how come some can eat on opti while others cant at all?

I am just curious why some centres are allowed to eat and some cant? Not that it matters now I am half way through week two and only have one more to go... but just curious?

They all do what they feel work best.

3 years ago when I had my surgery..I told my surgeon straight-up that I thought I would have a difficult time sticking to liquids only for 2 weeks...we then agreed upon a small dinner with reduced portions and concentration on protein...I lost 8lbs and he was happy with that~!

I think it's just based on the surgeon and what they believe will work best for each individual patient.

That is a very good question without a good answer. It's decided at each individual centre and like issues with PPIs post-op, caffeine and other differences between the centres, it is not always made based on evidence.

Personally, I think optifast is a sort of 'test' they like to put us fatties through before surgery to see whether we're worthy of surgery. There is no reason at all that we need to be on a liquid diet, you could acheive the same effect of ketosis and liver shrinking on a low carb diet of real food. Or you could have real food with the optifast or other protein drinks. And there is no evidence whatsoever that any further effect on the liver is achieved after 2 weeks, so doing optifast for more than 2 weeks regardless of your weight is just torture without any scientific backing. Most surgeons in the US don't even require a pre-surgical diet. They have accepted that operating on the morbidly obese means developing skills that allow them to safely move and manipulate an enlarged liver.

Arg. Rant over.

I agree with the testing people. I don't think people who were told to stay on a low carb low fat real food diet would be as successful as people on optifast. As someone who did optifast for 5 weeks I am so glad I did it. It taught me the kind of control needed for the post op life.

 I disagree that it's a test for us "fatties". I think most of us have already proven that we are experts at failing on diets - be they low carb or otherwise so a test of our committment seems asisine. How I behaved pre-op won't necessarily be how I behave post op.  I simply think the centres have chosen Opti because it takes thinking out of the equation. I certainly agree that a low cal, high protein, low carb diet would have the desired liver-shrinking outcome. The problem, as I see it, is that people will have to be responsible to plan, cook, and eat within very strict dietary guideline. Optifast minimizes the "risk" of people consuming the wrong things or in the wrong portions.

Don't get me wrong. I think the Ontario Bariatric Network needs to adopt a uniform process but I, personally, believe Optifast was a valuable tool to get me ready for surgery. I, too, wonder who decides who can eat what at which centre. Don't they ever talk to each other???

Thea

I have to say that I was more successful on Atkins than I was on Opti. On 4 weeks of Opti I lost 11lbs. On 1 week of Atkins I lost 10lbs. Looking back I think I would've done a low-carb diet with real food. I was able to do Atkins for a few months because it's not a difficult plan to follow short term. I had one heck of a time on Opti. I was constantly hungry and angry! And I was allowed greens!

Why the centres differ on the recommended eating plans is up to the individual doctors in each site and I don't think you will find them agreeing on a best practice, since it is related to their own experience. Surgeons vary the way the do surgery based on their own skills, expertise etc and if you having any other surgery done in 1 city vs another there would be slight difference also. We are only aware of the differences in bariatric surgery because of this website. Optifast is a diet system on its own, it isn't just for wls patients. If my surgeon is more comfortable operating on me after having opti, then I will do that to make it easier for them. What is a few weeks after a lifetime of what I've been through...

We wondered the same - Dave had his surgery in the U.S, and only had to fast 24 hours before surgery and has been very successful almost 3 years out and he is .01lbs away from goal weight lost slowed down a year out but still losing.