Nutrient Deficiencies in Bariatric Surgeries

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Pre-existing and Postoperative Nutritional
Deficiencies in Bariatric Patients

• Nutrition education and medical nutrition
  therapy are integral to the success of a
  patients bariatric surgery journey.  Nutrition
  counselling plays an especially important part in
  long-term weight loss maintenance, but it also
  serves to correct any pre-existing nutritional
  deficiencies or for any that come about after
  surgery.  This article summarises nutritional
  deficiencies common to bariatric patients prior
  to and after surgery.

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Pre-existing nutritional deficiencies

• Some of the vitamin and mineral deficiencies
  we see in bariatric patients prior to their
  surgery include vitamin D, iron, zinc and vitamin
  B12.  These could be due to a number of reasons
  including not getting enough sunlight (Vitamin D)
  or dietary sources of the nutrients, or there may
  be a physiological cause leading to poor
  absorption of these nutrients.  Obesity is an
  inflammatory disease and inflammation can
  interfere with metabolic processes.

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Why are nutrients at risk after surgery?

• There is an increased risk of nutritional
  deficiencies with all types of bariatric
  surgery.  This is due to several reasons
  including a reduced capacity for food, possible
  food intolerances coming about after surgery,
  poor food choices and occurrences of
  regurgitation or reflux.  Some bariatric
  procedures are associated with a higher risk of
  nutritional deficiencies than others. 

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• While the Obera Intragastric
  Balloon and Laparoscopic Adjustable Gastric
  Band (LAGB) do reduce capacity for food and can
  be associated with the previously mentioned
  reasons for nutritional deficiencies, they do not
  alter human anatomy and physiology.  The
  Roux-En-Y Gastric Bypass (RYGB) and Laparoscopic
  Sleeve Gastrectomy (LSG) both result in altered
  human anatomy and physiology, by which they help
  to contribute to weight loss, but may thus result
  in nutritional deficiencies. 

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• Some reasons behind the increased risk for
  nutritional deficiencies in the RYGB and LSG
  include reduced acid production in the stomach
  and the reduced production of a substance called
  intrinsic factor, which enables the body to
  absorb vitamin B12.  Dumping syndrome or
  abnormally rapid bowel evacuation can occur with
  the RYGB and LSG and this can cause nutritional
  deficiencies if it leads to food intolerance.