Asked by Paulina Thomas, Jacksonville
What vitamins and supplements are recommended for people who have had weight loss surgery? And how much?
Diet and Fitness Expert
Dr. Melina Jampolis
Physician Nutrition Specialist
Hi Paulina. This is a very good question, but I can't give you any specific recommendations without knowing what type of surgery you had and without knowing more about you specifically.
According to my colleague, weight-loss surgeon Dr. John Rabkin, any type of weight-loss surgery will initially require some supplementation due to the restricted amount of food you can eat post-operatively. When you eat less food, you also take in less vitamins, minerals, and protein, leading to the need for short- and/or long-term supplementation. This is particularly important for optimal healing post-operatively and for long-term health. In addition, he notes that, many (if not most) patients have vitamin and/or mineral deficiencies at baseline (before surgery) as these deficiencies are quite common in the general population.
Rabkin goes on to explain that many procedures including gastric bypass, duodenal switch, and biliopancreatic diversion require supplementation of the fat-soluble vitamins (A,D, E, & K) and minerals (calcium, iron, zinc, occ. copper, trace minerals). These operations remove portions of the gut where these nutrients are absorbed, so you may need to take higher amounts to ensure that you get an adequate dose. In addition, you may need to take the fat-soluble vitamins in a "dry" form to improve absorption, which means that they dissolve in water instead of fat, since the procedures decrease fat absorption. Gastric banding and sleeve procedures do not remove areas in the gut where nutrient absorption takes place, so they often require less supplementation long term and have less risk of deficiencies.
The doses of vitamins, minerals and protein vary considerably between individuals, so it is important that you work closely with your weight-loss surgeon and primary care physician after the surgery to determine the right amount for you. These surgeries are not a quick fix and do have side effects, so it is critical to find a weight-loss surgeon who provides long-term care. A good place to start would be in choosing a center certified as a Center of Excellence in Bariatric Surgery by the American Society for Metabolic and Bariatric Surgery. In addition, Rabkin notes that patients who join patient support groups do better long term, so if your surgeon does not offer a support group, seek one out in your community.
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