Long-term nutritional follow-up post bariatric surgery.

Abstract

Bariatric surgery is an effective treatment for classes II and III obesity and its associated diseases. However, many important long-term outcomes of bariatric surgery are still poorly understood, such as neurological and psychological complications, bone health, and so on. This review summarizes the current evidence and expert opinions on nutritional care in the long-term postoperative period. In the first section, we will provide an update of the main long-term complications: risk of anaemia, risk of bone fracture, neurological and psychological complications, and risk of developing Barrett's oesophagus after sleeve gastrectomy. We will also examine the current strategies used to increase weight loss or reduce weight regain. As adherence to long-term follow-up has been shown to decrease over time, the second section aims to identify all measures that improve follow-up rates, to get the maximum benefit from bariatric surgery, while minimizing long-term adverse effects and complications. There is still a significant level of uncertainty regarding the best clinical practices for maintaining the health benefits provided by bariatric surgery. The role of family physician in postsurgery care needs to be clearly defined. More effort is needed to improve psychological care, behaviour management, and therapeutic patient education after bariatric surgery. A more patient-centred approach should probably be considered.