The Importance of the Pre-op Diet

The pre-op surgical diet that we have to do before bariatric surgery is, I think, one of the most unifying things in the bariatric surgery process. No matter what surgery you are having gastric bypass, gastric sleeve or duoduenal switch you have to do the pre-op diet. In New Zealand the typical pre-op diet is Optifast shakes and as many green, non starchy vegetables as you like.

I had to do the pre-op diet for two weeks which seems to be the minimum but I have heard of some people having to do it for longer. A couple of people I know have had to do it two or three times over because of their surgery date getting moved for whatever reason. Basically whatever happens you need to do the pre-op diet for a couple of weeks before your surgery date.

The main reason it has to be done is to help shrink your liver for surgery. By putting you on this diet the surgical team are trying to get as much fat as possible out of your liver because they have to move it during surgery and the smaller it is the less risk there is involved in moving it. Having a strictly calorie controlled, high in protein and low in fat and sugar diet does this very well and makes surgery safer.

For me the pre-op diet was the absolute hardest bit of this whole process. I was still hungry and honestly could have eaten my own arm off after a few days on the diet. It made me tired, cranky and I was hungry, so freaking hungry. There were two things that kept me on track with the diet my absolute desperation to have the surgery and the support of my husband.

I knew that if I strayed from the diet and didn’t shrink my liver enough there was a possibility that they could get in to do the surgery and not do it if my liver had not shrunk enough. I would not allow myself to get that close to having the surgery only for it to be taken away at the last hurdle. The rate I was losing weight on the pre-op diet was also quite motivating, when I could forget how hungry I was.

Day 11 of my 14 day pre-op diet is a day I will never forget. I lost the plot. Completely. I had a tantrum of epic proportions and if it wasn’t for my husband stopping me I would have gone and got something I shouldn’t have had and eaten it. For some reason I was particularly fixated on Doritos. It doesn’t make any sense because I usually didn’t like them that much.

My top five tips for getting through the pre-op diet without falling off the wagon are:

  1. Keep your eye on the prize. You have come so far you cannot let it slip from your reach now.
  2. Have an ultimate cheerleader on your side. You need someone who is going to keep your best interests in mind and not give in to you because you are having a tantrum.
  3. Count the days down. It’s an oldie but a goodie.
  4. Tell yourself you can do this and believe yourself when you say this. I know you can do it, I did so I absolutely know you can. The things you say to yourself and believe are going to by and large dictate your outcome so be your own biggest cheerleader.
  5. Get rid of anything you have a particular weakness for. Out of sight, out of mind. If you can’t easily get to something you really want it’s going to be so much harder for you to mess this up. Other people in the house may have to live without it for a couple of weeks but they will get over it.

If you’re struggling with Optifast I have a post about how to make it more palatable. The pre-op diet is a very crucial part of the process. You need to follow the guidelines from your surgical team to get your body as ready and primed for surgery as possible. How long did you have to do the pre-op diet for? Do you agree it with me that it was the worst part of the process or did you get through it okay? Comment below I’d love to know how you found it.

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There are 8 comments for this article
  1. Sarah at 9:29 pm

    Yes, totally agree – the pre-op diet was the hardest part for me too. I was hungry; I was nervous about what lay ahead, and worrying about how I would cope after surgery, and whether I was really making the right decision to have weight-loss surgery. Fortunately I only had 2 weeks on it, but it was over my birthday; and my husband was away too – so it wasn’t the best birthday. But fast-forward 3 months and I’ve lost heaps of weight, feel so much healthier, have so much more energy, and am eating normal food. I have no regrets at all about the surgery; and the pain of the pre-op diet is long forgotten.

    • Melissa Peaks Author at 9:56 pm

      Oh gosh that’s bad timing on your birthday but then look at the amazing present you have given yourself! It’s great to hear you are doing so well three months out. While there are hard things like the pre-op diet that you have to do as part of the process I wouldn’t trade any of it for the outcome I’ve had.

  2. Merrill at 6:52 am

    Hi Melissa, I am now day 11 of my pre-op diet with 10 days to go until my surgery, I am so pleased to have found your page, love your inspirational upbeat attitude. I am excited and nervous about what is ahead for me, I haven’t been slim since I was a teenager 30 years ago!!! I’m coping ok on the diet, keep busy to take my mind off wanting eat….. I’m finding if I vary the day with different optifast products it’s working for me. I’ve lost my first 3 kilos so the journey has begun…

  3. C at 10:18 pm

    Hi Melissa

    Really enjoy and find your blog valuable. I’m interested in the products (avalanche and fresh as) in your photo. What are these? Can they be incorporates into he pre op diet? I’m dying for a hot choc or any thing similar so this really caught my eye. 6 days to go!



    • Melissa Peaks Author at 6:34 am

      Hi C, I’m so glad to hear you’re finding my blog valuable 😀 The Avalanche is cocoa powder and the Fresh As are freeze dried things such as fruits and all sorts. I’m not entirely sure about incorporating them into your pre-op diet if the normal form of that kind of food is not on the allowed list then I wouldn’t. The best thing to do is ask your team what they think and if it’s okay. Good luck, those six days will hopefully go fast for you!

  4. Frances at 12:22 am

    Thank you so much for this. I am on day 3 of my optifast pre op diet. I have to lose 15kg before surgery so I don’t have a date. I’m so so hungry and tonight I had a little cry wondering if this is all worth it. I’m starving. Iv been having headaches, sweating day and night. I feel like I’m detoxing from drugs. My body is craving sugar and carbs, and takeaways. I know I can’t, but my gosh this is harder than when I have up smoking. I was a heavy smoker.
    How much weight did you lose in 2 weeks if you don’t mind me asking? I am 143.7kg starting weight, and female. Thank you

    • Melissa Peaks Author at 7:04 pm

      Day 3 is one of the hardest days! It’s absolutely worth it. Honestly, I’d do that all over again if I had to. I lost 7.5kg in the two weeks of pre-op Optifast but I had lost 8.5 in the few months before that. My starting weight was 132. You’ve got this, I promise you it’s so worth it.

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