Nutritional Deficiencies After Roux-en-Y Gastric Bypass for Morbid Obesity Often Cannot Be Prevented by Standard Multivitamin Supplementation

Am J Clin Nutr. 2008 May;87(5):1128-33. doi: 10.1093/ajcn/87.5.1128.

Abstract

Background: Despite the increasing use of Roux-en-Y gastric bypass (RYGBP) in the treatment of morbid obesity, data about postoperative nutritional deficiencies and their treatment remain scarce.

Objective: The aim of this study was to evaluate the efficacy of a standard multivitamin preparation in the prevention and treatment of nutritional deficiencies in obese patients after RYGBP.

Design: This was a retrospective study of 2 y of follow-up of obese patients after RYGBP surgery. Between the first and the sixth postoperative months, a standardized multivitamin preparation was prescribed for all patients. Specific requirements for additional substitutive treatments were systematically assessed by a biologic workup at 3, 6, 9, 12, 18, and 24 mo.

Results: A total of 137 morbidly obese patients (110 women and 27 men) were included. The mean (+/-SD) age at the time of surgery was 39.9 +/- 10.0 y, and the body mass index (in kg/m(2)) was 46.7 +/- 6.5. Three months after RYGBP, 34% of these patients required at least one specific supplement in addition to the multivitamin preparation. At 6 and 24 mo, this proportion increased to 59% and 98%, respectively. Two years after RYGBP, a mean amount of 2.9 +/- 1.4 specific supplements had been prescribed for each patient, including vitamin B-12, iron, calcium + vitamin D, and folic acid. At that time, the mean monthly cost of the substitutive treatment was $34.83.

Conclusion: Nutritional deficiencies are very common after RYGBP and occur despite supplementation with the standard multivitamin preparation. Therefore, careful postoperative follow-up is indicated to detect and treat those deficiencies.

MeSH terms

  • Adult
  • Body Mass Index
  • Calcium / administration & dosage
  • Calcium / blood
  • Female
  • Folic Acid / administration & dosage
  • Folic Acid / blood
  • Follow-Up Studies
  • Gastric Bypass / adverse effects*
  • Humans
  • Iron / administration & dosage
  • Iron / blood
  • Male
  • Nutrition Disorders / blood
  • Nutrition Disorders / epidemiology
  • Nutrition Disorders / etiology
  • Nutrition Disorders / prevention & control*
  • Nutritional Requirements*
  • Nutritional Status*
  • Obesity, Morbid / surgery*
  • Postoperative Complications
  • Retrospective Studies
  • Vitamin B 12 / administration & dosage
  • Vitamin B 12 / blood
  • Vitamin D / administration & dosage
  • Vitamin D / blood
  • Vitamins / administration & dosage*
  • Weight Loss

Substances

  • Vitamins
  • Vitamin D
  • Folic Acid
  • Iron
  • Vitamin B 12
  • Calcium