Long-term Follow-up Protocol of Bariatric Patients

Bariatric procedures induce weight loss using a combination of restrictive and/or malabsorptive surgical techniques. The metabolic and nutritional complications of bariatric surgery are, in part, directly related to the surgically created anatomical changes in the gastrointestinal tract. They also occur due to patient noncompliance with nutritional supplementation and dietary alterations following surgery. Despite having huge stores of energy in the form of excess fat, morbidly obese patients (BMI 35 kg/m2) may have clinical or subclinical nutritional deficiencies preoperatively as a consequence of poor diet over a prolonged period of time. Therefore, the severity of the postoperative nutritional deficit is dependent on several factors, including the patient’s preoperative nutritional status, the specific bariatric procedure undertaken, postoperative complications, patient-related nutritional compliance, and routine follow- up with his or her surgeon and primary care provider.

At the end of this chapter we have included Tables 10.1 to 10.3, which describe the site of absorption of nutrients, mechanism of action of various bariatric surgical procedures, and common nutritional and metabolic complications of bariatric surgery. Table 10.4 contains suggested mineral and vitamin supplementation following various bariatric surgical procedures, and Table 10.5 provides recommended screening tests prior to bariatric surgery and postoperatively.