By Sally-Anne Livock
Bariatric Dietitian
We can not stress enough how important it is to take a vitamin and mineral supplement for life after bariatric surgery.
We always take time to explain why this is important in our pre surgery consultations, and I’d like to summarise just why this is so important.
Often we see clients who have followed various restrictive diet for years and are at the point where they are quite confused as to exactly what is a healthy diet and may not be meeting all their nutritional needs.
There is a surprisingly high rate of nutritional deficiencies in Bariatric patients pre surgery
Nutrient Deficiency (up to)
Iron 45%
Vit D 65-95%
B12 18%
Folate 54%
Post surgery volumes of food are quite small. Depending upon the type of surgery you undergo volumes may only be ½ cup or less in size for some months after the operation.
With such small volumes it is almost impossible to meet all your nutritional requirements. Even if you follow a high quality diet requirements in iron, calcium, B12 and Vitamin A can be impossible to meet with food alone.
Then there is the malabsorption to consider.
The Sleeve, Omega Loop and Bypass procedures result in reduced stomach volume (up to 80% less stomach volume) and as such gastric acid and Intrinsic factor production is reduced. Reduction of gastric acid and Intrinsic factor reduces absorption of many nutrients including B12, folate, beta carotene and iron. The only way to meet needs of these nutrients is via a Bariatric Multivitamin.
The more restrictive the procedure the greater the chance of nutrient deficiencies. Bypass procedures (unlike the Lap band and Sleeve) bypass sections of the small intestine which are essential for nutrient absorption. This as well as reduced stomach capacity inhibits the opportunity for nutrient absorption and more often than not added vitamin and minerals may be required on top of your Bariatric supplements.
Regular blood testing is essential post surgery. We test at 6 months (or before if we have concerns) and then annually. These tests allow us to monitor your nutrition and adjust your supplements accordingly. That’s one of the reasons why keeping in touch with your team and your bariatric dietitian is most important post-surgery.
Why can’t I just take a regular supplement?
These do not contain enough iron, B12, Vitamin A and other nutrients to meet your increased requirements post surgery.
Bariatric supplements have been specifically formulated but chemists and bariatric dietitians to replace what your tiny tummy can’t absorb after your surgery. Regular supplements just don’t have enough vitamins and minerals to meet your needs and can lead to deficiencies often seen 1 or 2 years down the track.
You will be advised to take a bariatric multivitamin as well as a calcium supplement daily.
The calcium is vital as post surgery the risk of Osteoporosis is real. Tiny tummies cannot fit enough dietary calcium to meet needs, even if you are taking dairy foods daily.
Its important to set up a regular routine for taking your vitamins. Get into a habit early after surgery and try to stick with this until it is just as regular as brushing your teeth.
Remember to separate your Bari multi from your calcium by 3 hours so they don’t interfere with each others absorption.
Taking up to 4 tablets each day can be a challenge but it is very important to keep yourself in the best shape you can and daily vitamins should become part of your new healthy daily routine!
And don’t forget annual blood tests will help us monitor your health – we don’t want you slimmer but unhealthy!!