Hi. I wanted to write in to get some advice regarding the (first) meeting with my surgeon.

Some background about 16 months ago due to a knee problem I started swimming daily and eating better; lost 30 pounds. Five months ago out of nowhere I had a blood clot which caused stroke like symptoms. The treatment for the clot is going well but requires taking blood thinners. Hopefully my March tests will indicate that I can go off the blood thinners. Lost 5 pounds before attending screening session.

Nurse practitioner said the doctor might put me on a liquid diet once I met with him. In the six weeks since that meeting I have lost 12 ponds. I had a great meeting with the surgeon and asked lots of questions. At the end I asked whether he would be putting me a liquid diet. He said that from feeling my abdomen that he could do the surgery today without a liver shrinking diet. However, to reach a lower goal weight he recommended I jump start weight loss by doing a specialized 500 calorie liquid diet. The hospital sells the shakes at their pharmacy though you don’t need a prescription to take them.

At this point I do not have a surgery date. The doctor said he may be booked until April. I had an appointment with the nutritionist and she said this particular doctor likes this liquid diet. She is not a huge fan. The liquid diet consists of 5, 100 calorie shakes. The Nut said she sometimes has someone do 2 shakes and one sensible meal for two weeks before the surgery. The Nut said she would tell the doctor we were holding off on the liquid diet at least until I meet with the NP in March.

One thing I did not like about this brand of shake is that the Protein level was low (10 grams) versus the higher levels of Whey Protein Powder.

Given the facts what would you do? Start liquids today, wait until you had a surgery date, do two weeks before surgery? If I stop loosing weight I might change my mind; but for now doing a liquid diet for 2-3 months just seems excessive.

Well, this is what I did. I thought it was tough but managable - plus definitely worth it afterwards.

3 x AES advantage shakes (at 130 calories each)

1 x lean cuisine meal (less than 300 calories)

So, I did 690 calories a day for 5 days before surgery, and lost 8 pounds! :-)

Though it was hard, I kept on telling myself "this is the LAST time I will ever be hungry again - so it's so worth it" and boy was I right! :-)

I actually felt a great sense of accomplishment from doing it and after the surgery felt much more inclines to keep up the good work.

Best of luck on your journey!

The hospital sells the shakes at their pharmacy though you don’t need a prescription to take them.

This is off-putting to me. You can get good-quality Protein shakes in myriad places; I am always put off when a doctor suggests purchasing on-site. Then, the motivation is not health (as is indicated by the lower protein content), but profit.

If my liver were appropriate in size, I would not do an optional liquid diet at all. You've lost a substantial amount already---your loss does not require jump-starting, IMO.

ETA: My surgeon recommends the 2-shake, 1 protein/veg meal a day for 2 weeks prior to surgery; that was livable and sensible--and I was happy to comply. But an optional, possible months-long (what doctor doesn't know how far out he's booked? It sounded almost like he was coercing you...) liquid diet? I would have walked out the door. Losing weight IS the aim of the whole thing---but it doesn't all need to be accomplished preoperatively!

Edited February 9, 201016 yr by BetsyB

Thanks for the replys so far. I must say that the doctor did suggest I look on line as the program may be cheaper. Based on this comment I can't fairly say he was putting me on a diet that the hospital would profit from.

I am thinking perhaps once a week until my next appointment with the Nurse Practitioner I will do 2 Protein shakes with a protein heavy WW or lean cuisine for dinner. That would be four days over the next month.

As I am currently unemployeed I am not having to get up and go to work everyday (though my profession is a desk job). As mentioned in my first post I do exercise daily. My biggest concern about the 500 calorie diet is that I would not be able to function as I currently do. I do an hour of continuous swimming (I'm not Mark Spitz or Jenny Thompson but I am moving constantly:w00t:). The Excercise Calorie Burning sites on line say on average that I burn 900 in that hour. Even if they are off by 50% the doctors diet would barely cover the calories I burn excercising. I would be concerned that I would not just be burning stored fat to metabolicly (sp) run my body but lean tissue/muscle.

If your Protein intake is adequate, I think you have less cause for concern regarding exercise and losing lean muscle tissue.

That's why I'd want a Protein shake that had LOTS more protein bang for the buck!

Your body will burn stored fat for energy if its protein needs are met.

I really like Inspire Protein drinks from Bariatric Eating. They are low carb, and have ~30 grams of protein per serving.

But there are lots of higher-protein alternatives to what your doctor is recommending.

(And I agree: if they're offering them in the pharmacy as a convenience, but you're encouraged to shop around, it's probably not a situation in which the doctor is looking to make a buck; OTOH, it may be one that indicates that--while he's brilliant at surgery, he's not a good dietitian :cursing:)

My surgery is 3/10. When I had my initial meeting with the surgeron's PA I was told that a "MediFast" diet was required 2 weeks prior to surgery. Four shakes plus 5oz protein and 1 & 1/2 cups veg. My starting weight at the first appt - 279. My pre-surgery goal weight - 252. I was 263 on 1/29 when I had to meet with the "MediFast Nurse" - six weeks prior to surgery. They wanted me to start the MediFast diet then - to lose 11 pounds?! I have had an indirect calorimeter done at my local hospital which indicated I need about 1900 cal to maintain my weight; about 1200-1500 to lose about 2 pounds a week. A week in to this diet I had severe allergic reactions so I called the nurse. She tells me that I can use Slimfast or other low-carb/high protein shake mixes, "that's what the people who can't afford MediFast use"?! and that this diet phase it like Adkins - 70+grams of protein a day and less than 65 carbs being the goal. Incidentally my actual CT's are being done next week - so my liver has yet to be examined in any way. I'm ravenous and ready to call my doc for an rx for an appetite supressor! :thumbup: