Dietary Supplements— Pre- and Postsurgery

Bariatric surgery is associated with lifelong nutritional deficiencies, which can have deleterious effects on health and well-being. The malabsorptive procedures produced by the surgery is associated with deficiencies in B vitamins and fat-soluble vitamins A, D, E, and K along with the minerals—zinc, magnesium, iron, and copper. There is a great variability in the recommendation of dietary supplements despite the significant effects on the surgical outcome and weight loss success.

With more than two-thirds of American adults taking dietary supplements, there are a number of responsible manufacturers who provide safe products. Because consumers are constantly bombarded with information they need to consider product comparisons for quality and quantity pre- and postbariatric surgery. They cannot afford to pay for dietary supplements that do not provide a high return on their investment.

Ensuring production of pharmaceutical grade dietary supplements with a Good Manufacturing Practice (GMP) designation on the label is the best way to start the evaluation process for safety and efficacy. Supplement providers need to be able to provide a Certificate of Analysis (COA) on their products to verify high-quality ingredients analyzed by a laboratory independent of their facility for pureness and bioavailability. In the absence of that level of verification, consumers should look elsewhere for dietary supplements. Over 50% of supplement users consider their health-care professionals as a trusted source for reliable information, so clinics should verify any/all products they provide to patients.

Some bariatric surgery patients have even purchased weight loss products via the Internet only to realize that the Federal Trade Commission (FTC) and U.S. Department of Justice have filed a suit against the company for manufacturing dietary supplements under conditions that do not meet U.S. Food and Drug Administration’s current GMP requirements [1]. Careful vetting of products recommended to patients is necessary.

Unfortunately, health-care professionals understand the benefits of dietary supplements but lack evidence-based research because such studies are expensive. To improve the quality of life for bariatric surgery patients, unhealthy behaviors need to be changed and healthier nutrition choices in food and supplements need to be implemented.

Until insurers provide full coverage for dietary supplements for bariatric patients, health-care providers need to recommend products to meet the individual health needs of each patient and emphasize that cost should not be the only factor in selecting a supplement pre- and postsurgery.

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