This article takes a research-based approach to common questions about bariatric multivitamins. We gathered frequently asked questions from patients and healthcare providers and explored what scientific studies say about each topic. The answers below are based on published research and clinical guidelines to help readers better understand nutrition after bariatric surgery.
Question 1 you may have!
If a woman plans to become pregnant after bariatric surgery, are there any special multivitamins recommended for pregnancy?
Answer from the research study:
It is recommended to wait until 12–18 months after bariatric surgery, once maximal weight loss and weight stabilization have been achieved, before considering pregnancy. The first year after bariatric surgery is critical for ensuring adequate nutrient status. Ideally, planning for pregnancy should occur before bariatric surgery to ensure not only sufficient nutrient intake and adherence to prescribed supplements but also the adoption of a healthy eating pattern by the woman during pregnancy.
Supplementation should be tailored and prescribed by a specialist who can provide comprehensive evaluation and follow-up, as both excessive and deficient doses of certain micronutrients can have detrimental effects. Nutritional status should be closely monitored before pregnancy, during pregnancy, and throughout lactation to ensure the safety of both the mother and the baby.
Question 2, you might have!
Vitamin D matters for everyone, but does it matter more after bariatric surgery?
Answer from the research study:
Yes, vitamin D really matters a lot after bariatric surgery. Vitamin D3 deficiency is the most frequently observed micronutrient deficiency associated with malabsorptive procedures, which remove or bypass segments of the small intestine responsible for its absorption.
Calcium absorption is dependent on adequate vitamin D levels.
Question 3, you may have!
Men vs women (Gender differences in bariatric surgery): who undergoes bariatric surgeries more?
Answer from the research study:
Women are more likely to undergo bariatric surgery, and it’s their higher proportion rate that reflects real-world trends. Women represent approximately 70–80% of bariatric surgery patients in many registries.
Question 4, you may have!
B12 levels matter after bariatric surgery. How?
Answer from the research study:
ASMBS guidelines recommend lifelong vitamin B12 supplementation for all patients undergoing bariatric surgery. Studies have reported a significant increase in B12 deficiency after surgery due to reduced intrinsic factor and altered absorption. Apart from supplementation, other factors include a vegan diet, age over 50 years, and the use of medications such as proton pump inhibitors or metformin.
Question 5, you may have!
What is the connection between anaemia and bariatric surgery?
Answer from the research study:
Anaemia is the most common manifestation of nutrient deficiencies after bariatric surgery. It's prevalent in every third woman and 15% of men after bariatric (weight loss) surgery.
Some more findings on anaemia after surgery are mentioned in studies:
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Anaemia occurred more than twice
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Anaemia is diagnosed even after 4 years of follow-up
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Women are at a higher risk of developing anaemia
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Younger age is associated with a higher anaemia risk
Question 6, you may have!
Why do some bariatric patients regain weight even while taking supplements?
Answer from the research study:
Some of the causes are:
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procedural failures like slippage of the gastric band, gastro-gastric fistulas, dilated gastric fundus, and enlargement of the gastric pouch or gastro-jejunal stoma.
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Dysregulated or maladaptive eating
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Unhealthy eating habits
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Sedentary lifestyle
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Non-compliant in following dietary recommendations
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Hormonal changes that regulate energy intake cause increased appetite and food cravings
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increased caloric intake
References:
Noria SF, Shelby RD, Atkins KD, Nguyen NT, Gadde KM. Weight Regain After Bariatric Surgery: Scope of the Problem, Causes, Prevention, and Treatment. Curr Diab Rep. 2023 Mar;23(3):31-42. doi: 10.1007/s11892-023-01498-z. Epub 2023 Feb 8. PMID: 36752995; PMCID: PMC9906605.
Bjørklund G, Peana M, Pivina L, Dosa A, Aaseth J, Semenova Y, Chirumbolo S, Medici S, Dadar M, Costea DO. Iron Deficiency in Obesity and after Bariatric Surgery. Biomolecules. 2021 Apr 21;11(5):613. doi: 10.3390/biom11050613. PMID: 33918997; PMCID: PMC8142987.
