Identification, Assessment, and Treatment of Vitamin and Mineral Deficiencies After Bariatric Surgery

Abstract

Although much remains to be established regarding the prevalence and etiology of vitamin and mineral deficiencies after bariatric surgery, this chapter serves as a guideline for the identification, assessment, and treatment of potential vitamin/mineral deficiencies after commonly performed bariatric surgery procedures. In 2008, the ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient was published as a supplement in Surgery for Obesity and Related Diseases (SOARD). It included suggestions for preoperative and postoperative nutrition screening, assessment, and treatment of the bariatric patient, including vitamin and mineral deficiencies commonly seen after these procedures. Although gastric bypass, gastric banding, and biliopancreatic diversion (BPD) and BPD with duodenal switch (D/S) were included in this paper, vertical sleeve gastric gastrectomy (VSG) was not included, although plans are underway to add this as a supplement to this paper in the future. In the interim, suggestions for vitamin/mineral assessment and guidelines for the treatment of the VSG patient will be based upon the most recent reports in the literature. Although it is commonly known that bariatric surgery patients may be at risk for particular vitamin/mineral deficiencies associated with surgery, it may not be as clear that there are possible micronutrient deficiencies evidenced prior to surgery that bear mentioning. An overview of micronutrients most at risk after bariatric surgery is provided, as well as guidelines for the assessment and treatment of common vitamin/mineral deficiencies seen postoperatively.