Wondering why?

[shelbys mom 70]

Im just curious why so many bariatric plans (diet) vary so much. The surgery is the same, so why do some doctors allow some things on ones diet plan and others don't .One Example: there was a huge debate over drinking alcohol. Im not seeing a standard across the board with these doctors like one would think there would be. I was told never to drink, but I read that one woman said her doctor said she could drink 3 month out. I just find this strange. Any thoughts.....

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[KristenLe 5,979]

It's about training, experience, beliefs, success, etc. Our Program has "standards" they give to all patients. Some of the nutritionist are more "strict" in their beliefs than others but the "plan" we are given is approved by the Program Directors. Same as not all surgeon's believe the pre-op diet is necessary and there are so many versions. It's all about how they were trained/educated, research and what they have had success with. Some are more strict. They have to go by "Standards of Care" which are usually approved by a Medical Director (and go by studies or latest suggestions by the ASMBS.) It's to cover their asses basically.

[JJCool 104]

I believe our surgeons and bariatric teams also tend to cater the programs to their patient. My pre-op meetings with the surgeon, dietician and nurse helped them to understand enough about me, my eating/drinking habits and attitude towards food to build a program for me that would help make this surgery as successful as possible. Provided I follow it, THAT bit is up to me.

And this is why I have to keep stoping from comparing myself to others - we are all on our own path.

Jo x

[WLSResources/ClothingExch 3,444]

With some, it seems a matter of medical interpretation, for lack of a better term, and personality. Some are by nature on the conservative side while others are less so. One hopes that in laying down the law or easing up on it, they consider whether a patient has particular health concerns. I also suspect that the more conservative are that way because they think the patient will go wild if not given limitations; they don't want to leave room for such a patient to blame them for failure to lose or worse. It's called "CYA," isn't it? That same surgeon may also judge another patient to have sound judgment from the start and, therefore, be less rigid in advising.

Edited August 14, 2016 by WLSResources/ClothingExch

[LxA 72]

I agree some of it is confusing. I am doing Clear liquids for 10 days (so so sick of broth), so only SF Gelatin, SF popsicles, broth and Water. I'm amazed that other people are drinking Protein drinks, Decaf coffee or eating eggs 3 days out.

I believe my surgical facility is more strict than others though.

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[gina171 626]

I agree some of it is confusing. I am doing Clear Liquids for 10 days (so so sick of broth), so only SF Gelatin, SF popsicles, broth and Water. I'm amazed that other people are drinking Protein drinks, Decaf coffee or eating eggs 3 days out.

I believe my surgical facility is more strict than others though.

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10 days on CLEAR liquids? ? Wow, that's not strict, that's Draconian!

YOU are a rock star if you can make it through that.....that's essentially NO nutrition for 10 days? Are you feeling ok?

I'm weak and tired on just Protein shakes. Now I feel like a wimp!!!!

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[LxA 72]

I agree some of it is confusing. I am doing clear liquids for 10 days (so so sick of broth), so only SF Gelatin, SF popsicles, broth and Water. I'm amazed that other people are drinking Protein drinks, Decaf coffee or eating eggs 3 days out.

I believe my surgical facility is more strict than others though.

Sent from my SAMSUNG-SM-G900AZ using the BariatricPal App

10 days on CLEAR liquids?? Wow, that's not strict, that's Draconian!

YOU are a rock star if you can make it through that.....that's essentially NO nutrition for 10 days? Are you feeling ok?

I'm weak and tired on just Protein shakes. Now I feel like a wimp!!!!

Sent from my iPhone using the BariatricPal App

It's rough. I have learned to hate the smell of broth and today was the first day that I feel fatigued and tired. It seems like almost everybody else is allowed Protein Shakes 3 days post op, so I may "cheat" with those soon.

I agree some of it is confusing. I am doing clear liquids for 10 days (so so sick of broth), so only SF Gelatin, SF popsicles, broth and Water. I'm amazed that other people are drinking Protein Drinks, decaf coffee or eating eggs 3 days out.

I believe my surgical facility is more strict than others though.

