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Patient perspectives on post-bariatric surgery nutritional supplementation

  • 2021 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Bariatric procedures increase patient risk of long-term metabolic complications primarily due to nutrient deficiencies. The mainstay of prevention includes routine vitamin and mineral supplementation; however, patient-reported barriers to daily compliance are poorly understood.

Methods

Post-bariatric surgery patients electively participated in an 11-point outpatient survey at a single academic institution. Surgical procedures included either laparoscopic sleeve gastrectomy (SG) or gastric bypass (GB). At the time of survey, patients ranged from 1-month to 15 years from surgery. Survey items consisted of dichotomous (yes/no), multiple choice, and open-ended free response questions. Descriptive statistics were evaluated.

Results

Two hundred and fourteen responses were collected, 116 (54%) underwent SG and 98 (46%) underwent GB. Of these, 49% of samples were during short-term postoperative follow-up visits (0–3 months), 34% intermediate follow-up (4–12 months), and 17% long-term follow-up (> 1 year). A total of 98% of patients reported that insurance did not cover their supplement cost. Most patients reported current vitamin use (95%), with 87% reporting daily compliance. Daily compliance was observed in 94%, 79%, and 73% of SG patients at short-, intermediate-, and long-term follow-up visits, respectively. While GB patients reported daily compliance in 84%, 100%, and 92% of short, intermediate, and long-term responses. Of those who were unable to take vitamins daily, non-compliance was attributed most to forgetting (54%), and less often to side effects (11%), or taste (11%). Patient-reported strategies for remembering to take vitamins included tying into daily routine (55%), use of a pill box (7%), and alarm reminders (7%).

Conclusions

Daily compliance with post-bariatric surgery vitamin supplementation does not appear to vary based on postoperative time-period or surgical procedure. While a minority of patients struggle with daily compliance, factors associated with non-compliance include patient forgetting, side effects, and taste. Widespread utilization of patient-reported daily reminder strategies may lead to improved overall compliance and reduce incidence of nutritional deficiencies.

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Authors and Affiliations

  1. Department of Surgery, Loyola University Medical Center, Maywood, IL, USA

    Alexandra L. Mathews & Patrick J. Sweigert

  2. Northwestern University, Chicago, IL, USA

    Rohan M. Shah

  3. Department of Surgery, Division of GI/Minimally Invasive Surgery, Loyola University Medical Center, Stritch School of Medicine, 2160 S. First Ave, Maywood, IL, 60153, USA

    Lauren Zuro, Kimberly Mahoney, Faith Flaherty & Bipan Chand

Authors
  1. Alexandra L. Mathews
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  2. Rohan M. Shah
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  4. Lauren Zuro
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Correspondence to Bipan Chand.

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Disclosures

Drs. Mathews, Sweigert, and Chand have no conflicts of interest or financial ties to disclose. Additionally, Rohan Shah, Lauren Zuro, Kimberly Mahoney, and Faith Flaherty have no conflicts of interest or financial ties to disclose.

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Mathews, A.L., Shah, R.M., Sweigert, P.J. et al. Patient perspectives on post-bariatric surgery nutritional supplementation. Surg Endosc 37, 5494–5499 (2023). https://doi.org/10.1007/s00464-023-09994-9

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  • DOI: https://doi.org/10.1007/s00464-023-09994-9

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