ADHERENCE TO NUTRITIONAL SUPPLEMENTATION, FOLLOW-UP CARE, AND LOST TO FOLLOW-UP IN POST BARIATRIC SURGERY PATIENTS

Authors

  • Muhammad Hassaan Wali California Institute of Behavioral Neurosciences and Psychology, California-USA
  • Khava Bekova California Institute of Behavioral Neurosciences and Psychology, California-USA
  • Noor Abdulla California Institute of Behavioral Neurosciences and Psychology, California-USA
  • Simhachalam Gurugubelli California Institute of Behavioral Neurosciences and Psychology, California-USA
  • Yi Mon Lin California Institute of Behavioral Neurosciences and Psychology, California-USA
  • Devendar Banoth California Institute of Behavioral Neurosciences and Psychology, California-USA
  • Samia Rauf Butt California Institute of Behavioral Neurosciences and Psychology, California-USA

DOI:

https://doi.org/10.55519/JAMC-02-12599

Keywords:

Bariatric surgery, Nutritional deficiencies, Follow-up care, lost to follow-up, adherence

Abstract

Background: With the global rise in obesity rates, bariatric surgery has emerged as an effective intervention for weight management and obesity-related comorbidities. Bariatric surgery offers transformative potential but demands lifelong adherence to multifaceted care, including nutritional supplementation and vigilant follow-up. Nutritional deficiencies affect 30% to 70% of patients, encompassing vital elements like vitamins (B12, D, folate), minerals (iron, zinc, calcium), and proteins, necessitating continuous monitoring to prevent complications. This comprehensive review explores the multifaceted challenges in post-bariatric surgery patient care, focusing on adherence to nutritional supplementation, follow-up care, and the prevalence of nutritional deficiencies. Methods: A systematic synthesis of relevant literature was conducted, encompassing studies examining post-operative care practices, adherence to prescribed multivitamin supplements (MVS), rates of follow-up, and nutritional deficiencies in bariatric surgery patients. Nine key studies were analyzed and synthesized to extract critical insights. Results: Findings revealed a complex landscape of post-bariatric surgery care, marked by both promise and pitfalls. Adherence to MVS regimens emerged as a significant challenge, influenced by factors such as forgetfulness, gastrointestinal side effects, cost concerns, and poor follow-up rate. Lost-to-follow-up rates varied across studies, raising concerns about the continuity of care. Nutritional deficiencies were prevalent, underscoring the importance of long-term monitoring. It highlights the need for tailored patient education, improved doctor-patient communication, and shared decision-making processes to enhance adherence and follow-up care. Conclusion: This review underscores the intricate nature of post-bariatric surgery patient care, emphasizing the critical role of adherence, follow-up, and nutritional monitoring. Disparities in care among different regions of the world with varying healthcare systems are acknowledged as a significant challenge; addressing these challenges necessitates a collaborative effort among healthcare providers, patients, and policymakers to optimize the long-term well-being of individuals who undergo bariatric surgery.

References

Via MA, Mechanick JI. Nutritional and Micronutrient Care of Bariatric Surgery Patients: Current Evidence Update. Curr Obes Rep 2017;6(3):286–96.

Centers for Disease Control and Prevention. [Internet]. Obesity Basics (2022) [cited 2023 Aug 31]. Available from: https://www.cdc.gov/obesity/basics/index.html

Lupoli R, Lembo E, Saldalamacchia G, Avola CK, Angrisani L, Capaldo B. Bariatric surgery and long-term nutritional issues. World J Diabetes 2017;8(11):464–74.

Faria GR. A brief history of bariatric surgery. Porto Biomed J 2017;2(3):90–2.

Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery. Obes Surg 2023;33(1):3–14.

Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, et al. Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg 2017;27(9):2279–89.

Zarshenas N, Tapsell LC, Neale EP, Batterham M, Talbot ML. The Relationship Between Bariatric Surgery and Diet Quality: a Systematic Review. Obes Surg 2020;30(5):1768–92.

Sherf Dagan S, Goldenshluger A, Globus I, Schweiger C, Kessler Y, Kowen Sandbank G, et al. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice. Adv Nutr 2017;8(2):382–94.

Mehaffey JH, Mehaffey RL, Mullen MG, Turrentine FE, Malin SK, Schirmer B, et al. Nutrient Deficiency 10 Years Following Roux-en-Y Gastric Bypass: Who's Responsible? Obes Surg 2017;27(5):1131–6.