Sent from my SAMSUNG-SM-G900AZ using the BariatricPal App

Sent from my SAMSUNG-SM-G900AZ using the BariatricPal App

[Inner Surfer Girl 12,015]

I agree some of it is confusing. I am doing clear liquids for 10 days (so so sick of broth), so only SF Gelatin, SF popsicles, broth and Water. I'm amazed that other people are drinking Protein drinks, Decaf coffee or eating eggs 3 days out.

I believe my surgical facility is more strict than others though.

Sent from my SAMSUNG-SM-G900AZ using the BariatricPal App

10 days on CLEAR liquids?? Wow, that's not strict, that's Draconian!

YOU are a rock star if you can make it through that.....that's essentially NO nutrition for 10 days? Are you feeling ok?

I'm weak and tired on just Protein shakes. Now I feel like a wimp!!!!

Sent from my iPhone using the BariatricPal App

It's rough. I have learned to hate the smell of broth and today was the first day that I feel fatigued and tired. It seems like almost everybody else is allowed Protein Shakes 3 days post op, so I may "cheat" with those soon.

I agree some of it is confusing. I am doing clear liquids for 10 days (so so sick of broth), so only SF Gelatin, SF popsicles, broth and Water. I'm amazed that other people are drinking Protein Drinks, decaf coffee or eating eggs 3 days out.

I believe my surgical facility is more strict than others though.

Sent from my SAMSUNG-SM-G900AZ using the BariatricPal App

Sent from my SAMSUNG-SM-G900AZ using the BariatricPal App

You definitely need protein. Bone Broth has more protein than some of the other commercially available broths.

You can also get clear protein supplements like Isopure, ProtiDiet liquid beverage concentrates. Personally, I would consider some of the Syntrax Nectars clear.

Protein is critical for healing and weight loss. Even if you are restricted to clear liquids it is really important that you get enough protein.

[ella37 455]

i found this odd too. a lot of people, esp with BMI under 40, didn't have to do the liquid diet before surgery but had an alternative low fat diet. my dr says i need one with BMI 37.

most oddly he said that he doesn't make low BMI sleeve patients quit smoking, which i thought was CRAZY, every other doc ive spoken to made a big deal about it. he said if it was bypass i would have to quit for 3 months but with sleeve i should just try to quit. im still totally determined to before surgery because it seems a bit stupid to spend all this $$ to get healthy and keep smoking and i want to lower my risk for post op problems.

weird, i guess they just all have different ways!

[Inner Surfer Girl 12,015]

i found this odd too. a lot of people, esp with BMI under 40, didn't have to do the liquid diet before surgery but had an alternative low fat diet. my dr says i need one with BMI 37.

most oddly he said that he doesn't make low BMI sleeve patients quit smoking, which i thought was CRAZY, every other doc ive spoken to made a big deal about it. he said if it was bypass i would have to quit for 3 months but with sleeve i should just try to quit. im still totally determined to before surgery because it seems a bit stupid to spend all this $$ to get healthy and keep smoking and i want to lower my risk for post op problems.

weird, i guess they just all have different ways!

Definitely quit smoking.

Nicotine can seriously inhibit healing and can wreck havoc on your digestive track. Not to mention that smoking is not healthy for you or the people around you.

Congratulations for choosing to become healthy.

[OutsideMatchInside 10,166]

This a complicated question, the short answer is what @@KristenLe said, it varies based on training and experience what the team recommends.

I am just going to speak on my situation. My post-op book has all kinds of food options, a lot of them carby and a lot crappy. The thing is several doctors work within this program and do all different kind of surgeries. Even though my book told me I could have xyz, my doctor told me on an individual level if I want to be successful to avoid these things.

I was told I could have alcohol 3 months, but I didn't drink before surgery so I still don't drink on a regular basis. I will have a couple tiny sips of wine with a meal, because I'm not a savage and I do enjoy a complimentary wine with a quality meal, but that is more about taste and less about alcohol. So a couple tastes are fine. I doubt in the past year I have had enough alcohol to even equal one drink. Mentally I know alcohol is empty calories. Drinking alcohol does not align with my long term weight loss goals. So I avoid it.

I think programs try to make the books middle of the road so people feel like surgery is viable. If they made them as restrictive as they should be most people wouldn't opt for surgery even if it could save their life. People are addicted to food, and addicted to processed foods. Telling people moderation is easier than telling them abstinence.

