Bariatric Surgery and Ketosis

[bulkbiker]

I was just reading through some pre bariatric surgery diet plans prompted by another thread and came across the advice from Guys and Thomas Hospital in London. They recommend reducing glycogen stores in the body before surgery and suggest various diets.

I got to the end and read this with open mouthed amazement...

"
How will I feel while I am on this diet?

As your body responds to the diet it releases ketones, which are made when the body breaks down fat for energy. These are released in the breath, urine and sweat – sometimes causing odour. You may also experience other symptoms such as thirst, and a slightly metallic taste in the mouth. In addition, you may also find that your appetite is suppressed after the first 3 - 4 days, meaning that you feel much less hungry than you would have expected. Some people report feeling a little light-headed in the first few days. Just make sure you are sticking to the plan and drinking plenty – this will pass. "

They actually recommend getting into ketosis before the surgery.

Is this the reason people get remission without weight loss after surgery.... because they are in ketosis?

Should Prof Taylor be looking at a ketogenic diet rather than 800 cals?

 

[Lamont D]

Ketosis is a good idea wether in the short term or long term.
Being in ketosis after surgery might be the only way to control bloods and weight.

I'm tagging @ickihun she will have an opinion!

 

[Mr_Pot]

Ketosis is a good idea wether in the short term or long term.

Why is that?

 

[bulkbiker]

Why is that?

Seems to keep Type 2 under pretty strict control.. help with weight loss and a host of other benefits.. what's not to like?

 

[ringi]

Remember that for a lot of people "his" 800 cals diet is a ketogenic diet. (Just not one I would choose myself.)

 

[bulkbiker]

Remember that for a lot of people "his" 800 cals diet is a ketogenic diet. (Just not one I would choose myself.)

I reckon we should be able to come up with a much more satisfying keto diet that would work equally well (I imagine probably better)...
Shame that Diabetes.org.uk wouldn't give us any cash to try it out even if we asked nicely..

 

[ringi]

The one unknown I have is.

Are peaks in BG needed to wake up the Beta Cells along with removing the fat?
​

Otherwise, 800 cals off low carb would clearly be better than the current shakes!

 

[Guzzler]

I reckon we should be able to come up with a much more satisfying keto diet that would work equally well (I imagine probably better)...
Shame that Diabetes.org.uk wouldn't give us any cash to try it out even if we asked nicely..

I would willingly volunteer for Dotorg to pay my food bills for 12 weeks... where do I sign?

 

[ickihun]

I was just reading through some pre bariatric surgery diet plans prompted by another thread and came across the advice from Guys and Thomas Hospital in London. They recommend reducing glycogen stores in the body before surgery and suggest various diets.

I got to the end and read this with open mouthed amazement...

"
How will I feel while I am on this diet?

As your body responds to the diet it releases ketones, which are made when the body breaks down fat for energy. These are released in the breath, urine and sweat – sometimes causing odour. You may also experience other symptoms such as thirst, and a slightly metallic taste in the mouth. In addition, you may also find that your appetite is suppressed after the first 3 - 4 days, meaning that you feel much less hungry than you would have expected. Some people report feeling a little light-headed in the first few days. Just make sure you are sticking to the plan and drinking plenty – this will pass. "

They actually recommend getting into ketosis before the surgery.

Is this the reason people get remission without weight loss after surgery.... because they are in ketosis?

Should Prof Taylor be looking at a ketogenic diet rather than 800 cals?

That is the liver diet.
All, even none diabetics go on but...... Diabetic one is more carbs!
Once I get mine in black and white I'll share it.

A few posts say what the liver diet is. I'll try and dig one up.

 

[ickihun]

I'm still looking...

That is why I feel type2 is a liver problem and not a pancreas one.
It should resolve the fatty liver so surgeon can get at stomach in op.

If they carry on a ketosis diet they will or may reach remission, especially prediabetics. Type2s on less meds/insulin.

I want op so I don't have to suffer hunger, be monitored on extreme low cal diet and to make it longstanding (hopefully permanent).

From what I remember it was water, no diary and low fat.
I must find it now.

 

[Mr_Pot]

Seems to keep Type 2 under pretty strict control.. help with weight loss and a host of other benefits.. what's not to like?

It just seems rather drastic to modify your body's homeostasis for the long term if you don't need to.

 

[bulkbiker]

It just seems rather drastic to modify your body's homeostasis for the long term if you don't need to.

Maybe it's just putting it back to it's "normal" state before we began cramming in carbs?
Long term it seems to have a lot of "anecdotal" benefits.
https://www.ketogenicforums.com/t/join-this-thread-conditions-keto-can-heal-or-cure/30214

 

[ickihun]

It just seems rather drastic to modify your body's homeostasis for the long term if you don't need to.

They/we do need too. Morbidly obese bmi 35+ or over. I'm 44.

I've just been speaking to a none diabetic 10yr post bariatric surgery woman who has just had he gall bladder removed and now her liver is playing up.
She hasn't divulged her diet but her baby is 3yr old.

