Post-bariatric Surgery Research Articles

Effectiveness of an interventional program on nurses knowledge about bariatric surgery in Al- Sulaymaniyah teaching hospital

This study indicates that there is significant association among post-test nurses’ knowledge with their qualification in nursing (p-value =0.02) and years of employment p-value =0.03. This study shows that nurses’ general knowledge about bariatric surgery and their knowledge about the nursing management of pre and post bariatric surgery were statistically significantly increased in the intervention group post-test (96.6% and 94.8%, respectively), p0.001..A Quasi-experimental design was performed from February to March 2021 at a referral surgical hospital for bariatric surgery in Al-Sulaymaniyah city, with 50 nurses (25 in the control group and 25 in the study group).

Effect of COVID-19 Lockdowns on Physical Activity, Eating Behavior, Body Weight and Psychological Outcomes in a Post-Bariatric Cohort

PurposeLittle is known about the consequences of COVID-19 lockdowns on physical activity (PA), eating behavior, and mental health in post-bariatric surgery (BS) patients. We aimed to analyze the relations between changes in PA during COVID-19 lockdowns and changes in body weight and a comprehensive set of lifestyle and psychological outcomes in patients who have undergone BS.Material and MethodsIn April–May 2020 (lockdown#1), we performed an online survey in a cohort of 937 adults who underwent BS and were followed-up at our university medical center for at least one year. We assessed changes in PA, eating behavior, body weight, fatigue, and depression (PHQ-9). In November–December 2020 (lockdown#2), we recorded body weight in 280 patients who had reported decreased PA during lockdown #1.ResultsDuring lockdown #1 (N = 420 patients included, 44% response rate), decreased PA was reported by 67% patients. Compared to those who reported increased or unchanged PA, patients with decreased PA were more likely to report a ≥ 5% weight gain (OR (95% CI): 3.15 (1.46–7.65), increased fatigue (2.08 (1.36–3.23)), a worsening of eating behavior (2.29 (1.47–3.58)), and moderate-to-severe depressive symptoms (4.74 (2.14–11.76)). During lockdown #2 (N = 225 patients, 80% response rate), significant weight gain since before lockdown #1 was reported (+ 2.8 (95% CI: 1.7–3.8) kg, p < 0.001), with 36% patients reporting a ≥ 5% weight gain.ConclusionsPA may counteract detrimental effects of COVID-19 lockdown on post-BS weight trajectories and mental health outcomes. Follow-up measures are needed in this setting to assess the long-term impact of lockdown.Graphical abstract Supplementary InformationThe online version contains supplementary material available at 10.1007/s11695-022-06069-x.

Prevalence of and Risk Factors Associated with Alcohol Overconsumption at 2 Years After Bariatric Surgery

IntroductionAlcohol overconsumption remains one of the adverse effects associated with bariatric surgery. Many previous studies have used subjective methods to evaluate the prevalence of alcohol overconsumption. In 2018, Örebro University Hospital started to use phosphatidylethanol 16:0/18:1 (PEth) as a screening tool pre- and postbariatric surgery. Research exploring alcohol use after bariatric surgery assessed with PEth is scarce.AimThe aim of this study is to evaluate the prevalence of alcohol overconsumption in bariatric surgery patients measured 2 years postoperatively with PEth and to identify possible risk factors associated with alcohol overconsumption.MethodsThis was a register-based retrospective, observational cohort study with PEth results collected from medical records at Örebro University Hospital. Patients who underwent bariatric surgery between January 2016 and June 2019 and who were registered in the Scandinavian Obesity Surgery Registry (SOReg) were included.ResultsPEth results from 410 bariatric surgery patients were identified. PEth values significantly increased from baseline to the postoperative follow-up (from 3.0% before surgery to 8.3% at the 2-year follow-up). In a univariate logistic regression analysis, the associated risk factors were found to be male sex (odds ratio, OR 2.14), older age (OR 1.06), and hypertension (OR 3.32).ConclusionThe prevalence of alcohol overconsumption measured with PEth 2 years after bariatric surgery was 8.3% and was associated with male sex, older age, and hypertension. More studies are needed to validate the results of this study because it is not known whether PEth values are affected by bariatric surgery.Graphical abstract

Overvaluation of Shape and Weight (Not BMI) Associated with Depressive Symptoms and Binge Eating Symptoms Pre- and Post-bariatric Surgery.