Smelt HJM, Pouwels S, Smulders JF, Hazebroek EJ. Patient adherence to multivitamin supplementation after bariatric surgery: a narrative review. J Nutr Sci 2020;9:e46.

Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, et al. Obesity Management Task Force of the European Association for the Study of Obesity Released "Practical Recommendations for the Post-Bariatric Surgery Medical Management". Obes Surg 2018;28(7):2117–21.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71.

Ottawa Hospital Research Institute. [Internet]. [cited 2023 Sep 12]. Available from: https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

JBI Critical Appraisal Tools | JBI [Internet]. [cited 2023 Sep 12]. Available from: https://jbi.global/critical-appraisal-tools

RoB 2: A revised Cochrane risk-of-bias tool for randomized trials | Cochrane Bias [Internet]. [cited 2023 Sep 12]. Available from: https://methods.cochrane.org/bias/resources/rob-2-revised-cochrane-risk-bias-tool-randomized-trials

Spetz K, Svedjeholm S, Roos S, Grehn S, Olbers T, Andersson E. Adherence to vitamin and mineral supplementation after bariatric surgery–A two-year cohort study. Obes Res Clin Pract 2022;16(5):407–12.

Smelt HJ, Heusschen L, Theel W, van Rutte PW, Nijboer T, Pouwels S, et al. Factors affecting patient adherence to multivitamin intake after bariatric surgery: a multicentre survey study from the patient’s perspective. Obes Surg 2021;31:4316–26.

Heusschen L, Berendsen AA, Deden LN, Hazebroek EJ, Aarts EO. Nutritional deficiencies 3 years after sleeve gastrectomy can be limited by a specialized multivitamin supplement. Obes Surg 2022;32(11):3561–70.

Ben-Porat T, Elazary R, Goldenshluger A, Dagan SS, Mintz Y, Weiss R. Nutritional deficiencies four years after laparoscopic sleeve gastrectomy—are supplements required for a lifetime? Surg Obes Relat Dis 2017;13(7):1138–44.

Graham YN, Earl‐Sinha C, Parkin L, Callejas‐Diaz L, Fox A, Tierney C, et al. Evaluating a potential role for community pharmacists in post‐bariatric patient nutritional support. Clin Obes 2020;10(4):e12364.

Rao R, Mehta M, Sheth DR, Hogan G. Four-Year Nutritional Outcomes in Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Patients: an Australian Experience. Obes Surg 2023;33(3):750–60.

Lourensz K, Himantoko I, Shaw K, Laurie C, Becroft L, Forrest E, et al. Long-term outcomes of revisional malabsorptive bariatric surgery: do the benefits outweigh the risk? Obes Surg 2022;32(6):1822–30.

Parretti HM, Subramanian A, Adderley NJ, Abbott S, Tahrani AA, Nirantharakumar K. Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study. Br J Gen Pract 2021;71(707):e441–9.

Steenackers N, Van der Schueren B, Mertens A, Lannoo M, Grauwet T, Augustijns P, et al. Iron deficiency after bariatric surgery: what is the real problem? Proc Nutr Soc 2018;77(4):445–55.

NICE. Quality statement 6: Follow-up care after bariatric surgery: Obesity: Clinical assessment and management: Quality standards. [Internet]. [cited 2023 Sep 10]. Available at: https://www.nice.org.uk/guidance/qs127/chapter/quality-statement-6-follow-up-care-after-bariatric-surgery

O'Kane M, Parretti HM, Pinkney J, Welbourn R, Hughes CA, Mok J, et al. British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery-2020 update. Obes Rev 2020;21(11):e13087.

Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, et al. Practical recommendations of the obesity management task force of the European association for the study of obesity for the post-bariatric surgery medical management. Obes Facts 2018;10(6):597–632.

Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures–2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis 2020;16(2):175–247.

Martínez-Ortega AJ, Olveira G, Pereira-Cunill JL, Arraiza-Irigoyen C, García-Almeida JM, Irles Rocamora JA, et al. Recommendations based on evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the pre-and postoperative management of patients undergoing obesity surgery. Nutrients 2020;12(7):2002.

Lange J, Königsrainer A. Malnutrition as a Complication of Bariatric Surgery - A Clear and Present Danger? Visc Med 2019;35(5):305–11

Downloads

Published

2024-06-30

Issue

Vol. 36 No. 2 (2024): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD

Section

REVIEW ARTICLE

License

Copyright (c) 2024 Muhammad Hassaan Wali, Khava Bekova, Noor Abdulla, Simhachalam Gurugubelli, Yi Mon Lin, Devendar Banoth, Samia Rauf Butt

Creative Commons License

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.