Micronutrient Deficiencies as a Result of Bariatric Surgery

The most effective method of sustainable weight loss in obese patients is bariatric surgery. However, micronutrient deficiencies that can result after bariatric surgery can cause health problems that may outweigh its benefits. Micronutrient deficiencies are most common in patients who undergo Roux-en-Y gastric bypass or biliopancreatic diversion with or without duodenal switch. The majority of vitamin B12 and folate deficiencies studies showed significant prevalence rates in their patient populations. Most concluded that routine oral B12 supplementation was ineffective at resolving deficiency; very high oral doses (> 350 μg) or intramuscular injections of crystalline B12 were typically required. Studies of iron deficiency after bariatric surgery found high prevalence rates due to inadequate oral supplementation, which can lead to the need for parenteral supplementation. Calcium and vitamin D deficiency studies also showed high prevalence rates of deficiency, which is important to address as deficiency can result in metabolic bone disease. Overall, the need for lifelong supplementation and follow up, early detection of deficiencies, patient education, and more aggressive supplementation regiments were emphasized to increase quality of life in bariatric surgery patients. Future research in bariatric surgery studies should include long-term health outcomes, patient education on required supplementation, and more aggressive supplementation regimens.