What is VLED?
A Very Low Energy Diet (VLED), also known as a Very Low Calorie Diet (VLCD), is an important first step in preparing for bariatric surgery. VLED are most commonly available in the form of meal replacement shakes, bars, or soups and are often used as a general weight management strategy for people who are overweight or obese. The purpose of a VLED in bariatric surgery is different so it is important to follow a VLED meal plan that has been specifically designed for the preoperative phase of your surgery.
Why do I need it?
A VLED is very low in carbohydrates, forcing your body to start burning fat which produces ketones that are used as the main source of fuel. This is known as ketosis. Being in ketosis for a period before bariatric surgery is needed to reduce fat stores in the abdomen (around your organs) and especially within your liver. A liver with excess fat is larger than normal and makes it more difficult for the surgeon to reach the stomach to operate. Surgery that is more technically difficult may have a higher chance of complications or, worse case scenario, it may no longer be safe or possible for the surgery to go ahead at all. If that were the case, the procedure would be halted and a longer period of preoperative preparation with a prolonged VLED program would most likely be required.
What to expect
Food and the experience of eating a meal are embedded in our daily routine and usually revolve around family gatherings or social interactions. Following a meal plan based predominantly on shakes, bars or soups is not easy. It requires commitment and persistence. The first 3-4 days is the most challenging. As you go into ketosis you may experience headaches, nausea, hunger, and fatigue. These symptoms will subside as you continue to stay in ketosis.
How long do I need it for?
The duration of pre-bariatric surgery VLED is usually between 2-4 weeks and depends on your Body Mass Index (BMI) and other medical conditions. We will advise how long you as an individual need to be on the VLED following your initial consultations with us.
Does it matter if I ‘cheat’ every now & then?
Yes, it really does matter. If you eat more than the recommended amount of food or have something that is too high in carbohydrate or sugar, you may come out of ketosis and start to feel hungry again. You will then have to work hard again to get back into ketosis. Coming out of ketosis may mean that you don’t lose enough fat from your abdomen or liver to allow the surgery to go ahead as planned.
Tips for success
1. Be Organised
The list of ‘allowed foods’ will be given to you during your initial dietitian consultation and can be found on each of the VLED company websites. Use this list to prepare appropriate foods that you can have in addition to the VLED products. If a container of leavy greens is chopped & ready to go it is much easier to include them at mealtimes rather than reach for something that is not part of your meal plan. Have the recommended condiments available to improve the taste of your food. Prepare some diet jelly in advance. Finally, get rid of any foods that you know will tempt you, after all, you are only human!
2. Stay hydrated
It is important to stay well hydrated by drinking water throughout the day as sometimes hunger can be mistaken for thirst. You could try using a water bottle with time marking on it to monitor how much you have had throughout the day and set reminders on your watch or phone.
3. Be aware of your eating habits.
Do you normally eat as soon as you walk in the door from work out of habit? Are you actually hungry after dinner or do you just eat something sweet out of habit? Identify the times of the day when you tend to eat out of habit or boredom and do something else during this time, such as go for a walk outside, call a friend, run a bath, clean if you must!
4. Surround yourself with positive people
The last thing you need is someone trying to twist your arm in to having just one little snack or a treat here or there. Make sure people around you know how important this surgery and the preoperative diet is to you and how important it is that you follow it properly. This will make eating out very difficult, but it is only a few weeks and a small price to pay for an effective surgery that should lead to endless benefits in the long term.
5. Persist
I know this is repetitive, but I want to emphasise how important it is to push through the first 3-4 days as you are going into ketosis. After this, when you are in ketosis your hunger should subside and you should start to feel better.