Overvaluation of shape and weight (OSW) involves defining self-worth by body shape/weight. Among persons seeking bariatric surgery, cross-sectional studies have found associations between OSW, depressive symptoms, and disordered eating. Relationships among OSW, depressive symptoms, binge eating symptoms, and BMI were analyzed both cross-sectionally and over time among 145 adults who had bariatric surgery. Participants completed the following measures pre-surgery and 1.5 to 3years post-surgery: Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale, Patient Health Questionnaire, and body weight and height. OSW was measured by averaging two items on the EDE-Q which ask participants to rate how much their weight/shape influences how they judge themselves as a person. Analyses included Wilcoxon signed-ranks, bootstrapped Pearson correlations, and bootstrapped hierarchical linear regressions. OSW was significantly associated with depressive symptoms and binge eating symptoms both pre- and post-surgery, but was not associated with BMI at either timepoint. Improvements in OSW were associated with concurrent changes in depression and binge eating; reductions in BMI were not significantly associated with changes in any of these variables. Findings suggest that self-evaluation is more important in regard to changes in depressive and binge eating symptoms than is BMI (and vice versa), and support the importance of assessing and treating psychological considerations among persons seeking bariatric surgery.

Post-Bariatric Surgery Patients: A Quality of Life Assessment in Saudi Arabia.

BackgroundBariatric surgery has emerged as the most successful and long-lasting treatment for weight loss because of its effect on losing weight, diminution or elimination of sedentary lifestyle-related comorbidities, and a concomitant decrease in mortality and healthcare expenditures. Understanding its effects on the quality of life of patients is a crucial aspect of treatment. This study aims to assess the quality of life and its associated factors following bariatric surgery in Saudi Arabia.MethodologyIn this cross-sectional study, 400 adult patients who had undergone bariatric surgery were recruited from different regions in Saudi Arabia between December 2021 and February 2022. Data were collected and analyzed using SPSS version 23 (IBM Corp., Armonk, NY, USA).ResultsOf the 400 participants, 160 (40%) were males and 240 (60%) were females. The average weight of the participants before surgery was 113.9 ± 18.7 kg (range = 84-146 kg) and after surgery was 84.8 ± 18.3 kg (range = 58-138 kg). The average quality of life score was -0.13 ± 2.0 (range = -3-3). Most of the participants (35%) had a fair quality of life, 25% had very poor quality, 20% had very good quality, 15% had good quality, and 5% had poor quality of life. A statistically significant association (p < 0.001) was found with the following factors: gender, age, nationality, educational level, marital status, and history of chronic diseases.ConclusionsQuality of life following bariatric surgery was mostly reported to be fair or average. Several sociodemographic factors were found to be associated with the reported quality of life including age, gender, nationality, educational level, marital status, and history of chronic disease or comorbidities.

The Neuro-Endo-Microbio-Ome Study: A Pilot Study of Neurobiological Alterations Pre- Versus Post-Bariatric Surgery.

Plausible phenotype mechanisms following bariatric surgery include changes in neural and gastrointestinal physiology. This pilot study aims to investigate individual and combined neurologic, gut microbiome, and plasma hormone changes pre- versus post-vertical sleeve gastrectomy (VSG), Roux-en-Y gastric bypass (RYGB), and medical weight loss (MWL). We hypothesized post-weight loss phenotype would be associated with changes in central reward system brain connectivity, differences in postprandial gut hormone responses, and increased gut microbiome diversity. Subjects included participants undergoing VSG, n = 7; RYGB, n = 9; and MWL, n = 6. Ghrelin, glucagon-like peptide-1, peptide-YY, gut microbiome, and resting state functional magnetic resonance imaging (rsfMRI; using fractional amplitude of low-frequency fluctuations [fALFF]) were measured pre- and post-intervention in fasting and fed states. We explored phenotype characterization using clustering on gut hormone, microbiome, and rsfMRI datasets and a combined analysis. We observed more widespread fALFF differences post-bariatric surgery versus post-MWL. Decreased post-prandial fALFF was seen in food reward regions post-RYGB. The highest number of microbial taxa that increased post-intervention occurred in the RYGB group, followed by VSG and MWL. The combined hormone, microbiome, and MRI dataset most accurately clustered samples into pre- versus post-VSG phenotypes followed by RYGB subjects. The data suggest surgical weight loss (VSG and RYGB) has a bigger impact on brain and gut function versus MWL and leads to lesser post-prandial activation of food-related neural circuits. VSG subjects had the greatest phenotype differences in interactions of microbiome, rsfMRI, and gut hormone features, followed by RYGB and MWL. These results will inform future prospective research studying gut-brain changes post-bariatric surgery.

