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It may seem counterintuitive, but as soon as you have learned you are a candidate for bariatric surgery, you should use the downtime before surgery to lose some weight. Several excellent reasons exist, including lower surgical risk and preparing yourself for your postoperative lifestyle. These are essential considerations, and after a quick chat, most patients understand the need for reduced weight during surgery, so much so patients will undergo a 10-day preoperative liver shrink diet to facilitate weight loss and get them on track.
With that said, the answer to the question of how much weight you should lose is much more nuanced. Losing weight can be challenging, but this is a great time to ensure you are physically and mentally prepared for the road ahead. What does that mean? You will have diet and lifestyle change responsibilities after surgery, which are challenging to maintain. We like to say the real work starts after bariatric surgery. Any mental and physical advantage you have before the procedure will pay dividends later.
Typically, patients can lose significant weight during their two-week preop liver shrink diet if they follow their instructions and work hard. Nothing stops you from losing even more weight before that time, and we encourage it for the reasons stated above.
However, as with any weight loss, it is essential to remember to lose weight appropriately. As bariatric surgeons, we have seen thousands of patients and understand when they may pursue an unhealthy diet pattern, making them less likely to succeed after surgery. But a poor diet regimen does not necessarily mean overeating, it can also mean eating too little. Patients who overindulge in the days and weeks before their 10-day liver shrink diet may need more time to prepare psychologically for what is to come. Similarly, those who resort to extreme dieting and cut calories drastically may also need more time to prepare for the long-term consistent weight loss program they will have to follow to be successful.
The Bottom Line
Every person is different, and the amount of weight they lose before bariatric surgery differs. Some will lose a few pounds, while others will lose dozens. More importantly, from a long-term success standpoint, we want patients to understand that their weight loss needs to be measured, and their methods should not be extreme. This, more than the actual weight loss before surgery, is also predictive of success after their procedure.