[magoosmom 115]

Ours had a standard plan for each patient but it's definitely different from the ones I have seen here. In some ways, it was more lenient, especially pre-op. We had low carb for ten days, followed by three days of liquids, and one clear.

But in other ways it's more strict. I am not supposed to have beef or pork until 2 months out. No idea why but I know many of you can have it. My coworker who had it at the same clinic was given the go ahead to drink at 6 weeks. I didn't ask and she didn't say (not tempted and not missing it). But I can't take ibuprofen until three months out and there are a few other things that will still be restricted even after most foods are ok.

Overall I trust my plan. I don't think anything was advanced too soon. Sometimes I will start a little early on adding a food if it's close to the date to start anyway and I am feeling good. Haven't had a problem that way.

I figure each plan is the nutritionist's and doctor's opinions on how to best do it and that's going to vary based on each clinic.

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[ShelterDog64 2,364]

It's about training, experience, beliefs, success, etc. Our Program has "standards" they give to all patients. Some of the nutritionist are more "strict" in their beliefs than others but the "plan" we are given is approved by the Program Directors. Same as not all surgeon's believe the pre-op diet is necessary and there are so many versions. It's all about how they were trained/educated, research and what they have had success with. Some are more strict. They have to go by "Standards of Care" which are usually approved by a Medical Director (and go by studies or latest suggestions by the ASMBS.) It's to cover their asses basically.

While there is a cya aspect to any standard of practice, there are reasons 'standards of care' are developed and most of those are related to patient safety and morbidity/mortality outcomes. It's all rolled into one ball.

[ShelterDog64 2,364]

@@magoosmom My program does no pre-op diet for someone at my BMI (which was 40.5 at surgery), and only 1 week of Clear Liquids. I had read so much about liver shrinking and so forth that I was prepared for the diet, but when I had my appt with my surgeon a week before my procedure, he said he's found it to be unnecessary. I was relieved, and I completely trust him so I wasn't concerned about not doing a diet. But seeing the variations in programs since I joined BP has been fascinating, as has seeing how some things that were universal 'musts' even a couple of years ago have been relaxed or revised.

[shelbys mom 70]

This a complicated question, the short answer is what @@KristenLe said, it varies based on training and experience what the team recommends.

I am just going to speak on my situation. My post-op book has all kinds of food options, a lot of them carby and a lot crappy. The thing is several doctors work within this program and do all different kind of surgeries. Even though my book told me I could have xyz, my doctor told me on an individual level if I want to be successful to avoid these things.

I was told I could have alcohol 3 months, but I didn't drink before surgery so I still don't drink on a regular basis. I will have a couple tiny sips of wine with a meal, because I'm not a savage and I do enjoy a complimentary wine with a quality meal, but that is more about taste and less about alcohol. So a couple tastes are fine. I doubt in the past year I have had enough alcohol to even equal one drink. Mentally I know alcohol is empty calories. Drinking alcohol does not align with my long term weight loss goals. So I avoid it.

I think programs try to make the books middle of the road so people feel like surgery is viable. If they made them as restrictive as they should be most people wouldn't opt for surgery even if it could save their life. People are addicted to food, and addicted to processed foods. Telling people moderation is easier than telling them abstinence.

Good point, thanks

Ours had a standard plan for each patient but it's definitely different from the ones I have seen here. In some ways, it was more lenient, especially pre-op. We had low carb for ten days, followed by three days of liquids, and one clear.

But in other ways it's more strict. I am not supposed to have beef or pork until 2 months out. No idea why but I know many of you can have it. My coworker who had it at the same clinic was given the go ahead to drink at 6 weeks. I didn't ask and she didn't say (not tempted and not missing it). But I can't take ibuprofen until three months out and there are a few other things that will still be restricted even after most foods are ok.

Overall I trust my plan. I don't think anything was advanced too soon. Sometimes I will start a little early on adding a food if it's close to the date to start anyway and I am feeling good. Haven't had a problem that way.

I figure each plan is the nutritionist's and doctor's opinions on how to best do it and that's going to vary based on each clinic.

Sent from my iPhone using the BariatricPal App

Sent from my SM-N920P using the BariatricPal App