What to Expect Before Surgery

Our General Surgery Process

Before Your Surgery, on the morning of your procedure, do not eat or drink anything – not even juice, coffee, water, or gum!

Usual Medications

Continue to take all your usual medications in their usual doses. If you normally take any medications for blood pressure or heart problems in the morning, these can be taken with a SMALL sip of water on the morning of surgery.

Pre-op Liquid Liver Shrinking Diet

The purpose of the Liver Shrinking Diet before weight loss surgery is to reduce the size of your liver and make it easier for the surgeon to operate as the stomach is underneath the liver. You will need to start this liquid diet 5-10 days before surgery. Remember to get at least 60gm of protein and minimize your intake of high sugar and high fat liquids. Choices include:


Bariatric Advantage, Nectar, Premier, Muscle Milk, Carb Solutions Shakes or any protein shake with at least 15gm protein, less than 20gm total carbohydrates, less than 5gm total fat per 8 oz serving. You may drink 1-2 shakes a day and can use them as a meal replacement only during this diet phase. You will find them at Costco, Walgreens, CVS and GNC. DO NOT BUY: Regular Slim Fast, Ensure, Boost, Atkins.

*We have Bariatric Advantage supplements (vitamins, protein shakes, etc…) and Nectar protein powder for sale in our office. Please contact the office if you need them.

B. SUGAR FREE LIQUIDS: These liquids contain no sugar.

Water, sugar-free beverages such as Crystal Light, Wyler’s Light, sugar-free Kool Aid, or sugar-free Tang, Diet Snapple, Fruit2O®, Propel®, decaffeinated tea or coffee with sugar substitute.
Broth soups (all varieties), thick soups (low sodium, low fat) that contain no rice, pasta or noodles.
Sugar-free popsicles and sugar-free Jell-O®

C. LOW SUGAR LIQUIDS: These liquids contain moderate amounts of sugar.

Juice, Gatorade®, or POWERADE® – limit it to 2 cups or less each day. Examples: diluted apple juice, orange or grapefruit
1 cup of milk (skim, 1%, or 2%) or 8 oz. light yogurt (Dannon Light, Yoplait Light or Colombo Light)
Low Sugar Cream of Wheat or oatmeal (may be prepared with skim or 1% milk)

A Note to Diabetics

ATTENTION DIABETICS! For our patients with diabetes we recommend consuming 15 grams of carbohydrates every 2 hours or so. Check your blood sugar levels more often and adjust your pills or insulin accordingly. Be sure to contact us if necessary to help manage your diabetes during this period. If your blood sugar is above 150, spread out the sugar-sweetened liquids over a 3 hour period.

For Diabetics, any liquids with 15 grams or less of carbohydrates are allowed. You may include these choices:

½ cup orange, apple, or grapefruit juice
1 popsicle
1 cup milk
6 ounces light yogurt (Dannon Light, Yoplait Light or Colombo Light)
½ cup cottage cheese
1/3 cup regular JELL-O®
½ cup Kool-Aid®
1 tbsp. honey or sugar (can be used to sweeten a beverage)
If you have any questions please contact the office at 858-457-4917

Pre-op Medication Instructions Before and After Surgery

In Preparation for and after your Bariatric Surgery:

Please make sure to schedule your Post-Op appointment with Dr. Bhoyrul and our dietictian, Mary (2 weeks after your surgery date).
Please follow these directions with regard to medications, prescription and over-the-counter medications:
Continue all your usual medications in their usual doses. Nothing to eat or drink after midnight the night before your surgery (unless if taking medication for blood pressure and/or diabetes. Anything more specific, please ask). If you normally take any medications for blood pressure or heart problems in the morning, these can be taken with a SMALL sip of water on the morning of surgery.
Please ask your doctor whether to continue any pill medications for your diabetes. If you use insulin, we will frequently suggest that you only take half of your normal morning dose, but please verify this with Dr. Bhoyrul if instructions have not been given to you.
If you take Coumadin (a type of blood thinner), we will frequently suggest that you discontinue this medication 5 days prior to your operation. Only discontinue this following the specific instructions of your doctor.

Due to the risk of increased bleeding, you should stop any of the following medications at least 10 days prior to surgery:

Any other medications not listed, please discuss with Dr. Bhoyrul. It is okay to take Tylenol.

The same day of surgery: You must have a responsible adult available to drive you home following your procedure. Due to anesthesia considerations, you also need to have a responsible adult available at home that evening

Following your surgery: You must follow the Stage 1 Dietary guidelines outlined in the handout given to you by our Dietitian, Mary.

Physical Limitations: Do not lift more than 10 pounds for 4 weeks following your surgery. If You Have Any Questions…

Following these guidelines will help to ensure that your surgery goes smoothly and on schedule. Please contact our practice by phone or by e-mail if you have any questions.

Bariatric surgery hospital
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Perform surgical procedures
at an ASMBS-accredited center

Contact Us

Dr. Sunil Bhoyrul
9850 Genesee Ave., Suite 570
La Jolla, CA 92037

Phone: (858) 457-4917
Fax: (858) 457-3287