4.1 Review

Nutritional consequences of bariatric surgery - prevention, detection and management

Journal

CURRENT OPINION IN GASTROENTEROLOGY
Volume 37, Issue 2, Pages 135-144

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOG.0000000000000707

Keywords

bariatric surgery; micronutrients; monitoring; nutrition; protein

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Bariatric surgery is an effective treatment option for severe and complex obesity, but patients need access to nutritional monitoring and supplementation to prevent nutritional deficiencies. Recent updates recommend preoperative and postoperative nutritional monitoring and supplementation, with a focus on malabsorptive procedures that carry a higher risk of nutritional deficiencies. Long-term follow-up and shared care models are recommended for aftercare to ensure patients receive proper nutritional adjustments.
Purpose of review Bariatric surgery is an effective treatment option for severe and complex obesity; however, those who undergo such surgery need access to nutritional monitoring and vitamin and mineral supplementation to avoid the development of nutritional deficiencies. Recent findings The British Obesity and Metabolic Surgery Society and the American Society for Metabolic and Bariatric Surgery have recently updated their recommendations on preoperative and postoperative nutritional monitoring and supplementation. There is a growing interest in the more malabsorptive procedures that are associated with an increased risk of nutritional deficiencies. Nutritional monitoring and prevention of nutritional deficiencies are discussed. Long-term follow-up that includes annual nutritional monitoring and access to a dietetic annual review is recommended; however, in the United Kingdom, many bariatric surgery centres are only commissioned to provide 2 years of follow-up, after which care is transferred to the general practitioner. Consideration should be given to developing shared care models for aftercare and also for the aftercare of malabsorptive procedures to remain with specialist centres. Bariatric surgery is a safe and effective treatment option for severe and complex obesity. It is essential that patients have access to lifelong nutritional monitoring adjustment of vitamin and mineral supplements to prevent nutritional issues.

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