When patients attend for their pre-surgery appointment I ask them how they see nutrition playing a role in their weight loss journey.
Why? My experience tells me patients, and at times their GPs, often downplay the role of postoperative nutrition in long-term health and yet nutritional deficiencies are a real possibility following bariatric surgery.
All bariatric surgery
procedures affect nutritional intake and some procedures may affect the absorption of macronutrients and/or micronutrients.
When weight loss and improved (sometimes resolved) comorbidities are occurring, nutrition deficiencies may seem insignificant, however they are a real concern for patients following bariatric surgery
Unmonitored deficiencies can leave patients vulnerable to both acute and chronic conditions, including changes in bone density and neurological damage (vitamin B12 deficiency).
As patients do not always attend for their follow-up care with their bariatric specialist team there is a key role for the GP to monitor and prevent nutritional deficiencies in patients following bariatric surgery
Micronutrient deficiencies are regularly seen in morbidly obese patients prior to bariatric surgery
including gastric band surgery
, gastric bypass surgery
and gastric sleeve surgery
With each of the weight loss surgeries, food portions are significantly reduced, however the quality of the food and fluid consumed and dysfunctional eating patterns can continue.
I have learnt I cannot assume that all patients are eating a well-balanced diet as some struggle to comply with the dietary recommendations.
While most patients will tolerate a wide variety of foods following their first year of surgery some will form maladaptive eating behaviours, or have restricted food variety resulting in poor nutritional intake.
Since dietary intake and nutrition is compromised following bariatric surgery, patients require life-long nutrition supplementation in addition to having a balanced diet.