Management of Nutritional Complications

  • Liz Goldenberg
  • Alfons Pomp


Weight loss procedures change the manner in which the body intakes, digests, and/or absorbs food and its nutrients. The surgically altered gastrointestinal tract may cause potential nutritional complications. This can be the result of restriction of stomach capacity, hormonally altered appetite, or induced malabsorption via intestinal bypass or a combination of all these mechanisms. Surgeries that induce malabsorption, such as biliopancreatic diversion, with or without duodenal switch, or the distal (long limb) gastric bypass, are associated with more numerous and more serious nutritional complications. The more common postsurgical concerns include vomiting, loss of appetite, anemia, bowel habit changes, dumping syndrome, and maladaptive eating. Protein malnutrition and diseases of the ocular, musculoskeletal, and neurological systems are less frequently encountered. Healthcare professionals should be aware that the morbidly obese patient is by definition not a well-nourished patient. Many patients present with asymptomatic, unrecognized, and/or untreated nutrient deficiencies prior to undergoing surgery. Studies have demonstrated reduced levels of almost all of the vitamins and minerals in this population, including vitamins A, B6, B12 C, E, thiamin, and folate and the minerals iron, zinc, and selenium, as well as vitamin D deficiency with or without secondary hyperparathyroidism.


Bariatric Surgery Gastric Bypass Sleeve Gastrectomy Hair Loss Biliopancreatic Diversion 
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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of GI Metabolic and Bariatric SurgeryWeill Medical College of Cornell University, New York Presbyterian HospitalNew YorkUSA

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