Bariatric Nutrition

It’s essential for bariatric surgery patients to pay close attention to nutritional guidelines and recommendations made by their doctors and dieticians. Patients are at risk of developing nutritional deficiencies as a result of their new smaller post-surgery stomachs. These nutritional deficiencies can lead to health problems such as anemia, from the limited absorption of iron and vitamin B-12, and osteoporosis, from insufficient calcium absorption. Gastric bypass, Lap-Band and other bariatric surgery patients should follow a doctor or dietician-designed bariatric diet, adhere to proper eating methods, and take a multivitamin and other recommended supplements.

Bariatric Nutrition before Surgery

The American Society for Metabolic and Bariatric Surgery (“ASMBS”) recommends that patients undergo a comprehensive evaluation of their nutrients levels prior to surgery. The dietician may inspect the patient’s skin, nails and hair for any signs of nutritional deficiencies, discuss weight and medical history, and suggest lab blood work to ascertain nutrient and other values. The ASMBS also advises that an assessment of other factors should be made, including the person’s knowledge of bariatric nutrition, cultural and economic influences, and her ability to change eating habits. The ASMBS recommends that bariatric patients follow a healthy diet and take vitamin and mineral supplements prior to their surgery to help ensure that micronutrients are at sufficient levels before they begin life with a greatly reduced stomach.

Nutrition after Bariatric Surgery

According to the ASMBS, nutritional deficiencies after bariatric surgery vary by the type of procedure performed. Risk of deficiencies is quite high for Roux-en Y gastric bypass as well as for biliopancreatic diversion with or without duodenal switch. Post gastric bypass nutrition levels are at increased risk for deficits in vitamin B12 and other B vitamins, iron and calcium, while biliopancreatic diversion procedures may result in low levels of vitamins K, A, D and E along with iron and calcium. Lap-Band and other adjustable gastric band surgery does not result in nutritional deficiencies to the degree seen with the malabsorptive surgeries discussed above, however, Lap-Band /gastric band patients are still at risk and should be diligent about following the nutritional advice of their doctors and dieticians.

Proper bariatric nutrition after surgery requires the person to follow a diet rich in vitamins and minerals and high in fiber and protein. Dieticians may also recommend that the diet is low in omega-6 fatty acids and high in omega-3 fatty acids. Taking a multivitamin and other supplements is a must and is further described in the next section. Proper post-surgery diets do vary depending on the procedure, so if you are looking for assistance with gastric bypass nutrition or Lap-Band nutrition requirements please consider the subscribing to the Bariatric Skinny Gastric Bypass Diet or the Bariatric Skinny Lap-Band Diet.

Vitamin and Mineral Supplements after Bariatric Surgery

Vitamin and mineral supplements are a critical part of post-bariatric surgery nutrition. Not only do they help prevent nutrient shortages that may lead to health problems, but they also are an important component in achieving significant weight loss and in keeping the weight off permanently. Please consult your surgeon or dietician for your specific supplement recommendations, but the ASMBS generally recommends the following to improve post Lap- Band, biliopancreatric diversion or gastric bypass nutrition levels:

  • Roux-en-Y Gastric Bypass: complete formula multi-vitamin/mineral, vitamin B12, iron, calcium
  • Lap-Band/Gastric Band: complete formula multi-vitamin/mineral, calcium
  • Biliopancreatic Diversion: complete formula multi-vitamin/mineral, iron, calcium, vitamins A, D, K

Additionally, a B vitamin complex supplement may also be recommended for all of the above surgeries.

Post-Bariatric Surgery Protein Intake

Lap-Band, gastric bypass and other bariatric surgery patients are also at risk of protein malnutrition usually deriving from decreased intake after surgery. Therefore, according to the ASMBS, it is generally recommended that patients consume between 1.0 and 1.5 grams of protein per kilogram of ideal body weight per day. A complete protein supplement is usually recommended to ensure that adequate levels of the 9 essential amino acids are consumed and the daily bariatric protein intake goals are being met. Dieticians also encourage eating protein first each meal to ensure that the person gets her required intake before getting full.

Source: ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient

From the Bariatric Surgery Journals

  • Living posted by 2merriewoode
    Hello, I have got to start learning to live. even though I'm working and I'm feeling a little bit better. still drained it's been 11 weeks since I had surgery and I've lost 40 pounds altogether still feel like I should've lost a lot more. I have to learn to be good enough.

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