Micronutrient deficiencies following bariatric surgery - strategies for nutritional care

Obesity causes serious health problems and is officially recognized as a disease nowadays by multiple professional bodies. The main reason behind this is the complexity of body-weight regulation, increased morbidity and mortality associated with obesity, and the substantial burden on public health. Micronutrient deficiency is a common complication of metabolic changes in obese patients and malnutrition together with fat excess is very often detected among them. Guidelines for the treatment of obesity include diet therapy, respective energy restriction, lifestyle modification, behavior therapy, and pharmacotherapy if the previous approaches have acted insufficiently to reach a 5%-10% loss of body weight. Weight-loss surgery (bariatric surgery) has proven to be the most effective therapy for people with severe degrees of obesity and related comorbidities but this approach can exacerbate some previously existing micronutrient deficiencies, if not properly managed. The purpose of this review was to focus the attention on some deficiencies of micronutrients among obese patients considered for bariatric surgery and post-bariatric and to outline the main approaches to reduce some nutritional risks of this intervention through long-term supplementation and monitoring.