Evaluation of the professional practices of specialized obesity centers on the strategy of vitamin B12 follow-up and supplementation after obesity surgery

Abstract

ObjectivesVitamin B12 deficiency is frequent after obesity surgery. The goal of this study was to establish the current practices in specialized obesity centers in terms of dosage, supplementation, and management of B12 deficiency after obesity surgery. Materials and methodsIn 2021, a survey has been sent to the 37 French specialized obesity centers to perform an assessment of the physician professional practices relating to B12 supplementation after obesity surgery. ResultsForty-one responses were collected from 29 centers, representing a response rate of 78%. All physicians routinely monitored plasma B12 in the postoperative period. The first intent route of B12 supplementation after obesity surgery was mainly: oral, then intramuscular, then subcutaneous, with respectively 38 (93%), 9 (22%), and 3 responses (7%). The preferred prescription for prevention of B12 deficiency, used as long-term maintenance therapy, was 1mg per week, orally (n=21; 51%). The other schemes used for that purpose were rare and specific to a single center. In case of B12 deficiency, the two most used therapeutic schemes were 1mg per day orally for 15 days (n=8; 20%) and 1mg intramuscular per week for 1 month (n=4; 10%). ConclusionThis assessment of the current physician professional practices revealed a diversity in the practices of B12 supplementation after obesity surgery, with a trend to favor the oral route. This is due to the lack of evidence and clear-cut recommendations. A comparative randomized study would help to identify the best route and posology for B12 supplementation after obesity surgery.