Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient—2013 Update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

“…With BMI ≥ 40 kg/m 2 (EL A, B, C [14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] 3. BMI criterion may be the current BMI or previously maximum attained BMI of this severity.…”

“…Some of the evidence level data was also retrieved from the following publications: Commonwealth of Massachusetts Betsy Lehman Center for Patient Safety and Medical Error Reduction Expert Panel on Weight Loss Surgery [15] , Obesity Surgery Evidence-Based Guidelines of the European Association for Endoscopic Surgery (EAES) [16] , Maggard et al's Meta-Analysis: Surgical Treatment of Obesity [17] and Laville et al 's Recommendations Regarding Obesity Surgery [18] , and the Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient -2013 Update by Mechanick et al [19] .…”

Living with Hemoglobin of 3.7 After Bariatric Surgery! Follow-up is Key to Preventing Adverse Outcomes

“…When iron deficiency does occur, iron supplementation is necessary; iron is often recommended following gastric bypass [22,24]. Iron deficiency presents primarily as a microcytic anemia and is confirmed by a measure of hemoglobin, blood smear for microcytic, hypochromic red cells and determining serum iron, iron binding capacity, transferrin saturation, and ferritin assays periodically [24][25]. Iron supplements must be administered and tailored to patient [25]; intravenous infusion of iron is indicated when intolerant to iron.…”

“…Iron deficiency presents primarily as a microcytic anemia and is confirmed by a measure of hemoglobin, blood smear for microcytic, hypochromic red cells and determining serum iron, iron binding capacity, transferrin saturation, and ferritin assays periodically [24][25]. Iron supplements must be administered and tailored to patient [25]; intravenous infusion of iron is indicated when intolerant to iron. Oral iron is best administered as ferrous sulfate, 325 mg daily, on an empty stomach; larger doses are not necessarily more effective and in fact may be associated with more side-effects [26,27].…”

“…Besides B12 and iron deficiency, nutritional anemias involving protein, copper, selenium, and zinc may result from malabsorption following bariatric surgery and require consideration when routine screening is negative for iron deficiency anemia [21,[25][26].…”