Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient

Publication Date: November 1, 2010

Key Points

Key Points

  • Bariatric surgery is not a guarantee of successful weight loss and maintenance.
  • Common operations include various banding procedures, which restrict the amount of food entering the stomach, the Roux-en-Y gastric bypass (RYGB), the duodenal switch (DS)/gastric sleeve (GS), or the biliopancreatic diversion (BPD) (Figure 1).
  • The use of routine algorithms in postoperative care is essential to reduce the risk of weight regain (WR) and postoperative complications.
  • Active nutritional patient education and clinical management to prevent and detect nutritional deficiencies are recommended for all patients undergoing bariatric surgery.
  • Management of potential nutritional deficiencies is particularly important for patients undergoing malabsorptive procedures.
  • All patients should participate in a comprehensive nutrition and lifestyle management program from a multidisciplinary team including an experienced primary care physician, endocrinologist, or gastroenterologist.

Figure 1. Diagram of Surgical Options


Assessment and Management

...nt and Management

...ive Nutritional Manageme...

...Endocrine Society (ES) recommends that...

...ends that long-term vitamin and mineral s...

...ecommends periodic clinical and biochemical mon...


...gement of Diabetes Mellitus and...

...commends that postoperative glycemic...

...ts that physicians and floor nurses be...

...e ES recommends that obese patients with...

The ES recommends that lipid abnormalities shou...


...ne Health and Go...

...ES recommends that patients who have undergone...

...ecommends vitamin D and calcium supplementation p...

The ES suggests that patients with f...


...roenterological and Eating Behavior Consid...

...ES recommends that bariatric surger...

...er procedures with a gastric restrict...

...S suggests continuous reinforcement of new...

...that patients who present with postpra...


...le 1. Schedule for Clinical and Bioc...


...Diagnosis and Treatment of Nutritional Deficienci...


...n and Treatment of WR...

...able WR is defined as over 50% of wei...

...ES recommends that a technically proficien...

...mmends that treatment of WR postopera...

...suggests, in cases of severe or unrem...


...auses and Prevention of WRHaving trouble vie...


...atric Surgery - Post-op Management...


Selecting a Treatment Regimen

...ng a Treatment Regimen...

...4. Hypoglycemic AgentsHaving trou...


...able 5. Pharmacokinetics of Human Insul...


...6. Gout MedicationsHaving trouble view...


.... Drugs Affecting Lipid MetabolismHaving troub...


...FDA-Approved Lipid Modulating Combination Tabl...


...es of Currently Available Statins Required to A...