This is out of the Aesthetic Surgery Journal, August 2015. The title of the CME article is simple: “Post Bariatric Body Contouring.” The things to think can be vast for those who lost weight from bariatric surgery. The authors state problems can be due to obesity and unhealthy dietary habits, which lead to deficiency in protein, vitamins, and minerals. The surgery also changes the anatomy of the GI tract, so the patient doesn’t have the same ability to absorb nutrients and electrolytes.
NUTRITIONAL ISSUES:
- ANEMIA (low blood count) This can be caused by iron, folate, or B12 deficiency.
- This is caused by poor absorbtion, and a frequent aversion to red meat in patients after surgery
- In one study after Roux en Y bypass, 54% of patients were anemic.
- These patients are treated with multivitamins, but it only corrected 43% of iron deficiency and 80% of Vitamin B12 deficiency.
- PROTEIN DEFICIENCY
- This is more rare, but can be devastating. Most patients need to gradually increase their protein intake after surgery.
- The goal is 60-120 grams of protein daily
- THIAMINE
- Never heard of it? Thiamine is Vitamin B1. You need it to metabolize carbs and amino acids. It is note stored in an organ, so you need to have it regularly.
- Low level causes Beriberi: irritation, fatigue, edema, neuropathy are all symptoms
- High level loss is Wernicke encephalopathy: gait ataxia, and eye issues
- CALCIUM, VITAMIN D
- Patients need routine Ca and Vitamin D, if not they will get osteoporosis and hypocalcemia
- FAT SOLUBLE VITAMINS: AEK
- of these, Vitamin A is the most symptomatic. 86% of them had decreased visual acuity and dry eyes, 71% had decreased night vision, and 57% had eye pain.
What do they recommend?
They state you should check all of these levels prior to any surgery. (I recommend doing it 3 months ahead if you can, so you have time to correct any issues). They test for electrolytes, B1, B6, B12, foalte, iron, zinc, albumin, prealbumin, and Vitamins A, D, E, and K.
They recommend supplement your daily multivitamin with A, Zinc, and copper. Additional supplements of B12, Calcium, and Vitamin D are common.