Nutritional consequences of bariatric surgery.
OBJECTIVE
Bariatric surgery is being increasingly used to help treat morbidly obese adults and adolescents. As a greater percentage of this population faces a lifetime of living with surgically altered gastrointestinal anatomy and physiology, increased awareness of the nutritional consequences is critical for all health care practitioners, as many of these patients may be lost to follow-up and can present with significant nutritional complications years after surgery.


RESULTS
Nutritional deficiencies can occur after bariatric surgery, although to a lesser degree after restrictive procedures. Risk may increase over time, perhaps due to poor compliance with supplementation, continued inadequate intake and/or ongoing malabsorption. Adolescent patients may be at greater risk due to poor compliance and longer life span. Nutritional monitoring and supplementation among bariatric programs has been widely variable and few prospective studies of outcomes exist.


CONCLUSIONS
Bariatric surgery can carry significant risk of nutritional complications. Compliance with dietary recommendations should be monitored and encouraged, with annual screening for selected deficiencies. Prospective longitudinal research is needed to identify the true prevalence and significance of nutritional deficiency in these patients and to determine optimum dietary recommendations.
Xanthakos
Stavra A
SA
Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Ohio 45229-3039, USA. stavra.xanthakos@cchmc.org
Inge
Thomas H
TH
D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D019587:Dietary Supplements; D006801:Humans; D009748:Nutrition Disorders / Q000209:etiology*; D009751:Nutritional Requirements; D009767:Obesity, Morbid / Q000601:surgery*; D010349:Patient Compliance