title: Malnutrition secondary to non-compliance with vitamin and mineral supplements after gastric bypass surgery: What can we do about it?
abstract: BACKGROUND
  Nutritional deficiency due to loss of follow up and non-compliance with routine mineral and multivitamin supplements is not uncommonly encountered following bariatric surgery. In this report, and utilizing a case study, we will address issues related to loss of long term medical follow up and the measures that can be taken to prevent it in this patient population.
  
  
  METHODS
  The case of a 38-year-old female patient who was recently managed for severe vitamin deficiency and iron deficiency anemia following bariatric surgery is presented. Non-compliance with routine vitamin and mineral supplements was believed to be the main culprit of her condition. Articles published in English addressing issues related to non-compliance with supplementations and regular follow up after bariatric surgery were accessed from PubMed and are discussed.
  
  
  CONCLUSIONS
  Multiple factors affecting long term follow up and compliance have been studied including age, financial costs, distance from the clinic and psychiatric comorbidities. Preventive measures have also been tested and some of them have shown significant benefit. More research is needed to identify other modifiable factors and preventive measures influencing compliance and long term follow up following bariatric surgery.
authors.affiliation: Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO, U.S.A.
authors.forename: Dina S
authors.initials: DS
authors.lastname: Ahmad
authors.forename: Mohammad
authors.initials: M
authors.lastname: Esmadi
authors.forename: Hazem
authors.initials: H
authors.lastname: Hammad
keywords: compliance; gastric bypass; nutritional deficiency