Elevated enzymes are mostly caused by fatty liver (Hepatic steatosis) and you won't see them normalizing until approximately two years postop, as rapid weight loss puts additional strain on your liver. The surgeon knows it very well.
However you'll see some (minor) improvement after optifast, as this diet specifically targets this liver fat, Sooo, they just want to see positive dynamics after opti. This would indicate that your problem indeed is fatty liver (like all of us had/have) and not something else going on.
Nata, a very happy DSer!
Starting BMI - 62, current BMI - NORMAL!!!!!.
204 pounds lost!!!!