Today, I would like to kowtow to my friend and colleague Dr Priya Manjoo, endocrinologist at the University of Victoria, who gave a fantastic talk about nutritional support of the bariatric patient at the Canadian Obesity Summit. 

 
I’ll highlight a few of the key points here: 
 
1.  Prior to obesity surgery, many patients are already often deficient in nutrients; for example, one study showed that 65% of patients were deficient in vitamin D before surgery, and 27% were deficient in iron.  Therefore, it is imperative that these levels be checked and corrected before surgery is undertaken. 
 
2.   Following obesity surgery, there are a number of reasons why nutritional deficiencies can occur,  including insufficient intake due to dietary restrictions and food intolerances, anatomical causes due to changes made in the intestinal anatomy, and a disconnect between the timing of release of digestive enzymes and entry of food into the intestine. 
 
3.  Dr Manjoo then went through a fabulous review of the various vitamins and nutrients that we need to be on the watch for after bariatric surgery.  Adequate protein intake, and monitoring and supplementation (depending on the type of surgery) of calcium, vitamin D, iron, vitamin B12, folate, thiamine, zinc, copper, and selenium are all things that we need to think about.Finally, as previously blogged, she pointed us towards the 2013 American Bariatric Guidelines for some guidance on this complex topic.

 
Thanks Priya for a fabulous session!
 
Dr Sue Pedersen www.drsue.ca © 2013 

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