Current nutrition management of patients undergoing bariatric surgery

Abstract

CURRENT NUTRITION MANAGEMENT OF PATIENTS UNDERGOING BARIATRIC SURGERY Nazy Zarshenas, Department of Nutrition & Dietetics, St George Upper GI Surgical Unit, Sydney, Australia. Obesity is emerging as the most challenging chronic health problem facing our society, surpassing smokingrelated illnesses, with a prevalence rate in Australian adults of 20%. Medical treatments have poor results with a 1-2% long term success rate. Weight loss surgery is the most effective treatment for morbid obesity (1), as it resolves the consequences of obesity (2,3) as well as decreasing the mortality rate in this population (3). There are no evidence-based guidelines for nutrition management of patients pre and post bariatric surgery (4). An interest group was developed for the dietitians working in this area and a survey was subsequently undertaken to determine the current nutrition management in this growing field and identify the shortfalls. The survey results indicate that most bariatric surgery centers use a weight loss program pre operatively. The duration and intensity of this depends on the severity of the patient’s obesity as well as their tolerance for the intervention. Post operatively nutrition counselling is provided at the hospital level and the diet is progressed according to patients’ tolerance and the clinicians’ experience. Recommendations for energy, protein and multivitamin supplementations are inconsistent and not evidence based. Micronutrients such as Calcium, Vitamin D, and Iron are not routinely supplemented. Long-term food intolerances were identified as these may contribute to nutritional inadequacy in this population. Ongoing counselling and education is essential to change eating habits, reinforce a healthy balanced diet and ensure compliancy with micronutrient supplementation. Further research is warranted in this growing field.