Effects of bariatric surgery on renal function and associated factors with bivariate analysis: a cohort study

Background: Obesity is a global pandemic, caused by genetic, biological and social factors, increasing the risk of many chronic diseases, including kidney disease. Bariatric surgery can control associated comorbidities and also improve renal function. Thus, the aim of this study was to evaluate the effect of bariatric surgery on renal function and associated factors, through bivariate analysis. Methods: A cohort, prospective, analytical study was carried out in the Department of surgery and obesity, in Campina Grande - Paraíba, Brazil. Thirty-five obese patients were evaluated in the preoperative period of bariatric surgery and after one year of bariatric surgery. Sociodemographic and anthropometric data were collected, body mass index was calculated, and renal function was estimated through the glomerular filtration rate. Results: Predominantly female (71.4%) and white (77.1%) patients were observed. Regarding the type of bariatric surgery, most patients (65.7%) underwent the sleeve technique. There was no significant difference between the mean levels of cystatin C pre and post bariatric surgery. There was a significant improvement in the mean glomerular filtration rates in the postoperative period (p=0.09). In further analysis of the association between the variables: type of bariatric surgery, diabetes or hypertension outcomes, no association was observed with the outcome improvement in glomerular filtration rate, without statistical significance, respectively (p = 0.312; p =0.217; p = 0.476). Similarly, there was no statistically significant difference between the variable loss of body mass index, under the effect of bariatric surgery, in relation to the outcome of the glomerular filtration rate (p = 0.904). Conclusion: After analyzing the association between outcome of glomerular filtration rate and the studied variables, no association was observed between these variables, under the effect of bariatric surgery, with improvement in glomerular filtration rate. Thus, bariatric surgery is associated with improvement of renal function independently.

Implications of Bariatric Surgery on the Pharmacokinetics of Antiretrovirals in People Living with HIV.

Bariatric surgery is increasingly applied among people living with HIV to reduce obesity and the associated morbidity and mortality. In people living with HIV, sufficient antiretroviral exposure and activity should always be maintained to prevent development of resistance and disease progression. However, bariatric surgery procedures bring various gastrointestinal modifications including changes in gastric volume, and acidity, gastrointestinal emptying time, enterohepatic circulation and delayed entry of bile acids. These alterations may affect many aspects of antiretroviral pharmacokinetics. Some drug characteristics may result in subtherapeutic exposure and the potential related risk of treatment failure and resistance. Antiretrovirals that require low pH, administration of fatty meals, longer intestinal exposure, and an enterohepatic recirculation for their absorption may be most impacted by bariatric surgery procedures. Additionally, some antiretrovirals can interact with the polyvalent cations in supplements or drugs inhibiting gastric acid, thereby preventing their use as these comedications are commonly prescribed post-bariatric surgery. Predicting pharmacokinetics on the basis of drug characteristics solely proved to be challenging, therefore pharmacokinetic studies remain crucial in this population. Here, we discuss general implications of bariatric surgery on antiretroviral outcomes in people living with HIV as well as drug properties that are relevant for the choice of antiretroviral treatment in this special patient population. Additionally, we summarise studies that evaluated the pharmacokinetics of antiretrovirals post-bariatric surgery. Finally, we performed a comprehensive analysis of theoretical considerations and published pharmacokinetic and pharmacodynamic data to provide recommendations on antiretrovirals for people living with HIV undergoing bariatric surgery.

Evaluating the Correlation of Bariatric Surgery and the Prevalence of Cancers in Obese Patients: A Study of the National Inpatient Sample (NIS) Database.

