American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic &amp; Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient

Mechanick, Jeffrey I.; Kushner, Robert F.; Sugerman, Harvey J.; González-Campoy, J. Michael; Collazo–Clavell, Maria L.; Guven, Safak; Spitz, Adam F.; Apovian, Caroline M.; Livingston, Edward H.; Brolin, Robert E.; Sarwer, David B.; Anderson, Wendy; Dixon, John

doi:10.1016/j.soard.2008.08.009

Cited by 313 publications

(221 citation statements)

References 696 publications

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“…Seria importante conhecer os resultados dos exames bioquímicos (vitamina B12, hemoglobina, hematócrito, albumina, ferritina, cálcio e vitamina D) prévios à cirurgia bariátrica, pois as deficiências encontradas já podem começar a ser corrigidas antes da cirurgia. A suplementação nutricional é muito enfatizada como importante conduta terapêutica para o sucesso do tratamento cirúrgico da obesidade [48]. A utilização do suplemento nutricional só é considerada correta quando utilizada pelo menos cinco vezes por semana [15], mas infelizmente apenas 33% dos pacientes atendem a essa recomendação.…”

Section: Artigo Originalunclassified

Perfil nutricional e estilo de vida de pacientes pré e pós cirurgia bariátrica

Zyger

Zanardo

Tomicki

2016

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. ABSTRACT Aims:To analyze the nutritional profile and the lifestyle of patients before and after bariatric surgery by Roux-en-Y gastric bypass. Methods: Retrospective cohort study carried out in the period from 2010 to 2014, including data on patients submitted to bariatric surgery by Roux-en-Y gastric bypass in a private hospital located in the northern region of Rio Grande do Sul, Brazil. Sociodemographic data, lifestyle, anthropometric measurements, and the intake of calories, nutrients, vitamins, and mineral salts before surgery and one year thereafter were analyzed. The results for biochemical tests (vitamin B12, hemoglobin, albumin, hematocrit, and ferritin) performed six months to one year after surgery were also assessed. Results: Fifty patients were included in the study, and 44 (88%) were female. Thirty-five patients (70%) presented with some conditions before surgery, among which high blood pressure (35%) and diabetes mellitus (20%) were the most frequent. Between the preoperative evaluation and one year after the surgery, physical activity level increased ( The intake of calories and of vitamin B12 also decreased significantly (p<0.05). The tests performed within six months to one year after the surgery indicated one patient with vitamin B12 deficiency, seven patients with anemia, and three with ferritin deficiency. Conclusions: After bariatric surgery by Roux-en-Y gastric bypass there was weight loss, reduction in body mass index and abdominal circumference, and a decrease in sedentary lifestyle. Some nutritional deficiencies were observed, which indicates the need for nutritional management after bariatric surgery in order to ensure a successful outcome.

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Section: Artigo Originalunclassified

Perfil nutricional e estilo de vida de pacientes pré e pós cirurgia bariátrica

Zyger

Zanardo

Tomicki

2016

Sci Med

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“…For these patients, diet and exercise, even with pharmacologic therapy, are unlikely to achieve desired weight loss [3]. The American Society for Metabolic and Bariatric Surgery (ASMBS) has estimated that the number of bariatric surgeries in the USA has increased dramatically from 16,000 procedures performed in the 1990s to 103,000 in 2003 and 200,000 in 2007 [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…The type and frequency of deficiency is associated with the type of surgery performed and the portion of the intestine affected [6,7]. There are several types of bariatric surgery available delineated as restrictive (limiting amount of food intake) or malabsorptive (affecting food absorption) based on the mechanism of inducing weight loss [5,8]. Restrictive procedures such as gastric banding and gastroplasty, which restrict food intake, have the least impact on nutrient absorption since none of the intestine is bypassed.…”

Section: Introductionmentioning

confidence: 99%

“…Clinical practice guidelines for the nutritional, metabolic, and nonsurgical support of the bariatric surgery patient have been developed jointly by the American Association of Clinical Endocrinologists, the Obesity Society, and the American Society for Metabolic and Bariatric Surgery (Appendix 1) [5]. These guidelines support lifelong nutrient recommendations including multivitamin, vitamin B-12, folic acid, calcium, vitamin D, and iron supplementation, often more than what is available in a daily multivitamin with minerals [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Certain salt forms of these minerals are also critical for absorption, such as the citrate form of calcium and ferrous forms of iron [5]. Patients who do not follow these lifelong recommendations risk developing deficiencies and secondary conditions such as anemia, vitamin B-12 deficiency, and osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

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Nutritional and Pharmacologic Challenges in the Bariatric Surgery Patient

Lizer

Papageorgeon

Glembot³

2010

OBES SURG

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The purpose of this study was to describe vitamin and nutrient supplement practices and assess medication dosage formulations utilized in patients hospitalized with a history of bariatric surgery. Retrospective pilot study was conducted from January 1, 2006 through December 31, 2007 in patients with a past history of bariatric surgery. Demographic data, vitamin and nutrient supplements, and medication dosage formulations were evaluated upon admission. This was compared to published guidelines. Compliance with the following supplementation was categorized: daily multivitamin, calcium, iron, vitamin B-12, and folic acid. The frequency of non-immediate-release and enteric-coated medication dosage forms was also examined. Discrepancies were identified as lack of one of the supplements or if an inappropriate dosage formulation was ordered. Of 133 admissions, 117 (88%) had a history of a malabsorptive procedure and at least one discrepancy was found. Only 33.3% of admissions were ordered a multivitamin, 5.1% were ordered supplemental vitamin B-12, and 7.7% received a calcium supplement. Additional folic acid was ordered in 11.1% and iron ordered in 12.0%. Inappropriate medication formulations were ordered in 61.5% of patients; 34.7% included non-immediate-release formulations, 25.0% enteric-coated formulations, and 40.3% both non-immediate-release and enteric-coated. Upon discharge from the institution, 50% had inappropriate formulations continued. Patients with a history of bariatric surgery may not have their vitamin and nutrient needs met upon hospitalization. Prior bariatric surgery is not consistently taken into consideration when ordering medications. Healthcare providers need to be cognizant of vitamin regimens to recommend as well as medication dosage formulations to avoid.

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