Overview on nutritional issues in bariatric surgery

Curr Opin Clin Nutr Metab Care. 2016 Nov;19(6):484-490. doi: 10.1097/MCO.0000000000000325.

Abstract

Purpose of review: In the context of the worldwide obesity epidemic, bariatric surgery is the only therapy associated with a sustainable weight loss and to midterm prevention of obesity-related complications. However, nutritional and behavioral multidisciplinary medical preparation, as well as long-term postoperative nutritional follow-up, is strongly advised to avoid postoperative surgical, nutritional, or psychiatric complications.

Recent findings: Due to a long history of restrictive diets and large body weight fluctuations, preoperative nutritional assessment and correction of vitamin and trace elements deficiencies are mandatory. A rapid and massive weight loss induces the loss of muscle mass and fat-free mass that could lead to malnutrition and osteoporosis. Dietetic counseling is advised to prevent postoperative food intolerance syndrome, malnutrition, and weight regain. Protein intake should be at least 60 g/day. Planned and structured physical exercise should be systematically promoted to maintain muscle mass and bone health.

Summary: Bariatric surgery is mostly successful if patients are well prepared and monitored. The perfect patients' selection remains difficult in the absence of well defined predictive criteria of success. Future research is needed to define optimal perioperative nutritional management and its influence on long-term outcome, including quality of life and healthcare-related costs.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bariatric Surgery* / adverse effects
  • Body Composition
  • Female
  • Health Behavior
  • Health Care Costs
  • Humans
  • Male
  • Malnutrition
  • Micronutrients / deficiency
  • Nutrition Assessment
  • Nutritional Status*
  • Obesity / complications
  • Obesity / surgery
  • Osteoporosis
  • Patient Education as Topic
  • Postoperative Complications
  • Quality of Life
  • Risk Factors
  • Treatment Outcome
  • Weight Loss

Substances

  • Micronutrients