Bariatric Guide to the Liver Reduction Diet

After deciding on weight loss surgery, many people don’t realize how many steps have to be taken before actually getting surgery. One of the pre-op recommendations is the liver reduction diet. 

What is the liver reduction diet?

  • 2 week pre-surgery liquid protein diet usually consisting of high protein meal replacement shakes
  • High protein, low fat, and reduced carbohydrates 
  • Very low energy diet of 400-700 calories/day

Since this diet is so restrictive, it’s important to be under the observation of a healthcare team. Each surgeon might have slightly different recommendations of what foods can be included. 

Would you only consume protein supplements during the liver reduction diet and what else may be required?

The liver reduction diet can vary based on your surgeon’s recommendations. Some may recommend:

  • Protein meal replacement shakes
  • Addition of low-starch vegetables (asparagus, broccoli, brussel sprouts)
  • Vitamin and mineral supplements because of restrictive dietary intake
  • About 2 liters of calorie-free beverages/day to stay hydrated
  • Physical activity 

What kind of protein supplements are recommended during the liver reduction diet?

  • High protein meal replacement shakes (includes macronutrients, vitamins, minerals and fiber to mimic a small meal)
  • High quality, complete protein

Complete protein includes all of the essential amino acids and is usually found as animal-based protein sources (ex. Whey protein isolate). For those who don’t consume animal products, soy protein is also a complete protein. 

Why high protein during the liver reduction diet?

  • Preserves lean muscle 
  • Allows the body to burn fat for energy
  • Promotes consumption of high protein daily after weight loss surgery

Can someone who isn’t having weight loss surgery take part in the liver reduction diet to lose weight?

Meal replacement shakes are very low in calories, carbohydrates and fat. So, if you’re only drinking those shakes and not consuming anything else, you’re likely consuming less than 400 calories/day. A continual low calorie regimen can become a health concern if you’re not being followed by a healthcare provider. If you do pursue this diet, you will see short-term weight loss, but it shouldn’t be followed for longer than 2 weeks. It’s always good to consult with a dietitian or healthcare provider on this because there are better ways to achieve long-term weight loss. 

Why are such diets recommended before weight loss surgery?

Non-Alcoholic Fatty Liver Disease (NAFD) is seen in one-third of individuals who are severely obese.

  • Fat cells accumulate in and around the liver increasing the size of the liver and causing poor function
  • A fatty liver can increase the risk of complications during weight loss surgery

Does the liver reduction diet provide any other benefits?

  • Weight loss
  • Management of NAFLD associated with obesity

Short-term benefits of pre-op weight loss?

  • Reduction in liver volume
  • Decreased length of hospital stay
  • Decreased risk of complications
  • Better access to the stomach during surgery
  • Better control of high blood sugar during hospital stay

Long-term benefits of pre-op weight loss?

  • Increased weight loss post-op
  • Decreased fat tissue in the body
  • Better adherence to lifestyle change post-op
  • Decreased mortality rate 30 days after surgery