Nutrient Supplements for Post Weight Loss Surgery

Getting enough of the right nutrients can be tricky for weight loss surgery patients. Following surgery, drastically reduced calorie intakes and changes in physiology make choosing the right foods and supplements more important than ever to living a healthy life.

Additionally, many fail to realize the impact that weight loss surgery takes on the stomach. Bariatric surgeries often result in a reduction in stomach size, which means less surface area to help absorb nutrients you consume. Acknowledging this issue will help you prepare for proper nutrition after your operation.

Common Micronutrient Deficiencies Following Weight Loss Surgery

Some of the most important nutrients for our bodies are the ones most likely to be lacking. Sensitive systems still recovering from surgery may not be able to handle the qualities or recommended quantities of many highly nutritious foods in their natural forms. Some of the most crucial—and often missing—micronutrients include:

• Iron. Iron is the most common deficiency, manifesting as anemia and fatigue. Reduced stomach capacity also reduces stomach acid, which is necessary to convert food-borne iron into its more absorbable form.
• B Complex Vitamins. B vitamin deficiencies often coincide with iron deficiencies, as vitamin B12, thiamine, folate and B6 are essential to red blood cell production as well as neurological function.
• Calcium and Vitamin D. Vital to calcium absorption, vitamin D is essential to maintain bone mineralization. Lack of vitamin D is linked to hypocalcemia and osteoporosis as well as increased risk for cancer, diabetes mellitus, autoimmune diseases and cardiovascular disease.
• Fat-Soluble Vitamins—A, K and E. Like vitamin D, vitamins A, K and E must be absorbed as a lipid, or fat. Deficiencies in vitamin A can result in night blindness and vision problems. Insufficient vitamin K can result in bleeding and clotting issues. Prolonged vitamin E deficiency is associated with neurological deficits and liver disease.
• Zinc and Copper. While less common, deficiencies in zinc and copper can also cause problems like rashes and anemia, for example.

Protein—An Important Macronutrient

Protein is a miracle macronutrient in that it is the building block for everything, from bones, muscles, cartilage, skin and blood to hair and nails. Your body needs it to build tissue, maintain lean muscle mass, support its immune system and repair itself.

When you don’t consume enough protein, you can experience swelling of the body, physical weakness, hair loss and serious side effects from hypoalbuminemia. However, consuming enough protein after a bariatric procedure can be problematic because:

• Your body cannot store protein; it must either use it or store it as fat.
• The small intestine absorbs proteins and their individual amino acids. Portions bypassed cannot do their job.
• The most common proteins are meats and fats that many patients do not tolerate well.

Supplementation After Weight Loss Surgery

In short, surgical weight loss procedures limit the time and space your body has to digest and absorb the food that you eat. That’s why they work. However, both restrictive and malabsorptive techniques do it so well that all patients need to take at the very least a quality multivitamin every day.

Micronutrient Supplementation. You may need additional micronutrient supplementation for:

• Calcium citrate supplements: 1,200 to 2,000 mg daily—often 500 to 600 mg three times daily.
• Vitamin D: 800 to 1,000 International Units (IUs) daily—often 400 to 500 IUs twice daily.
• Vitamin B12: 500 mcg daily, often in a form soluble under the tongue.
• Folic Acid and Iron: Quality multivitamins should contain at least 18 mg of iron and 400 mcg of folic acid, but women—especially those considering pregnancy—may need more.
• Minerals: Quality multivitamins should also contain magnesium, iodine, copper, zinc, manganese, chromium, potassium and selenium.

Macronutrient Supplementation. Protein supplements are widely available. Many are quite appealing in both taste and texture and can help you achieve your daily protein intake goals:

• Liquid supplement drinks should be high in protein but low in calories. Look for labels that provide at least 20 grams of protein but less than 200 calories per serving—typically 8 to 11 ounces. Protein gram values should be at least double the carbohydrate gram values.
• Protein bars should be similar—high in protein but low in calories. They should also be low in carbohydrates, especially sugars, and fat. Look for label values similar to those suggested for liquids, and remember that you don’t have to eat the whole thing at once. If a bar has 32 g of protein, you can break it into several smaller servings.
• You can also add protein powders, powdered egg, egg substitute or nonfat dry milk powder to soups, hot cereals or other liquids.

Committing to a New Lifestyle

Weight loss surgery offers a new life, but it can also demand long-term lifestyle changes. Nutritional supplementation is an important one that requires daily commitment and regular check-ups and monitoring.