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Q&A with Australian Health Practitioners
Will I need to take any vitamins and supplements following weight loss surgery as my food intake will decrease?
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Dr Vytauras Kuzinkovas
Bariatric (Obesity) Surgeon, General Surgeon, Upper GI Surgeon (Abdominal)
Dr V. Kuzinkovas is a UK trained Consultant Surgeon, specializing in Upper Gastro-Intestinal, Obesity, advanced Laparoscopic and Gastro-Esophageal cancer Surgery. He has Visiting Medical Officer … View Profile
Patient’s compliance and long term follow up is absolutely essential after any weight loss surgery. Yes – the more complex is the surgery – the more vitamins or supplements patient will require. Lap band has minimal vitamin deficiencies as no part of the bowel is bypassed. However sleeve gastrectomy and gastric bypass require more vitamin, mineral and protein intake to fulfill the daily requirements. Postoperative follow up and monitoring by a practice dietitian usually addresses all those balanced diet and vitamin supplement issues so the compliant patient should not develop the deficiencies of essential nutrients.
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Dr Michael Hii
Bariatric (Obesity) Surgeon, Upper GI Surgeon (Abdominal)
Mr Michael Hii is an Upper Gastro Intestinal surgeon, who specializes in diseases of the oesophagus, stomach and adrenal glands. Mr Hii completed training in … View Profile
Each bariatric operation is different and each therefore has a tendency to affect the body’s requirement for vitamins and supplements differently. In theory some operations are much more likely to affect the body’s handing of minerals and vitamins.
It is important to know that many patients who suffer from obesity also have a relatively nutrient poor diet and many are seen to be deficient in minerals and vitamins pre operatively. This is often checked and correction began prior to surgery.
Gastric banding is an operation, which reduces food intake by slowing the speed of eating and promoting a feeling of fullness after a smaller meal. Eating good quality, fresh food in “normal” amounts is encouraged after this operation. There is no effect on food absorption after the food leaves the stomach, so in theory patients who stick to a good diet should not have any problems with vitamin deficiency.
A similar theory applies to sleeve gastrectomy. Patients eat normal food, but in smaller portions so again digestion of minerals and vitamins should be normal.
After a gastric bypass, the majority of the stomach and a varying amount of small intestine no longer comes into contact with food. Although this is not usually clinically noticeable, it is possible for this to lead to a tendency for micronutrient malabsorption.
Despite this theory (or because of it, most practitioners will monitor the levels of vitamins and minerals in their patients after bariatric surgery. In addition, the use of supplements is recommended to many people. This is because with marked weight loss it is important to be aware of subtle deficiencies, which may not be clinically obvious but may harm people in the long term if not detected.
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Chris Fonda
Dietitian, Nutritionist, Sports Dietitian
As an Accredited Sports Dietitian, APD and athlete (springboard diver), Chris has both professional and personal experience in sport at the sub-elite and elite level.Chris … View Profile
As Emma has mentioned it does depend on the type of weight loss surgery performed but also we need to consider what your diet was like before surgery as a low nutrient, energy dense diet tends to be lower in nutrient value compared to a high nutrient, low energy diet.
As Dr Michael Hii has mentioned, gastric banding doesn't have an effect on the bodies ability to absorb nutrients from the foods we eat. What it does do is limit the amount of food that a person can take in. It's important that because the person with gastric banding cannot eat large amounts of food that the meal is nutrionally adequate and an Accredited Practising Dietitian (APD) specialising in bariatric surgery can help you with this.
In a sleeve gastrectomy part of the stomach is removed leaving a smaller space (much like the gastric band) where food can sit, therefore, reducing the amount of food taken in. The problem with removing much of the body of the stomach is that it reduces the acidic environment of the stomach over time. This can lead to a inefficiency of absorption, vitamin B12 depletion and a deficiency is possible. Also the part of the stomach removed is responsible for the release of “ghrelin” the hunger hormone. A person who has this procedure will often have a reduced appetite. People with a sleeve gastrectomy may need a supplement, however, speak with your surgeon or APD first to determine if a deficiency is likely.
Gastric bypass surgery is the one that can potentially cause the most problems with vitamin and mineral deficiency. Many patients will need to go on a supplement to ensure they are getting the right amounts of nutrients to support a healthy diet and lifestyle.
Like with all bariatric surgery procedures it's advisable that you seek the expert advice and guidance from an Accredited Practising Dietitian (APD) who specialises in bariatric surgery. They can help you to make the right decisions on what foods to include in your diet to achieve optimal health. To find an APD near you head to www.daa.asn.auReport this post
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Chloe McLeod
Dietitian
Chloe graduated from Flinders’ University in 2008 and has since worked as a Dietitian in clinical, community and private practice, and as a university lecturer. … View Profile
In general a multi vitamin is recommended. Specific nutrient deficiencies will depend on the surgery performed, so is best to have a chat with your surgeon, or a dietitian who specialises in bariatric surgery for specific advice.
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