What Is a Liver Shrinking Diet?
Before a patient can have bariatric surgery, they are required to go on a special diet for a few weeks. They call it pre-operative diet, the liver shrinking diet, and it is probably not like any other diet you have ever been on.
Normally, the bariatric weight loss center will provide the details of the diet and possibly, even menus with a detailed diet plan. The diet will vary by patient but the goal is the same: to lose weight and shrink the liver size before the surgery by significantly reducing caloric and carbohydrate intake.
Why Would I Want to Follow a Liver Reduction Diet?
Patients who suffer from obesity normally have unhealthy eating habits that are high in fat, salt, and sugar, which is why they also tend to have enlarged livers. Most people would guess that alcoholism was the leading cause of fatty liver disease, but obesity is the #1 cause.
The primary reason that patients must follow a liver reduction diet before surgery is to ensure the surgery is safe and successful. During surgery, the patient is lying down causing the liver’s location to be directly on top of the stomach. The surgeon is going to need access to the stomach, and an enlarged liver can get in the way and make it very hard for the surgeon.
The liver needs to be moved to the side in a safe way to avoid complications. The pre-surgery diet is designed to shrink the liver down to a manageable size making it easier for the surgeon and ensuring the patient’s safety.
How Long Do I Have to Follow a Liver Shrinking Diet?
The duration of the liver shrinking diet will be determined by the bariatric surgeon performing your procedure. Many surgeons base the duration of the diet on the patient’s starting BMI.
Liver Reduction Diet Timeline Chart
| Patient’s Starting BMI | Diet Duration |
|---|---|
| 35-39.9 | 1 Week |
| 40-49.9 | 2 Weeks |
| 50-59.9 | 3 Weeks |
BMI CALCULATORHow Much Weight Can I Lose on a Liver Shrinking Diet?
Patient results will vary but most patients lose between 5 to15 pounds on the pre-bariatric surgery liver shrinking diet.
What Happens if I Cheat on My Liver Shrinking Diet?
If you cheat on your liver shrinking diet and your liver does not reduce an adequate amount, you may be risking your own safety or the surgeon may reschedule the surgery. The surgeon will know right away at the start of surgery if you have followed your liver shrinking diet or not.
If they feel the liver is going to hinder the procedure or the patient’s safety, they will not perform the surgery. It would be a shame to get that far, be put under anesthesia just to wake up and find out you have to reschedule and do this all over again at a later time.
How Does the Liver Shrinking Diet Work?
Glycogen is a form of energy that is derived from the carbohydrates that we eat and it is stored in the liver and muscles. The more carbs we eat, the more glycogen is stored, but it is not stored alone.
Glycogen and water are stored together and every gram of glycogen grabs 3 grams of water to store with it. This leads to the enlargement of the liver. The more carbs consumed, the bigger the liver can be.
The liver shrinking diet is created to be high in protein and low in fat and carbs, so your body does not produce more glycogen and actually forces your body to pull it out of storage. The glycogen and water reduction causes the liver to shrink. For patients with higher BMIs, the liver will normally take longer to shrink.
How Can I Tell if My Liver is Shrinking?
Short of a CT scan, you would not be able to tell if your liver has decreased in size. If you are following the liver-shrinking diet that your surgeon provided to you and you are losing weight, this is an indication that the diet is working and your liver is shrinking.
What Can I Eat during the Liver Shrinking Diet?
The diet patients have to follow to shrink their liver before bariatric surgery is a low fat, low carbohydrate, high protein diet that is normally restricted to between 800-1,200 calories. Your bariatric surgeon will provide you with a specific format to follow and a list of approved foods.
There are usually two different plans offered to patients, the first consisting mainly of protein shakes with one solid meal each day. This plan is harder but yields more weight loss. This plan may work for you if you are super busy and do not wish to cook or prepare food.
The other plan is more diverse but requires preparation. Some patients prefer to alter days between plans. If you are diabetic there will be added instructions, and it is important that you carefully follow them. Here is a sample of what your diet might look like:
Sample Liver Shrinking Diet Menu Plan for a Day
| Food Intake | Menu |
|---|---|
| Breakfast | Avocado toast made with: 1 egg 1 slice light whole wheat toast span avocado |
| Snack | Protein shake, read below. |
| Lunch | 3 oz baked chicken 1 cup green salad 2 tablespoons light salad dressing |
| Snack | 1 oz light cheese like string cheese |
| Dinner | 3 oz baked fish with lemon 1/2 cup mixed whole berries 1/2 cup steamed broccoli |
| Snack | Protein shake |
In between meals drink water and other beverages that are on the approved list to equal at least 64 oz a day.
Liver Shrinking Diet Protein Shake Criteria
Your bariatric clinic will often provide you with a list of “ready-made” protein shakes or powders that meet their criteria but the universal standards are as follows:
- No more than 200 calories;
- Contains between 20-25 grams of protein;
- 15 grams or less of carbohydrates;
- 5 grams or less of sugar;
- < 10% of the daily recommended amount of total fat;
- Powdered supplements can be mixed with unsweetened almond milk, unsweetened soy milk, 1% milk, or water;
- Do not add in extras, fruit or avocado, etc.
Sample Food Categories and Recommended Serving Sizes
- Lean protein baked, broiled, or grilled – nothing fried or breaded. About 3-4 oz of
- Fish/shellfish, salmon, tuna, crab, halibut, trout, tilapia, bass, etc. perch, etc.;
- Chicken or turkey breast (skinless) 90% lean ground turkey;
- Lean beef: loin, round, at least 90% lean ground beef;
- Lean pork: tenderloin;
- Eggs hard-boiled, soft-boiled, scrambled, poached, etc.
- Vegetables – most diets count 1/2 cup of vegetables, low carb, or 2 cups salad greens as 1 serving.
- Fruits are fairly high in carbs and consumed in limited amounts on this diet ½ cup total daily.
- Dairy milk and cheese – 6 oz of skim or low-fat light Greek yogurt, 1 oz low-fat cheese, 1 cup skim or low-fat cottage cheese.
- Beverages – water, fruit-infused water, i.e. water with a slice of citrus fruit. Also, drinks like Crystal Light, Mio, Fruit2O, Propel Zero are also approved. Usually, you are not allowed to have caffeine or anything carbonated while on a liver reduction diet.
Can You Drink Coffee on the Liver Shrinking Diet?
Yes, you can have black coffee, usually decaffeinated. If you like a little coffee with your creamer, you may want to just skip the coffee during the liver-reducing diet.
Regardless of the exact diet plan provided by your bariatric surgeon, it is important for your safety and the success of your surgery that you strictly follow it. This is the first step toward your new “normal” as you embark on your weight loss journey.
You are beginning a new lifestyle and you need to be 100% committed to all the dietary changes it entails. This is not an easy journey but it will be worth it because you, your health, and your quality of life are worth it!
If you would like more information about bariatric weight loss procedure options or would like to learn more about the liver shrinking diet, please call us today! During a consultation, we can answer any questions you may have and give you information regarding all the different programs we have to offer. Here, at the IBI Healthcare Institute, we are committed to you and your health.