PurposeObesity is a global pandemic that exerts a significant burden on healthcare worldwide. Multiple cancers, as well as deaths from the same, are more prevalent in obese patients. Bariatric surgery has been shown to be the most effective way of treating obesity once other measures have been exhausted. There is no concordant data available to support that bariatric surgery can reduce the prevalence of cancer. Using one of the largest data samples, we evaluate the correlation of bariatric surgery in morbidly obese patients with the prevalence of obesity-related cancers (breast, endometrial, esophageal, colorectal, prostate, and renal) in morbidly obese patients.Patients and methodsA sample of 7,672,508 morbidly obese patients was identified from the 1994 to 2004 records of the National Inpatient Sample (NIS) database, divided into those who did and did not undergo bariatric surgery, and studied for the prevalence of obesity-associated cancers.ResultsObesity was predominantly seen in the Caucasian population (68.22%). The mean age of cases who underwent bariatric surgery was younger when compared to those who did not undergo the procedure (43.89±25.16 vs. 54.90±36.40, p-value <0.0001). The highest bariatric surgery rate was seen in the Northeast (5.57%), followed by the West (4.15%), South (3.02%), and Midwest (2.96%) (p-value <0.0001). Overall, the odds of morbidly obese patients who underwent bariatric surgery and developed cancer are: esophageal cancer 0.19 (0.1218-0.3078, p <0.0001), colorectal cancer 0.0368 (0.0275- 0.0493, p <0.0001), endometrial cancer 0.0155 (0.0099-0.0244, p <0.0001), breast cancer 0.0712 (0.0582-0.0871, p <0.0001), prostate cancer 0.0285 (0.0199-0.0408, p <0.0001) and renal cancer 0.0182 (0.0106-0.0314, p <0.0001). The odds of cancer post-bariatric surgery remained significantly lower even after matching certain confounding factors.ConclusionsThe odds of developing breast, esophageal, prostate, renal, and colorectal cancers are significantly lower in morbidly obese patients who undergo bariatric surgery.

Uncommon presentation of bilateral subtrochanteric insufficiency fractures in young male associated with hypogonadism: A case report

Hypogonadism in men is a well-recognized cause of secondary osteoporosis. It is characterized by insufficient production of androgen, testosterone, and sperms. Testosterone deficiency is the key factor for insufficiency fractures in men, resulting from normal loading on an osteoporotic bone. In this report, we are presenting a case of a 27-year-old male known to have hypogonadotropic hypogonadism, who suffered from both femoral atraumatic subtrochanteric fractures that had been existing for a considerable time. The fractures interfered with the patient’s walking and daily activity. It is worth reporting this case because most of the proximal femur insufficiency fractures mentioned in the literature correlated with prolonged alendronate therapy or were post-bariatric surgery.

Lipoabdominoplasty in post-bariatric Surgery: a relevant Alternative to Fleur-de-Lis abdominoplasty?

The number of bariatric procedures, and thus also the number of post-bariatric operations, has increased dramatically in recent years. Although long scars are common in post-bariatric surgery and accepted in favour of body shape reconstruction, we increasingly notice the wish for aesthetically pleasing results in addition to the desire for body contouring. In particular, Fleur-de-Lis abdominoplasty (FdL) is viewed critically by younger patients after massive weight loss due to the visible vertical scar. Surgeons are also often bothered by the unsatisfying aesthetic outcome as well as the higher rate of complications. Retrospective analysis of 20 female patients with massive weight loss following bariatric surgery, who received lipoabdominoplasty instead of Fleur-de-Lis abdominoplasty in the period from January 2019 to June 2020. Data analysis was based on measurements of preoperative vertical and horizontal excess skin and fat (Pittsburgh Rating Scale), Body Mass Index, surgical technique and final result. Twenty female patients with an indication for FdL abdominoplasty underwent radical liposuction of the abdomen combined with abdominoplasty. The original weight before massive weight reduction ranged between 100 and 168 kg. Average weight reduction was 56.5 kg. The mean BMI was 27.3 kg/m². The average age of our cohort was 40 years. One patient (5 %) had a major complication. This was an infected seroma which could be treated conservatively. Two other patients (10 %) developed an uninfected seroma as a minor complication. Our work shows that lipoabdominoplasty can be performed safely and well even in patients after massive weight loss. It is possible to achieve good body contours without vertical incisions and with a high degree of patient satisfaction. The number of patients who have to undergo FdL abdominoplasty can be successfully reduced by this technique.

IDF21-0443 Glycaemic Control Outcomes Post-Bariatric Surgery In Individuals with Super Obesity: A single centre experience

Background: Bariatric surgery (BS) is the most effective intervention for “common” obesity. A BMI > 50 kg/m2, an obesity category known as super obesity, may have particular outcomes in glycaemic control apart from excess weight loss; there are few studies on these potential differences.

Exploring the causes of semen quality changes post-bariatric surgery: a focus on endocrine-disrupting chemicals.

