Long-term nutritional status in patients following Roux-en-Y gastric bypass surgery

Clin Nutr. 2018 Apr;37(2):612-617. doi: 10.1016/j.clnu.2017.01.022. Epub 2017 Feb 3.


Background & aims: Roux-en-Y gastric bypass (RYGB) is an effective treatment for obesity. However, it also leads to multiple nutritional deficiencies. Much is known about the short term prevalence, but hardly any long term data is available on deficiencies. The aim of this study was to assess the long term outcome of nutritional status after RYGB.

Methods: We performed a retrospective analysis of prospectively collected data obtained from 51 morbidly obese patients who underwent a primary laparoscopic RYGB. Primary outcomes were iron, vitamin B12 and vitamin D deficiencies. Secondary outcomes were deficiencies of other vitamins and minerals and compliance of the patients to multivitamin use.

Results: The mean follow-up was 81 ± 27 months. A total of 35%, 16% and 55% of the patients had deficiencies for iron, vitamin B12 and vitamin D respectively. Sixty-nine percent of patients used a (nonspecific) multivitamin supplement on a daily basis. Patients with multivitamin usage had a lower rate of iron deficiency (26% vs. 56%, p = 0.034), vitamin B12 (11% vs. 25%, p = 0.46) and vitamin D (46% vs. 75%, p = 0.07), compared to non-compliant patients.

Conclusions: Nutritional deficiencies are common after a RYGB operation. Therefore, strict follow-up by a bariatric surgeon, endocrinologist or general practitioner is required, both short and long term.

Keywords: Bariatric surgery; Deficiencies; Morbid obesity; Nutrient; Roux-en-Y gastric bypass; Vitamin.

MeSH terms

  • Dietary Supplements
  • Female
  • Follow-Up Studies
  • Gastric Bypass / adverse effects*
  • Humans
  • Iron Deficiencies*
  • Male
  • Malnutrition / drug therapy
  • Malnutrition / epidemiology*
  • Middle Aged
  • Nutritional Status*
  • Obesity, Morbid / surgery
  • Prospective Studies
  • Retrospective Studies
  • Time
  • Vitamin B 12 Deficiency / drug therapy
  • Vitamin B 12 Deficiency / epidemiology*
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / epidemiology*