My surgeon says I do not need to go on a liquid diet because my bmi is 46. They said they start liquid diets when patients have bmi of 48 or higher but everyone I talk to says they have to do at least 2 weeks . I even called and they said it's not necessary. I'm confused why not !

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My doctor requires a 1 week liquid diet for those under 50BMI. 50 and above have to do 2 weeks prior to surgery.

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Every surgeon is different. The point of the pre-op diet is to shrink the liver. If your surgeon feels confident and comfortable performing the surgery without shrinking the liver to make it easier to keep out of the way, then that's his prerogative. Maybe, over the years, he has found that people within your BMI range don't really need to shrink their livers at all for him to have the room he needs to operate?

Mine is 42 but I still have to do the 2 weeks ????

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As @@JamieLogical said, every surgeon is different. Until there is clear and convincing evidence from multiple studies that there is a "right way" to do something, doctors tend to rely on a combination of their training and personal experience with patients to decide what the protocols will be. Having worked in a teaching hospital, I will say the things doctors tend to be obsessive about are the things they personally encountered that were totally messed up with a patient in their internship/residencies and made an impression. LOL. The doc that saw the one in a thousand odd side effect or adverse reaction for a treatment or medication as an intern will forever stress about that treatment/medication.

We see it in all areas of medicine. I had to have a knee reconstructed, and given my penchant for medical research, I went into the orthopedist's office with a number of detailed questions - the primary one being which major rehabilitation plan did he model his from (there were two major schools of thought about rehab from those who originated the surgery in Norway). I freaked him out a little. LOL.

My surgeon doesn't do an extensive pre-op diet unless she sees signs of liver enlargement. She asked me to do a "modified liquid fast" for 2 weeks - 2-3 Protein shakes during the day, with fruit and a couple of other kinds of healthy Snacks approved, and a "sensible" meal for one meal of the day. But there was no strict requirements for it, no calorie/fat/carb limits or anything. Then, of course, the standard nothing by mouth the night before surgery.

I agree it's weird I asked my surgeon and he said no to me too

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But I think I might just do it myself so my body gets used to it

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