Bariatric surgeries help those who are morbidly obese lose weight by restricting intake and, in the case of some procedures, blocking calorie absorption. To maintain their health after surgery, patients must make long-term dietary changes and take multivitamin supplements for the rest of their lives. If you are considering any type of bariatic procedure, discuss your post-surgical nutritional needs with your physician.
Bariatric Surgery
Restrictive procedures such as adjustable gastric banding and sleeve gastrectomy limit food intake by reducing the size of the stomach. Malabsorptive procedures such as the biliopancreatic diversion rearrange the digestive system to block some calorie absorption. Gastric-bypass procedures combine both approaches by reducing the stomach to an egg-sized pouch and bypassing part of the small intestine. These changes can cause vitamin and mineral deficiencies that could affect every organ in your body.
Vitamins After Bariatric Surgery
All bariatric patients should take high-potency multivitamins for the rest of their lives to prevent vitamin deficiencies, according to Linda Aills, R.D., lead researcher in a study published in the September 2008 issue of "Surgery for Obesity and Related Diseases." A high-potency vitamin contains 100 percent of the recommended daily value of at least three-fourths of the nutrients in the supplement. Adjustable gastric-banding patients need one dose per day, while gastric-bypass and biliopancreatic-diversion patients need 200 percent of the recommended daily values.
Chewable Multivitamins
Bariatric patients should begin taking chewable multivitamins on the first day after their discharge from the hospital. Band patients will take the multivitamins once a day while on a liquid diet, and other patients will take them twice a day for at least the first three months. West Penn Allegheny Health System recommends bariatric chewables offered by Bariatric Advantage, Celebrate Vitamins, Opurity and Centrum. Follow your surgeon's recommendations if her advice differs.
Bariatric Vitamins
After the first 90 days, when you can eat solid foods and take pills, you may switch to a nonchewable multivitamin if you wish. Vitamins manufactured specifically for bariatric patients, called bariatric vitamins, offer the correct amount of supplements to meet your needs. Some companies offer surgery-specific compounds designed for gastric bypass, biliopancreatic-diversion and band patients. If you find the cost of bariatric vitamins to be prohibitive, check with your surgeon about over-the-counter vitamins.
Over-the-Counter Vitamins
If you use over-the-counter vitamins in either chewable or pill form, West Penn Allegheny Health System recommends adult compounds such as One A Day, Centrum Silver or Centrum Performance. Aills advises looking for a complete formula that has at least 18 mg of iron, as well as selenium, folic acid and zinc. Avoid children's vitamins, as they will not meet the needs of an adult.
References
- "Surgery for Obesity and Related Diseases 4"; American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient; Jeffrey Mechanick, M.D., et al; September 2008
- West Penn Allegheny Health System: Vitamin/Mineral Supplements After Bariatric Surgery
- "Surgery for Obesity and Related Diseases 4"; ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patients; Linda Aills, R.D., et al.; September 2008
- "ACSM'S Certified News 14"; Nutritional Care of the Bariatric Patient; Susan J. Kraus, M.S., R.D.; January/February/March 2009
- "Obesity Surgery"; Nutritional Consequences of Adjustable Gastric Banding and Gastric Bypass: A 1-Year Prospective Study; Muriel Coupaye, Ph.D., et al.; January 2009
- "Micronutrition for the Weight Loss Surgery Patient"; Jacqueline Jacques, N.D.; 2006
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