American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients

Parrott, J.; Frank, Laura L.; Rabena, Rebecca; Craggs-Dino, Lillian; Isom, Kellene; Greiman, Laura

doi:10.1016/j.soard.2016.12.018

Cited by 487 publications

(451 citation statements)

References 12 publications

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“…Clinical, socio-economic and psychological factors may therefore play a role [5]. Detailed descriptions of vitamin and mineral deficiencies that may be encountered after bariatric surgery, their symptoms and consequences, and the rationale for vitamin supplementation have already been published [4,5,6,25]. …”

Section: Micronutrient Supplementationmentioning

confidence: 99%

“…Iron: Iron deficiency with or without anaemia is common after gastric bypass, biliopancreatic diversion and duodenal switch [4], but it occurs also after sleeve gastrectomy [26] and more rarely after adjustable gastric banding [5,25]. Menstruating women are more frequently affected [4].…”

Section: Micronutrient Supplementationmentioning

confidence: 99%

“…Absorption of vitamin B12 mostly requires the presence of IF, but approximately 1% of oral vitamin B12 is passively absorbed even without IF [5]. Therefore, an oral dose of 350-500 μg/day is considered sufficient to guarantee the absorption of the daily vitamin B12 requirement [5,25]. Alternatively suggested regimens of administration are 1 mg/month intramuscularly, 3 mg every 6 months intramuscularly or 500 μg every week intranasally [4].…”

Section: Micronutrient Supplementationmentioning

confidence: 99%

“…The most important consequence of coupled calcium and vitamin D deficiencies is bone demineralisation. Therefore, even in the absence of conclusive evidence concerning the long-term risk of fractures after bariatric surgery, calcium and vitamin D routine supplementation is strongly recommended after gastric bypass and malabsorptive procedures [4,5,6,25]. Obese patients frequently present vitamin D deficiency at baseline; this deficiency should be corrected before surgery with an oral vitamin D load [5].…”

Section: Micronutrient Supplementationmentioning

confidence: 99%

“…Therefore, a short period of persistent vomiting impairing regular food intake can precipitate thiamine deficiency [5,25]. Symptomatic thiamine deficiency has been described after a few weeks of intractable vomiting after any bariatric procedure, usually as a consequence of mechanical problems such as stoma stenosis after gastric bypass [32], excessive band tightness or band slippage after gastric banding [33] and stomach oedema with impaired nutrition after sleeve gastrectomy [34].…”

Section: Micronutrient Supplementationmentioning

confidence: 99%

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Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

et al. 2017

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Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations.

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Section: Micronutrient Supplementationmentioning

confidence: 99%

Section: Micronutrient Supplementationmentioning

confidence: 99%

Section: Micronutrient Supplementationmentioning

confidence: 99%

Section: Micronutrient Supplementationmentioning

confidence: 99%

Section: Micronutrient Supplementationmentioning

confidence: 99%

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Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

et al. 2017

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Treatment of Iron Deficiency After Gastric Bypass

Auerbach

2020

JAMA

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disorders occurred in 39% of modafinil users and 4.5% of methylphenidate users, and use of other psychoanalytics in the modafinil-and methylphenidate-exposed groups was reported to be 41% and 30%, respectively (Table ).There were 6 major congenital malformations in the modafinil-exposed group (no patient with multiple sclerosis received teriflunomide, a suspected teratogen), 43 in the methylphenidate-exposed group, and 32 466 in the unexposed pregnancies group, for absolute risks of 12% for modafinil, 4.5% for methylphenidate, and 3.9% for unexposed. The adjusted ORs were 3.4 (95% CI, 1.2-9.7) comparing modafinil and methylphenidate and 2.7 (95% CI, 1.1-6.9) comparing modafinil with unexposed (Figure).Discussion | In this nationwide study, first-trimester in utero exposure to modafinil compared with methylphenidate or no medication was significantly associated with an increased risk of congenital malformations.In 2 case series totaling 274 patients with narcolepsy, no malformations among 13 modafinil-exposed pregnancies were reported. 4,5 Narcolepsy itself does not appear to increase the risk of congenital malformations. 6 There are several limitations. First, the potential for residual confounding exists. For example, baseline differences in psychiatric medications were adjusted for, but adjusting for psychiatric diagnoses was not feasible. Although methylphenidate was used as an active comparator to address confounding by indication, methylphenidate is indicated for ADHD as well as narcolepsy. Second, prescription redemptions were a proxy for actual use. Third, the small numbers of exposed women and events reflect the rarity of the exposure and decrease the precision of the point estimates. Fourth, specific malformations were not identifiable.Although further research is needed, women contemplating pregnancy should currently avoid or discontinue modafinil.

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Treatment of Iron Deficiency After Gastric Bypass—Reply

Murali

2020

JAMA

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American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients

Cited by 487 publications

References 12 publications

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

Treatment of Iron Deficiency After Gastric Bypass

Treatment of Iron Deficiency After Gastric Bypass—Reply

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