Nutrient deficiencies before and after sleeve gastrectomy

Obes Surg. 2014 Oct;24(10):1639-46. doi: 10.1007/s11695-014-1225-y.


Background: Obesity is associated with nutritional deficiencies. Bariatric surgery could worsen these deficiencies. Fewer nutritional deficiencies would be seen after sleeve gastrectomy compared to the Roux-en-Y gastric bypass, but sleeve gastrectomy would also cause further deterioration of the deficiencies. The aim of this study was to determine the amount of pre-operative nutrient deficiencies in sleeve gastrectomy patients and assess the evolution of the nutritional status during the first post-operative year.

Methods: Four hundred seven sleeve gastrectomy patients were assigned to a standardized follow-up program. Data of interest were weight loss, pre-operative nutrient status and evolution of nutrient deficiencies during the first post-operative year. Deficiencies were supplemented when found.

Results: Two hundred patients completed blood withdrawal pre-operatively and in the first post-operative year. pre-operatively, 5 % of the patients were anemic, 7 % had low serum ferritin and 24 % had low folic acid. Hypovitaminosis D was present in 81 %. Vitamin A had excessive levels in 72 %. One year post-operatively, mean excess weight loss was 70 %. Anemia was found in 6 %. Low-ferritin levels were found in 8 % of the patients. Folate deficiency decreased significantly and hypovitaminosis D was still found in 36 %.

Conclusions: In this study, a considerable amount of patients suffered from a deficient micronutrient status pre-operatively. One year after surgery, micronutrient deficiencies persisted or were found de novo in a considerable amount of patients, despite significant weight loss and supplementation. Significant reductions were seen only for folate and vitamin D.

MeSH terms

  • Adult
  • Bariatric Surgery / adverse effects*
  • Bariatric Surgery / methods
  • Dietary Supplements
  • Female
  • Folic Acid Deficiency / etiology
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Humans
  • Male
  • Malnutrition / etiology*
  • Micronutrients / deficiency*
  • Middle Aged
  • Nutritional Status
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / surgery*
  • Postoperative Period
  • Vitamin D Deficiency / etiology
  • Weight Loss / physiology


  • Micronutrients