title: Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Endocrinology, Diabetology, and Metabolism, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Gasteyger
authors.forename: Michel
authors.initials: M
authors.lastname: Suter
authors.forename: Rolf C
authors.initials: RC
authors.lastname: Gaillard
authors.forename: Vittorio
authors.initials: V
authors.lastname: Giusti
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002118:Calcium / Q000008:administration & dosage / Q000097:blood; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000097:blood; D008297:Male; D009748:Nutrition Disorders / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D009751:Nutritional Requirements; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000097:blood; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage*; D015431:Weight Loss
chemical_list: D014815:Vitamins; D014807:Vitamin D; D005492:Folic Acid; D007501:Iron; D014805:Vitamin B 12; D002118:Calcium