Audit of nutritional and dietary outcomes of bariatric surgery patients

Abstract

Bariatric surgery is the most effective means of achieving sustainable weight loss for the morbidly obese but resultant gastrointestinal functional changes and altered diet may lead to a number of eating and nutritional problems. This audit was conducted to evaluate Guernsey outcomes in relation to UK national standards and to determine the adequacy of current dietetic provision. A postal questionnaire was sent to 177 patients. Sixty-eight responded (48 gastric bypass, 15 banding and five other procedures). Mean body mass index preoperatively was 44.2 (five had body mass index <35). Five respondents (7%) had received preoperative and 26 post-operative dietary advice. Only 12 (18%) received any dietetic follow-up. Only one patient had any psychological support. Mean maximal weight loss and regain was 42.7 kg and 4.5 kg, respectively. Micronutrient supplementation and monitoring was variable. Deficiencies of B(12) (44%), iron (25%), vitamin D (10.2%) and folate (6.2%) were recorded. Problems with food intolerances were common and often protracted. The majority of respondents expressed satisfaction with the procedure, but many recognized that it had not solved their food-related issues. There was dissatisfaction with dietetic intervention. Overall, current treatment was shown to fall short of UK standards. A number of recommendations have been made to improve future outcomes, including re-audit and improved dietetic service provision.