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Review
. 2024 Aug;44(1):289-312.
doi: 10.1146/annurev-nutr-061121-101547. Epub 2024 Aug 12.

Nutritional Challenges and Treatment After Bariatric Surgery

Violeta Moize  1   2 , Blandine Laferrère  3 , Sue Shapses  4   5
Affiliations
Review

Nutritional Challenges and Treatment After Bariatric Surgery

Violeta Moize et al. Annu Rev Nutr. 2024 Aug.

Abstract

Bariatric surgery is an important weight loss tool in individuals with severe obesity. It is currently the most effective long-term weight loss treatment that lowers obesity-related comorbidities. It also has significant physiological and nutritional consequences that can result in gastrointestinal complications and micronutrient deficiencies. After gastric bypass, clinical events that negatively affect nutritional status include malabsorption, dumping syndrome, kidney stones, altered intestinal bile acid availability, bowel obstruction, ulcers, gastroesophageal reflux, and bacterial overgrowth. Risk factors for poor nutritional status and excessive loss of lean body mass and bone include reduced dietary quality and inadequate intake, altered nutrient absorption, and poor patient compliance with nutrient supplementation. There are unique concerns in adolescents, older individuals, and individuals who become pregnant postoperatively. With careful management, health-care professionals can assist with long-term weight loss success and minimize the risk of acute and long-term nutrition complications after bariatric surgery.

Keywords: bariatric surgery; gastrointestinal; nutrition therapy; nutritional deficiencies; obesity; weight loss.

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Conflict of interest statement

DISCLOSURE STATEMENT

The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review.

Figures

Figure 1
Figure 1
Bariatric surgical procedures (percent per year) for sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), adjustable gastric band (AGB), biliopancreatic diversion (BPD), and endoscopic bariatric therapies (balloons and other procedures to reduce stomach size). Data from the American Society for Metabolic and Bariatric Surgery were used to create this figure (https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers).
Figure 2
Figure 2
Bariatric surgeries: (a) Roux-en-Y gastric bypass, (b) sleeve gastrectomy, (c) adjustable gastric banding, and (d) biliopancreatic diversion with duodenal switch. Figure adapted with permission from Dr. Walter Pories.
Figure 3
Figure 3
Fracture risk 5–15 years after bariatric procedures. Abbreviations: AGB, adjustable gastric band; RYGB, Roux-en-Y gastric bypass; SG, sleeve gastrectomy.
See this image and copyright information in PMC

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