I don't know enough about the gall bladder but very very common after bariatric surgery for it to be removed due to large/medium stones which intestine can no longer pass. I did once assume due to poor diet but I'm not sure. I believe not an instant problem from op but a longterm one. My gallbladder is fine as I was scanned last year, just in case, after chest pains, breathlessness and swelling in the stomach.

"A sensible diet is the best way to prevent gallstones. Avoid crash diets or a very low intake of calories (less than 800 calories daily). Seek out good sources of fiber -- raw fruits and vegetables, cooked dried beans and peas, whole-grain cereals and bran, for example -- and avoid eating too much fat."

 

[ickihun]

Fiber is difficult to digest at first after bariatric surgery so liquid and mashed food for a few weeks first. Potato skins, raw almond skins and seeds can be awkward to digest.

 

[ickihun]

Found this.......

Typical 2 Week Pre-Op Diet

You should always follow your surgeon’s recommended diet 2 weeks prior to surgery. Most 2 week pre-op diets recommend:

• Increase your protein consumption
  • Eat lean meats
• Lower your carbohydrate consumption
  • Avoid breads, pasta, cereals, rice, etc.
• Eliminate Sugars
  • Eliminate candy, desserts, juices, sodas

The list below is a typical diet two weeks before gastric sleeve surgery.

• Breakfast
  • Protein Shake – get a high quality protein shake from GNC or other supplement store in your area.
  • Make sure there is no sugar in the protein shake.
• Lunch
  • Vegetables and Lean Meat
• Dinner
  • Vegetables and Lean Meat
• Snacks
  • You can have a healthy, low carbohydrate snack in-between meals.
  • Nuts, berries, vegetables, small salad with oil and vinegar, etc.
• Fluids
  • Stay hydrated. This will help curb your hunger.
  • You can typically drink anything sugar free and low in calories.

Remember, it’s very important to stick to your two week pre-op diet. This shrinks your liver, decreases your risk of complications and makes the surgery quicker and easier for your surgeon.

 

[ickihun]

The part of the stomach that produces the majority of ghrelin is removed during surgery.

 

[Lamont D]

I'm still looking...

That is why I feel type2 is a liver problem and not a pancreas one.
It should resolve the fatty liver so surgeon can get at stomach in op.

If they carry on a ketosis diet they will or may reach remission, especially prediabetics. Type2s on less meds/insulin.

I want op so I don't have to suffer hunger, be monitored on extreme low cal diet and to make it longstanding (hopefully permanent).

From what I remember it was water, no diary and low fat.
I must find it now.

For whatever it's worth it is a liver problem but it involves the whole digestion process including what the brain thinks it needs by sending signals and giving you the symptoms to give you a nudge, which involves carb craving.
The gut biotic is as important and of course wether insulin resistance and high insulin levels are triggered by diet. How your glucose is processed, how your alpha and beta cells react, how your other hormones interact in your blood.
For some T2s, that is why what they eat is so important!

Getting rid of a fatty liver was so important for me, it helps with the fat burning process when in ketosis. It helps with liver function and the difference in energy levels as your liver gets healthier, as you get healthy.

Best wishes on your battles @ickihun

 

[ickihun]

I got rid of fatty liver but still didn't lose weight....then when I reduced fat from lchf I started losing. I think constantly dieting quickly risks gallstones so I'm doing it slowly to help that factor but op will be instant low calorie as fat and sugar cause dumping syndrome so I won't be going anywhere near it.
I'm looking forward to less insulin but not head hunger or dumping if I make a mistake. I'm looking forward to some smaller clothes. Smaller numbers on my scales and the loss of bloating.
I'm looking forward to being able to bend and touch my toes without severe indigestion and cramps. Even if in pain from back and sciatic nerve.

 

[ickihun]

So coming out of ketosis will be quick after op as liquid foods are veg, protein and potato is very common in ice cube mixed portions. Carrot cooked and blended, suede, cabbage, brussels and cauliflower. Chicken blended with veg. Fish with veg. Mush then lumpy then solids if you can but slowly. Like feeding a new baby and weaning over months.

Maybe its the baby food which causes remission?
I'd most likely say the shock and a reboot!!!!!!

 

[Lamont D]

So coming out of ketosis will be quick after op as liquid foods are veg, protein and potato is very common in ice cube mixed portions. Carrot cooked and blended, suede, cabbage, brussels and cauliflower. Chicken blended with veg. Fish with veg. Mush then lumpy then solids if you can but slowly. Like feeding a new baby and weaning over months.

Maybe its the baby food which causes remission?
I'd most likely say the shock and a reboot!!!!!!

No wonder they have baritric patients with problems with diet afterwards!!
That is not really appetisingat all!
I believe you will find that portion size is really troublesome, you just won’t feel like eating, no surprises with that menu.

Where’s the bacon and egg?

Best wishes