Bariatric surgery:
- Results in greater weight loss than nonsurgical interventions and is highly effective in treating comorbidities of obesity, particularly diabetes mellitus
- Reduces all-cause mortality and obesity-related mortality.
- NSAIDs should be avoided in bariatric patients.
- Patient’s medications will need to be adjusted post-op.
- “Patients should be encouraged to eat three meals and one or two snacks daily. Very dry foods, bread, and fibrous vegetables are most likely to cause problems. Fluids should be avoided during meals and for 15–30 minutes before and after meals.
- Those desiring pregnancy should wait for 12–18 months after surgery.
- Recommended laboratory studies include a CBC, a metabolic profile, a folic acid level, iron studies, a parathyroid hormone level, a lipid profile, vitamin B12 levels, 24-hour urinary calcium excretion, and 25-hydroxyvitamin D levels. It is recommended that bone density measurements be done every 2 years.”ABFM Critique
Iron deficiency anemia in gastric bypass surgery patients
40 yo Gastric bypass patient with iron deficiency anemia confirmed with labs. Hgb 8, microcytic. Patient is symptomatic with SOB on exertion. How should you treat it? IV iron replacement.
“Because she has had a gastric bypass, she is not able to absorb iron adequately and therefore needs intravenous iron replacement. A blood transfusion may help temporarily but will not restore her iron stores, so it is not indicated. She will not absorb oral iron adequately. If she does not respond to intravenous iron, consultation with a hematologist may be indicated.”ABFM critique
Further Reading
Treatment of adult obesity with bariatric surgery. Am Fam Physician 2016;93(1):31-37.