Rapid weight loss promoted by bariatric surgery (BS) can release accumulated lipophilic endocrine-disrupting chemicals (EDCs), making these chemicals systemically available. Men typically have a higher EDC body burden and lose more weight post-BS than women, which may put male BS patients at high risk for testicular toxicity. In this review, we analyze the impacts of BS on semen parameters with a particular focus on the potential effects of EDCs. After BS, serum EDC concentrations progressively increase; and there is evidence that semen parameters deteriorate after BS. Although elevated serum EDC concentrations are associated with inferior sperm parameters, links between semen parameters and EDCs post-BS have not been studied. Understanding these potential associations requires adequately powered studies, particularly within prospective longitudinal cohorts with long-term follow-up for sperm parameters, nutritional status, sex-hormones levels and serum EDC concentrations. Studying BS patients prospectively provides the important opportunity to evaluate dose-response effects of EDC serum concentrations on sperm quality and function. Research is also needed to identify critical chemical exposure periods post-BS to inform reproductive decisions, including consideration of sperm preservation before surgery.

A Case of Wernicke's Encephalopathy in a Post-Bariatric Surgery Patient in a Community Emergency Department

A 22-year-old woman with a history of idiopathic intracranial hypertension who presented to our emergency department with acute onset strabismus and bilateral sixth nerve palsy in the setting of recent sleeve gastrectomy and vomiting. Further testing revealed multiple vitamin deficiencies, including thiamine, leading to a diagnosis of Wernicke's encephalopathy.

Dietary experiences after bariatric surgery in patients with obesity: A qualitative systematic review.

This systematic review evaluated the dietary experience of patients with obesity post-bariatric surgery. Scopus, CINAHL, Medline, Psych INFO, and Embase databases were searched and JBI Critical Appraisal Tool was used for quality assessment. Thomas and Harden's three-stage thematic synthesis was undertaken using the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statement for reporting. Of the 24 studies extracted, we coded and developed 34 descriptive themes into 7 categories, which were then categorized to 3 analytical themes. The number of all the participants in the 24 articles is 383 people. The results revealed most patients can control their diet for a short period post-surgery. However, this was a matter of gradual self-consciousness as patients also required support and dietary management in postoperative recovery. CLINICAL TRIAL REGISTRATION NUMBER: The protocol for this qualitative systematic review has been registered with PROSPERO (registration number CRD42021229083).

Elements behind sedentary lifestyles and unhealthy eating habits in individuals with severe obesity

ABSTRACT Purpose This study examines elements behind sedentary lifestyles and unhealthy eating habits in individuals who lived with severe obesity during many years of their lives. Methods Ten post-bariatric surgery patients participated in semi-structured interviews 7 months after surgery. A year later, a second round of interviews was also conducted to address some knowledge gaps related to the study purpose. The qualitative data collected were analysed through content analysis. Results Embarrassment about showing their body publicly, pain and poor physical condition, and bad experiences in non-inclusive physical activity contexts were found as potential elements that contributed to their adherence to sedentary lifestyles. Poor family food education, loss of a loved one, family problems, arguments or disputes, and past traumatic events (e.g., childhood sexual abuses) could be related to their development of unhealthy eating behaviours. Findings also pointed out that participants’ failed attempts to lose weight provoked them anxiety, feelings of failure and rebellion, and influenced their return to an unhealthy diet and a sedentary lifestyle. Conclusions This study may be helpful to reveal some elements which could be related to the origin and perpetuation of severe obesity, and to design prevention/treatment strategies from a more holistic, sensitive, and respectful perspective.

The Relationship Between Percentage Weight Loss and World Health Organization-Five Wellbeing Index (WHO-5) in Patients Having Bariatric Surgery

PurposeThe association between bariatric surgery outcome and depression remains controversial. Many patients with depression are not offered bariatric surgery due to concerns that they may have suboptimal outcomes. The aim of this study was to investigate the relationship between baseline World Health Organization-Five Wellbeing Index (WHO-5) and percentage total weight loss (%TWL) in patients after bariatric surgery.Materials and MethodsAll patients were routinely reviewed by the psychologist and screened with WHO-5. The consultation occurred 3.5 ± 1.6 months before bariatric surgery. Body weight was recorded before and 1 year after surgery. A total of 45 out of 71 (63.3%) patients with complete WHO-5 data were included in the study. Data analysis was carried out with IBM SPSS Statistics (version 27) to determine the correlation between baseline WHO-5 and %TWL in patients having bariatric surgery.ResultsOverall, 11 males and 34 females were involved with mean age of 47.5 ± 11.5 and BMI of 46.2 ± 5.5 kg/m2. The %TWL between pre- and 1-year post-surgery was 30.0 ± 8.3% and the WHO-5 Wellbeing Index mean score was 56.5 ± 16.8. We found no correlation between %TWL and the WHO-5 Wellbeing Index (r = 0.032, p = 0.83).ConclusionThere was no correlation between the baseline WHO-5 Wellbeing Index and %TWL 1-year post-bariatric surgery. Patients with low mood or depression need to be assessed and offered appropriate treatment but should not be excluded from bariatric surgery only based on their mood.Graphical

