The continued success of bariatric surgery in treating obesity and obesity-associated metabolic conditions creates a need for a strong understanding of clinical nutrition both before and after these procedures. Bariatric surgery is being increasingly used to manage obesity and obesity-related comorbidities, but may lead to the development of micro and macronutrient deficiencies postoperatively.
Anatomical, physiological, nutritional, and behavioral reasons for nutritional vulnerabilities, along with recommendations for routine monitoring and supplementation, should always be considered after bariatric surgery. Monitoring by a multidisciplinary team is very important. The role of the dietician and their contribution to the identification, prevention and postoperative management of nutritional vulnerabilities in bariatric patients, as well as a correct follow-up by the endocrinologist and the bariatric surgeon, are also crucial.
In this talk, Dr. Aurora D. Pryor summarizes current knowledge about the nutrient deficiencies that can develop after bariatric surgery, and highlights follow-up and treatment options for bariatric surgery patients who develop a nutritional deficiency. The main macronutrient deficiency after bariatric surgery is protein malnutrition. Micronutrient deficiencies, which include trace elements, essential minerals, and water-soluble and fat-soluble vitamins, are common before bariatric surgery and often continue after the operation, despite worldwide recommendations for multivitamin and mineral supplements. Other disorders, including bacterial overgrowth of the small intestine, can promote micronutrient deficiencies, especially in patients with diabetes mellitus. Recognition of the clinical presentations of micronutrient deficiencies is important, both to allow early intervention and to minimize long-term adverse effects.
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