Screening for undernutrition in gastric bypass: a case study of four patients in the Marrakech Tensift Al Haouz region, Morocco

Published: 26 August 2024
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Undernutrition presents a major risk to patients’ health and well-being following gastric bypass surgery. After undergoing this surgery, the nutritional status of three women and one man was examined in this study. Follow-up visits were used to measure weight, body composition, and biological and biochemical data. After 3 months of follow-up after gastric bypass surgery, our findings revealed a reduction in muscle mass. The average loss of muscle mass was 4.375±1.470 kg. Their initial body mass index, which was 45.01 kg/m2, on average, dropped to 28.38 kg/m2. Significant drops were observed in the mean levels of albumin and pre-albumin (albumin: 38.6 g/L to 24.8 g/L, pre-albumin: 195 mg/L to 113 mg/L). In our study, patients with micronutritional deficiencies and gastric bypass demonstrated a significant and adaptive reduction in daily caloric intake. Early identification of undernutrition makes it possible to assess its severity and, as part of the patient’s overall follow-up, to implement appropriate nutritional management.

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Citations

Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity 2009;17:S1-70. DOI: https://doi.org/10.1038/oby.2009.28
Stocker DJ. Management of the bariatric surgery patient. Endocrinol Metab Clin North Am 2003;32:437-57. DOI: https://doi.org/10.1016/S0889-8529(03)00002-1
Maiz C, Alvarado J, Quezada N, et al. Bariatric surgery in 1119 patients with preoperative body mass index <35 (kg/m(2)): results at 1 year. Surg Obes Relat Dis 2015;11:1127-32. DOI: https://doi.org/10.1016/j.soard.2015.03.012
Kaidar-Person O, Person B, Szomstein S, Rosenthal RJ. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part A: vitamins. Obes Surg 2008;18:870-6. DOI: https://doi.org/10.1007/s11695-007-9349-y
Navez B, Thissen JP. Bariatric surgery: follow-up in general medicine. Louvain Médical 2018;137:250-4. [Article in French].
Shankar P, Boylan M, Sriram K. Micronutrient deficiencies after bariatric surgery. Nutrition 2010;26:1031-7. DOI: https://doi.org/10.1016/j.nut.2009.12.003
Handzlik-Orlik G, Holecki M, Orlik B, et al. Nutrition management of the post-bariatric surgery patient. Nutr Clin Pract 2015;30:383-92. DOI: https://doi.org/10.1177/0884533614564995
Reiber BMM, Leemeyer AR, Bremer MJM, et al. Weight loss results and compliance with follow-up after bariatric surgery. Obes Surg 2021;31:3606-14. DOI: https://doi.org/10.1007/s11695-021-05450-6
Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition 2009;25:1150-6. DOI: https://doi.org/10.1016/j.nut.2009.03.012
Martinez MC, Meli EF, Candia FP, et al. The impact of bariatric surgery on the muscle mass in patients with obesity: 2-year follow-up. Obes Surg 2022;32:625-33. DOI: https://doi.org/10.1007/s11695-021-05815-x
Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg 2006;244:734-40. DOI: https://doi.org/10.1097/01.sla.0000217592.04061.d5
UCSF Health. Dietary guidelines after bariatric surgery. Available from: https://www.ucsfhealth.org/education/dietary-guidelines-after-bariatric-surgery.
Brolin RE. Metabolic deficiencies and supplements following bariatric operations. Obes Surg 2004:275-99.
Ernst B, Thurnheer M, Schmid SM, Schultes B. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes Surg 2009;19:66-73. DOI: https://doi.org/10.1007/s11695-008-9545-4
Suárez Llanos JP, Fuentes Ferrer M, Alvarez-Sala-Walther L, et al. Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion. Nutr Hosp 2015;32:80-6. DOI: https://doi.org/10.1016/S0261-5614(13)60276-9
Rinaldi Schinkel E, Pettine SM, Adams E, Harris M. Impact of varying levels of protein intake on protein status indicators after gastric bypass in patients with multiple complications requiring nutritional support. Obes Surg 2006;16:24-30. DOI: https://doi.org/10.1381/096089206775222168
Guillet C, Masgrau A, Mishellany-Dutour A, et al. Bariatric surgery affects obesity-related protein requirements. Clin Nutr ESPEN 2020;40:392-400. DOI: https://doi.org/10.1016/j.clnesp.2020.06.007
Sarwer DB, Dilks RJ, West-Smith L. Dietary intake and eating behavior after bariatric surgery: threats to weight loss maintenance and strategies for success. Surg Obes Relat Dis 2011;7:644-51. DOI: https://doi.org/10.1016/j.soard.2011.06.016
Bloomberg RD, Fleishman A, Nalle JE, et al. Nutritional deficiencies following bariatric surgery: what have we learned?. Obes Surg 2005;15:145-54. DOI: https://doi.org/10.1381/0960892053268264
Gletsu-Miller N, Wright BN. Mineral malnutrition following bariatric surgery. Adv Nutr 2013;4:506-17. DOI: https://doi.org/10.3945/an.113.004341
Jauregui-Lobera I. Iron deficiency and bariatric surgery. Nutrients 2013;5:1595-608. DOI: https://doi.org/10.3390/nu5051595
Saltzman E, Karl JP. Nutrient deficiencies after gastric bypass surgery. Annu Rev Nutr 2013;33:183-203. DOI: https://doi.org/10.1146/annurev-nutr-071812-161225
Lewis CA, de Jersey S, Seymour M, et al. Iron, vitamin B12, folate and copper deficiency after bariatric surgery and the impact on anaemia: a systematic review. Obes Surg 2020;30:4542-91. DOI: https://doi.org/10.1007/s11695-020-04872-y
Lewis CA, Osland EJ, de Jersey S, et al. Monitoring for micronutrient deficiency after bariatric surgery-what is the risk?. Eur J Clin Nutr 2023;77:71-1083. DOI: https://doi.org/10.1038/s41430-023-01318-3
Goldner WS, Stoner JA, Thompson J, et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg 2008;18:145-50. DOI: https://doi.org/10.1007/s11695-007-9315-8
Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass?. J Gastrointest Surg 1998;2:436-42. DOI: https://doi.org/10.1016/S1091-255X(98)80034-6
Love AL, Billett HH. Obesity, bariatric surgery, and iron deficiency: True, true, true and related. Am J Hematol 2008;83:403-9. DOI: https://doi.org/10.1002/ajh.21106
Nuijten MAH, Monpellier VM, Eijsvogels TMH, et al. Rate and Determinants of Excessive Fat-Free Mass Loss After Bariatric Surgery. Obes Surg 2020;30:3119-26. DOI: https://doi.org/10.1007/s11695-020-04654-6
Hassan M, Barajas-Gamboa JS, Kanwar O, et al. The role of dietitian follow-ups on nutritional outcomes post-bariatric surgery. Surg Obes Relat Dis 2024;20:407-12. DOI: https://doi.org/10.1016/j.soard.2023.10.017

How to Cite

Belmoudden, H., Al Ibrahmi, B., & Bour, A. (2024). Screening for undernutrition in gastric bypass: a case study of four patients in the Marrakech Tensift Al Haouz region, Morocco. Italian Journal of Medicine, 18(3). https://doi.org/10.4081/itjm.2024.1778