Impact of Bariatric Surgery on Depression and Anxiety: A Review

Obesity is a complex disease that effect large amount of population, According to WHO overweight and obesity defined as abnormal or excessive fat accumulation that put the patient heath at risk to develop multiple disease [1], The treatment options are lifestyle changes, diet control, medication, non surgical management and surgical management, some of those treatment are linked to clinical depression.&#x0D; Aim: To look at the prevalence of depression post bariatric surgery.&#x0D; Methodology: We looked at published researches on internet about the prevalence of depression post bariatric surgery.&#x0D; Results: There is a significant association between bariatric surgery and prevalence of depression&#x0D; Conclusion: A full clinical and psychological assessment should be done prior to bariatric surgery to avoid depression.

Post-bariatric contour deformity correction: an endeavour to establish objective criteria nationally.

A marked increase in bariatric surgery has led to higher numbers of patients with contour deformities after massive weight loss seeking plastic surgical correction. Insurance coverage for these post-bariatric interventions is highly subjective and a common set of objective criteria has not yet been established. The aim was to evaluate the factors influencing insurance coverage for post-bariatric surgery, focusing on finding objective, reproducible criteria. This was a retrospective single centre chart review of all post-bariatric patients with redundant skin requesting body contouring surgery from 2013 to 2018. Demographic, bariatric and surgical, as well as insurance information were collected. A logistic regression model was used to identify predictors of successful insurance coverage. 116 Patients were included in the study. Insurance approval for post-bariatric body contouring surgery was obtained for only 47 patients (41%). Mentioning the term "medical indication" in the application letter was associated with a 15.2 times higher rate of receiving a positive answer (p <0.001), whereas mentioning "mental suffering" was associated with 82.3% lower chance of getting a positive response (p <0.001). A high body mass index (BMI) (p <0.009) before the bariatric operation as well as a high BMI reduction (p <0.021) were associated with a higher approval rate by insurance companies . An additional application letter to the insurance company (p <0.024) as well as mentioning mechanical restriction (p <0.022) were associated with a positive response from the insurance companies. We were able to establish certain objective predictive criteria for insurance coverage of post-bariatric surgery. However, it appears that the decisions of insurance companies for this condition are still rather randomly taken. Therefore, the establishment of objective criteria for insurance coverage may allow fairer treatment for this growing patient population.

Evaluation and Management of Patients Referred for Post-Bariatric Surgery Hypoglycemia at a Tertiary Care Center.

Following bariatric surgery, patients can develop non-specific symptoms self-described as hypoglycemia. However, confirming hypoglycemia can be technically challenging, and therefore, these individuals are frequently treated empirically. This study aimed to describe what diagnostic evaluation and therapeutic interventions patients referred for post-bariatric surgery hypoglycemia undergo. Retrospective observational cohort study of patients with a history of bariatric surgery was evaluated for post-bariatric surgery hypoglycemia in a tertiary referral center from 2008 to 2017. We collected demographic and bariatric surgery information, clinical presentation of symptoms referred to as hypoglycemia, laboratory and imaging studies performed to evaluate these symptoms, and symptom management and outcomes. A total of 60/2450 (2.4%) patients who underwent bariatric surgery were evaluated in the Department of Endocrinology for hypoglycemia-related symptoms. The majority were middle-aged women without type 2 diabetes who had undergone Roux-en-Y gastric bypass. Thirty-nine patients (65%) completed a biochemical assessment for hypoglycemia episodes. Six (10%) had confirmed hypoglycemia by Whipple's triad, and four (6.7%) met the criteria for post-bariatric surgery hypoglycemia based on clinical and biochemical criteria. All patients were recommended dietary modification as the initial line of treatment, and this intervention resulted in most patients reporting at least some improvement in their symptoms. Eight patients (13%) were prescribed pharmacotherapy, and two patients required additional interventions for symptom control. In our experience, evaluation for hypoglycemia-related symptoms after bariatric surgery was rare. Hypoglycemia was confirmed in the minority of patients. Even without establishing a diagnosis of hypoglycemia, dietary changes were a helpful strategy for symptom management for most patients.