Obesity is a chronic life-threatening disease, and bariatric surgery is the most effective treatment in those patients. The two main operations are laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB). LSG carries a smaller risk for nutritional deficiencies, while gastric bypass procedures are associated with increased nutritional deficiencies because the procedure is more complex and changes the gastrointestinal anatomy. Recent studies comparing LSG and RYGB have proven that these types of operation may lead to a similar weight reduction effect but cause different micronutrient deficiencies. Types of malnutrition after bariatric surgery include protein-energy malnutrition and deficiencies of micronutrients, such as iron, folate, vitamin A, and vitamin B<sub>12</sub>. Bariatric patients who do not adhere to the recommended diets are at a greater risk of developing relevant malnutrition. Therefore, life-long postoperative clinical and laboratory monitoring is necessary to diagnose deficiencies of vitamins, trace elements, and minerals and to correct them with supplements. Unfortunately, no standardized aftercare regimes exist for these patients, and the costs for nutritional supplements are paid by the patients themselves.
Keywords: Malnutrition; Nutritional status; Obesity; Postoperative monitoring; Sleeve gastrectomy.
Copyright © 2019 by S. Karger AG, Basel.
Conflict of interest statement
The authors certify that they have no commercial associations that might pose a conflict of interest in connection with the submitted article.
Nutritional Deficiencies in Patients after Roux-en-Y Gastric Bypass and Sleeve Gastrectomy during 12-Month Follow-Up.Obes Surg. 2019 Oct;29(10):3277-3284. doi: 10.1007/s11695-019-03985-3. Obes Surg. 2019. PMID: 31201694
Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study.Surg Obes Relat Dis. 2014 Mar-Apr;10(2):262-8. doi: 10.1016/j.soard.2013.07.014. Epub 2013 Aug 12. Surg Obes Relat Dis. 2014. PMID: 24182446
Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity.Wideochir Inne Tech Maloinwazyjne. 2012 Dec;7(4):225-32. doi: 10.5114/wiitm.2012.32384. Epub 2012 Dec 20. Wideochir Inne Tech Maloinwazyjne. 2012. PMID: 23362420 Free PMC article.
Surgery for weight loss in adults.Cochrane Database Syst Rev. 2014 Aug 8;(8):CD003641. doi: 10.1002/14651858.CD003641.pub4. Cochrane Database Syst Rev. 2014. PMID: 25105982 Review.
Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies.Diabetes Metab. 2009 Dec;35(6 Pt 2):544-57. doi: 10.1016/S1262-3636(09)73464-0. Diabetes Metab. 2009. PMID: 20152742 Review.