Surgery Preparation Diet

Contact your surgeon, the Urgent Care clinic, or the Emergency Room. You may try the medications listed under Indigestion, but this is a symptom that should be further evaluated. 

Starting meal replacements and a very low calorie diet often causes the release of stored water from your body. You will maintain a mild state of dehydration on the program. This can cause occasional dizziness, a lightheaded feeling, or fatigue because of salt and fluid loss. 

To minimize the dehydration, get 120-150 ounces of fluid daily, avoid whirlpools, saunas, steam baths, hot yoga, and prolonged baths or showers while on meal replacements.

The occasional lightheadedness makes certain activities dangerous. Swimming alone, piloting a plane (flying in a plane is fine), motorcycle or bicycle riding, regular or scuba diving, and hang-gliding should be restricted.

Severe symptoms (if you fall or faint) require medical evaluation. Kaiser Permanente members should seek immediate medical attention from their medical provider, the Urgent Care clinic, or the Emergency Room by calling 1(800) 290-5000, 24-hours a day, seven days a week.

Try liquid antacids including Maalox™, Mylanta™, other brand names, or generic versions: two tablespoons up to four times a day.

You may also add over-the-counter products such as Tagamet™, Axiid™, or Pepcid AC™, taken according to the instructions on the package. 

Losing weight means you are using your fat stores as energy. This will continue after surgery as well. When stored fat is metabolized for energy it travels in your blood in the form of ketones. Sometimes you can breathe out ketones through your lungs. You have experienced this when you have had “morning breath.”

While losing weight you can minimize “morning breath” by frequent and adequate water intake. 

Other suggestions to minimize morning breath include:

• Frequent brushing of teeth, tongue, and gums.
• Consuming a glass of water after each meal replacement. 
• Use mouthwash, breath spray, or a product called Breath Assure™. Breath Assure no longer is sold. Now it is a product called “Mind Asure.”
• Have 1-4 pieces of sugar-free gum or 1 to 4 sugar-free breath mints daily, being careful not to use the gum or mints as a food substitute. Note: too many artificially sweetened products in a day can cause stomach upset, gas, and diarrhea. 

Most people will feel some hunger and fatigue the first several days on meal replacements. Some will feel mild fatigue and hunger for a week or two. As you start burning predominately fat as your energy source you have a higher concentration of ketones in your blood stream which acts like a natural appetite suppressant.

Tips for minimizing hunger:

• Consume all 5 of your meal replacements every day. If you miss one, have two at your next meal. Do not skip any!
• Space them out evenly. Have your first meal replacement within 1-2 hours upon waking and then every 3-4 hours. Do not go longer than 4 hours without one unless you are sleeping.
• Skipping meal replacements will slow weight loss and risk causing your body to metabolize muscle mass for fuel (which can damage your heart muscle and jeopardize your health).
• Eating foods that are not a part of your program can make you feel hungrier and affect ketosis (a metabolic process where the body burns fat for fuel and that keeps you from feeling hungry). It can then take several days to return to this state after eating.
• Do not eat any additional carbohydrates while on this program.
• Too many artificial sweeteners, flavorings or caffeine can make you feel hungrier. 

Physical activity will help increase energy level, improve sleep, and maintain muscle mass while you lose weight. Mild to moderate aerobic exercise and muscle strengthening with light weights are recommended. Helpful tips include:

• Go easy your first week and then gradually increase the intensity and/or duration of your exercise routine for the first several days on meal replacements as you may feel light-headed or tired. 
• Warm-up and cool-down periods that include stretching help avoid muscle cramping.
• A meal replacement taken 30 minutes prior to exercise helps avoid fatigue. 

Try the online exercise videos at PositiveChoice.org/exercise-videos or for an even greater selection of workouts visit the Positive Choice Integrative Wellness Center YOUTUBE channel. There are videos on cardio, yoga, simple yoga, strength training you can do at home, exercise for seniors, etc. Videos are 5 minutes, 10-15 minutes, or up to 45 minutes. There is something there for every fitness level.

You may use artificial sweeteners, but keep in mind that artificial sweeteners may cause sweet cravings, stimulate appetite, and possibly disrupt the balance of healthy bacteria in your gut making weight maintenance more difficult. If you choose to use artificial sweeteners, use as little as possible. If you experience nausea, bloating, or stomach upset, discontinue artificial sweeteners (diet sodas, gums, mints, etc.)