Nutritional Follow-up of Patients After Obesity Surgery

Best Practice

Mary O'Kane; Julian H. Barth

Disclosures

Clin Endocrinol. 2016;84(5):658-661. 

In This Article

Abstract and Introduction

Abstract

Obesity surgery is an appropriate treatment option for patients with severe and complex obesity and helps in the improvement of comorbidities. In the first 2 years following surgery, follow-up is provided by the obesity surgery centre. Ongoing care is then usually returned to the general practitioner. Patients need access to ongoing support and monitoring otherwise may be at risk of developing nutritional deficiencies such as anaemia or protein malnutrition. The British Obesity and Metabolic Surgery Society have developed guidelines on nutritional monitoring and nutritional supplements to support both bariatric centres and general practitioners. The Royal College of General Practitioners and BOMSS have worked collaboratively to develop Ten Top Tips for the management of obesity surgery patients to aid with the long-term management in primary care. Women, planning to get pregnant, need access to preconception advice and additional monitoring during pregnancy. It is essential that long-term data are collected and inputted into the National Bariatric Surgery Register. Obesity surgery improves comorbidities; however, patients must have access to long-term nutritional monitoring.

Introduction

Obesity surgery is an appropriate treatment option for patients with severe and complex obesity (NICE).[1] Prior to surgery, patients should have the appropriate assessment and support in a specialist obesity service.[2] This gives an opportunity to optimize the management of comorbidities and prepare the patient for surgery. After surgery, patients need regular surgical review, support to make the necessary dietary and lifestyle changes and have access to medical review of comorbidities and psychological support. For NHS patients in England, this should be provided in the first two years by the obesity surgery centre. Usually, after this period, the patient's care is returned to the general practitioner (GP). Whilst obesity surgery does help improve comorbidities in the short to medium term, it may be complicated in the long term by anaemia or malnutrition if the patient is not appropriately monitored.[3,4]

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