Background

Limited nutrient intake and anatomical changes have been associated with nutrient deficiencies (ND) after bariatric surgery (BS). Whether weight regain as proxy of larger food intake is associated with lesser ND is currently unknown.

Methods

We prospectively evaluated 578 patients (306 F (78%); BMI=47±6.1 kg/m2; Age=44.3±11) undergoing BS (68% gastric bypass (GBP) and 32% sleeve gastrectomy (SG) at baseline and at 5 and 10 years. Protocolized laboratory analysis was performed at each nutritional appointment. Weight regain (WR) was evaluated and expressed as % of excess of weight loss (EWL) regained.

Results

A relevant number of deficiencies were identified (baseline-5years-10years): VitD (97%-85%-86%), tr-saturation (51%-10%-25%), VitB12 (32%-27%-26%), ferritin (27%-26%-21%), transferrin (Tr) (31%-37%-25%), low Hb (24%-23%-14%), iron (20%-25%-13%), calcium (19%-1%-3%), prealbumin (14%-26%-28%) and intraerythrocytic folic acid (8%-7%-7%). From 195 patients with ³4 baseline deficiencies (34%), 67% still remained so at follow-up. VitB12, Hb and other haematic parameters were more prevalent in BPG than in SG (p<0.05). WR of 20% occurred in 3% and 12%, and 22% and 27% of SG and GBP at 5 and 10y, respectively, and was not associated with deficiencies.

Conclusions

Our data shows that despite patients being immerse in an intensive and comprehensive long-term bariatric program with high retention rate, prevalence of deficiencies are frequent and considerable and probably, attributable to anatomical changes. Nutritional monitoring long term from baseline seems mandatory.