Malnutrition Following Bariatric Surgery: Underlying Mechanisms and Strategies for Prevention and Treatment

The benefits of bariatric surgery for severe obesity are well established. As more individuals undergo bariatric surgery, including special populations such as adolescents, stakeholders should have a better understanding of the consequences on nutritional status. Information regarding nutritional outcomes following gastric bypass, sleeve gastrectomy and biliopancreatic diversion is of primary importance because of the significant impact these surgeries can have on protein, minerals and fat-soluble vitamin nutritional status.

The driving factors for various nutritional complications include inadequate dietary intake, as well as impaired digestion and intestinal absorption. Inadequate intake of protein, particularly in the early post-operative period, can contribute to significant losses of lean mass and strength; longer term pathological changes in muscle strength and function have been reported and merit consideration in terms of impact on activities and overall quality of life. Iron deficiency associated with anemia and fatigue, and calcium and vitamin D deficiency, associated with bone fractures, commonly occur. This presentation will be an overview of malnutrition following bariatric surgery, the mechanisms involved, and emerging data regarding nutrition support.

CPE Level: Level 2
CPEU: 1.0

Performance Indicators

• 4.2.8 Identifies and implements a plan to address the problem, issue or challenge
• 4.1.2 Interprets and integrates evidence-based research and literature in decision making.
• 10.2.8 Establishes the plan of care, directly addressing the nutrition diagnosis in collaboration with the patient in defining the time, frequency and duration of the intervention.

Learning Objectives

• Describe the prevalence of malnutrition in protein, iron, vitamin D and calcium following bariatric surgery.
• Describe the current understanding of mechanisms that promote malnutrition following bariatric surgery.
• Describe the effectiveness of dietary or supplementary regimens for prevention and treatment of nutrient deficiency

Speakers

• Nana Gletsu-Miller
• Lisa Tussing-Humphreys
• Anne Schafer