65. Nutritional Management after Bariatric Surgery

Despite benefits to health, long-term problems such as nutritional deficiencies have been reported in patients following bariatric surgery. Deficiencies may occur after any of the procedures and are usually a consequence of non-compliance with diet and supplement recommendations, food intolerances, reduced dietary intake and malabsorption. The most commonly encountered deficiencies are those of iron, vitamin B_12, calcium, vitamin D and folate. However, deficiencies in protein, fat-soluble vitamins, thiamine, zinc or copper may also occur. Patients need to follow a balanced diet that is low in fat and sugar, adopt new eating behaviours that will minimise gastrointestinal problems and take a complete multivitamin and mineral supplement. After all bariatric procedures, routine biochemical monitoring should be carried out and deficiencies treated accordingly. Long-term follow-up is imperative in order to minimise potential problems. The dietitian has an important role in supporting the patient, both short and long term, to make the necessary dietary and lifestyle changes that will achieve a healthy and successful weight loss.