise you should do while you are on this type of diet. Your provider may suggest waiting until you are on a more long-term diet to start exercising.
Rapid weight loss diet is usually for people who have health problems because of obesity. For these people, losing a lot of weight quickly can help improve:
- Diabetes
- High cholesterol
- High blood pressure
You should only follow one of these diets with the help of your provider.