Nutritional Deficiencies Before and After Metabolic and Bariatric Surgery in Patients Above 50.0 kg/m: A Single Center Study.

PURPOSE

Metabolic and bariatric surgery (MBS) is an effective treatment for patients with body mass index (BMI) above 50.0 kg/m but nutritional deficiencies (ND) may arise. This study aimed to assess if patients with BMI above 50.0 kg/m have more ND and require more supplementation after MBS compared to patients in lower BMI groups.

MATERIALS AND METHODS

Retrospective single center study including all patients submitted to MBS from 2019-2020. Several parameters were collected. Statistical analysis was performed to compare ND between BMI groups (<40.0 kg/m; 40.0 to 49.9 kg/m; ≥50.0 kg/m), and between surgeries (Roux-en-Y gastric bypass [RYGB] vs. sleeve gastrectomy [SG]) in the group with BMI ≥50.0 kg/m.

RESULTS

We identified 951 patients, 85 (9.0%) with BMI ≥50.0 kg/m, with RYGB performed in 644 (68.4%) patients. Pre-operatively, vitamin D deficiency was observed in 80.0% of patients with BMI ≥50.0 kg/m, with significant differences between BMI groups. At follow-up there were no significant differences in ND according to BMI groups. In patients with BMI ≥50.0 kg/m, vitamin B12 deficiency was more frequent after RYGB. At 2-year follow-up, 95.4% patients were taking multivitamin supplementation, and 52.4% required additional supplements, namely vitamin D.

CONCLUSION

ND are common in patients with BMI ≥50.0 kg/m, even before MBS. After surgery, patients with BMI ≥50.0 kg/m may not have increased risk for ND, compared to other BMI groups. In these patients, RYGB resulted in an increased risk for vitamin B12 deficiency. Adequate supplementation and clinical follow-up are essential to mitigate these complications.