Bariatric surgery is the most successful treatment for obesity and its associated comorbidities, contributing, not only to lose great amounts of body weight, but to lower levels of cholesterol and blood glucose, to ease joint pains, to reduce sleep apnea, and even to improve fertility. Bariatric surgery has proven to be very effective on improving patients’ general wellbeing. However, in order to sustain that wellbeing and good health, nutrition remains to be the most important factor that should be considered and fully acknowledged, before the surgery and after the surgery, during the bariatric treatment, but also for the rest of the patients’ lives, as an ongoing habit.
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Vitamins needed before the surgery
Obesity in itself is a triggering factor for micronutrient deficiencies. Most obese patients suffer from a deficiency of Vitamin D. Prevalence of this deficiency has been reported to be as high as 90% in obese patients. Iron and folic acid deficiencies are also common among obese patients, with a prevalence as high as 45% in the case of iron deficiency, and 54% in the case of folate deficiency. Patients with obesity might also suffer from deficiencies of Vitamins B1, B12, A, E, K, Zinc, Copper and Calcium. This depends on the level of Body Mass Index (BMI), gender (since menstrual cycles and menopause will also contribute to micronutrient deficiencies), and other health factors.
Patients requesting bariatric surgery are required to take vitamin supplements at least 3 weeks before their surgical treatment in order to boost their defenses, replete any nutrient deficiencies, and get their body into optimal conditions to sustain the surgical intervention. Most doctors prescribe supplements that contain Vitamin B1, B12, folate, iron, Vitamins A, E, K, D, calcium, copper, and zinc, after conducting a preoperative nutrition screening to make a proper assessment of the patient’s needs. Only your doctor can prescribe which pre-bariatric surgery vitamins are the right choice for you.
Bariatric surgery vitamins
The risk of micronutrient deficiencies after bariatric surgery depends on the kind of surgical intervention received and the conditions of malnutrition the patient had before the surgery. Restrictive procedures such as the laparoscopic gastric band are less associated with deficiencies in comparison with malabsorptive procedures like the Roux-en-Y gastric bypass. However, the biliopancreatic diversion is the most likely to cause nutritional deficiencies due to the fact a large section of the small intestine gets bypassed.
Every bariatric patient should have regular blood screenings to detect any malnutrition deficiencies and prescribe proper bariatric surgery vitamins. At LIMARP International Center of Excellence for Obesity, our team runs nutrition tests as frequently as every two weeks to patients that receive bariatric treatment. We also run blood tests, screening for any micronutrient deficiencies, at 3 to 6 months intervals after the bariatric surgery. Bariatric surgery vitamins prescriptions are made for each patient, depending on their personal needs and test results.
The American Society for Metabolic and Bariatric Surgery (ASMBS) has proposed a series of nutrition guidelines for bariatric patients. These guidelines recommend standard dosages of bariatric surgery vitamins depending on the surgical procedure that the patient received. Most of the recommendations indicate that patients should take bariatric surgery vitamins that double the daily recommended dose of each type of micronutrient, as well as additional iron, folic acid, and calcium. The supplements recommended to prevent micronutrient deficiencies after bariatric surgery are:
- Vitamin B1 (Thiamin)
- Vitamin B12 (Cobalamin)
- Folate (Folic Acid)
- Iron
- Vitamin D
- Calcium (in divided doses, and with meals)
- Vitamins A, E & K
- Zinc
- Copper
In the case of malnutrition, prescribed dosages of these vitamins may triple or quadruple. Vitamins are an essential part of a bariatric treatment and should be prescribed by a specialized doctor or nutritionist. No patient should auto prescribe dietary or vitamin supplements, as consequences of having too little or too much of them might lead to serious health consequences, and some of them might be unreversible.
Important aspects to consider
Every patient needs to take bariatric surgery vitamins after their surgical procedure as a preventive measure to avoid risks of malnutrition, as it is very difficult to predict who and when a micronutrient deficiency will occur. As such, bariatric surgery vitamins will become a lifelong expense that cannot be ignored nor neglected. This should be taken into consideration, as most health care insurances don’t cover vitamin supplement costs.
Some dosages might be taken only once a day, but others, such as calcium, have to be taken twice or thrice a day. Patients should set a daily routine to take their vitamins regularly, without skipping schedules or dates. This calls for great discipline and commitment. The type and dose of vitamins needed might change according to lifestyle and health changes through different stages in a patient’s life, so regular blood test screenings are suggested on a yearly basis.
Contact us
If you would like to know more about which bariatric surgery vitamins are the right fit for you, please call our clinic LIMARP International Center of Excellence for Obesity, located at Tijuana. Our team will be very glad to help.