So I'm new here, and I'm less than two weeks away from my surgery, which is on the 18th. I'm getting Sleeved at Hospital Angeles in Tijuana. The pre-op diet they sent me seems kind of contradictory and I just want to know WHY these pre-op diets have to be liquids in particular. I've been low-carbing for a few months now and I've lost about 25lbs. I have a private WLS counselor who has had me eliminate almost all carbs from my diet. Here's the diet the hospital sent me:

1. There are *NO CALORIE* LIMITATIONS on the LIVER-SHRINKING diet. You may eat/drink as much as you wish of the allowed things to feel satisfied, although we suggest reasonable limits to assist your weight loss.

2. No solid foods at all for the period of time when you are on the liver-shrinking diet.

3. A maximum of 40-50 grams of carbohydrates (carbs) a day.

4. You may have as many high-protein/low carb Protein drinks a day as you wish. No limit!

5. You may add low-carb Protein Bars up to the max of 40-50 grams of carbs a day.

6. You may have any type, brand, and quantity of Protein Drinks and protein bars that you wish, as long as you read the labels carefully so you are getting a MAX of 40-50 grams of NET carbs a day.

7. Count only the *NET CARBS* that are on the label, not the “total” carbs. Please eat and drink NOTHING that is not clearly labeled as to net carb content. With some products, the “Net Carbs” are called “Impact Carbs” or “Effective Carbs”.

8. You may have as much Water, Crystal Light, herbal or regular teas, or coffee as you wish – but please remember, NO sugar, and NO milk/creamer with high carbs. You must count any carbs here in your daily total of 40-50 grams maximum.

9. Your local GNC or other nutrition store will have a variety of drinks and bars to try. We suggest getting one each of several kinds to try before you buy a larger quantity, so you can find some you really like. Don’t buy huge quantities, as protein bars and drinks are not useful or suggested after you are back on real foods after surgery.

We feel that the Atkins ADVANTAGE and ENDULGE bars are excellent, with about 3-4 grams of Net Carbs per bar, but there are several other brands that are fine.

11. If you find that you simply CANNOT get through this without some “real” food, *PLEASE eat *only* solid protein!* Choose only a piece of chicken, a lean steak, a hard-boiled egg, or some low-fat cheese.

PLEASE: *_NO mayo, BBQ sauce, ketchup, sweets, junk food, cereals, or anything else._* Even the smallest amount of non-protein, carb-laden food can take you out of ketosis and easily negate many day’s worth of the low carbs that are so greatly decreasing your surgical risk.

12. Watch out for things that you would normally not consider food! You must also have NONE of the following things that are full of sugar: chewing gum with sugar or carb sweetener · breath mints · cough syrup · hard candy and cough drops.

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So I guess my question is it okay to just keep on going the way I have been, with fried tofu, homemade chicken Soup, SF candy, diet soda, cheese, burgers and pork skins? The diet mentions nothing about limiting fats or calories, just carbs and ketosis, which sounds like Atkins. So instead of wanting me to just chug Protein shakes (which I've got as well), why can I just keep eating regular Atkins-okay foods, so long as I keep my carbs under 40 a day?

Sorry I got lost with the you can have as many Protein drinks a day and then it stating that you can only have a maximum of 40 - 50 carbs with the protein drinks. Then saying NO solid food allowed yet you can have protein bars and if you must chicken, steak, hard boiled egg... Plus there is no calorie limitations but how would you be able to have increased calories if you are not eating solids? When I was on my liquid diet post op I was trying to find ways to increase my calories to 500.

My pre op diet was lean Proteins min 60 gms and reduced carb to 40 gms for one week. Avoid sugar and increase Water to min 64 oz. I had no problem following mine. I think you might want to get some clarification from your doctor on the diet.

My pre-op diet sounds like yours just with not so much detail. I was able to drink 3 to 4 protein drinks per day, one control bar for hunger and a piece of baked/grilled chicken if I needed it at dinner. I think you just need to break it down like that and simplify it. I could drink as much as I wanted from the list of liquids you listed above. I don't think that continuing on your Atkins regimen would be the same, there is significantly less fat in the pre-op liquid diet.

Liquids help make sure you do not get dehydrated prior to surgery and also get you ready for doing all liquids for a time after your surgery. You are going to Hospital Angeles, so I assume you are going to Dr. Kelly. I basically did liquids only, protein shakes, clear liquids, juices, water, sugar free jello and green smoothies for more energy. The last three days I did only clear liquids. My BMI was 43 pre surgery. After the first 5 days of all liquids, I was not hungry anymore and had to force myself to 'drink' to make sure I was well hydrated. The first days are killers, the rest is fairly smooth and you will be in good stead for your surgery. The part about meat and protein bars is for those who absolutely cannot go without eating something solid and are having fits of hunger, then they want your choice to at least be something that has protein and some energy type stuff in it (like protein bars). If you can do without, I would do that. Dr. Kelly said my liver was in excellent shape and he could tell I had been doing the diet. (and I have a diagnosed fatty liver, haven't had my levels checked since I got out but they were good in the hospital testing). I also dropped 12 pounds prior to surgery. Good luck!!