Nutritional management after bariatric surgery

Bariatric surgery is currently the most effective method of sustainable weight loss among morbidly obese patients. For many patients, the benefits of weight loss, such as decreases in blood glucose, lipids, and blood pressure and increase in physical activity, will outweigh the risks of surgical complications. Proper patient selection, thorough preoperative nutritional education, and postoperative nutritional follow-up contribute to the long-term management of the metabolic abnormalities of obesity. Bariatric surgery is divided into 2 major categories: restrictive procedures and combination of malabsorptive with restrictive procedures. The more dramatic weight loss is generally associated with the combined procedures. There is an increased risk of specific nutritional deficiencies associated with these types of surgery. With proper nutritional supplementation and frequent monitoring of nutritional status, these deficiencies can be successfully managed. This article reviews the most common bariatric surgeries and their typical dietary support and reviews critical nutrition care in regards to total parenteral nutrition for the morbidly obese patient, following bariatric surgery.