Endocrine Society GUIDELINES Bundle

Bariatric Surgery

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Key Points Î Bariatric surgery is not a guarantee of successful weight loss and maintenance. Î Common operations include various banding procedures, which restrict the amount of food entering the stomach, the Roux-en-Y gastric bypass (RYGB), the duodenal switch (DS)/gastric sleeve (GS), or the biliopancreatic diversion (BPD) (Figure 1). Î The use of routine algorithms in postoperative care is essential to reduce the risk of weight regain (WR) and postoperative complications. Î Active nutritional patient education and clinical management to prevent and detect nutritional deficiencies are recommended for all patients undergoing bariatric surgery. Î Management of potential nutritional deficiencies is particularly important for patients undergoing malabsorptive procedures. ÎAll patients should participate in a comprehensive nutrition and lifestyle management program from a multidisciplinary team including an experienced primary care physician, endocrinologist, or gastroenterologist. Assessment and Management Postoperative Nutritional Management Î The Endocrine Society (ES) recommends that nutritional management should include an average of 60-120 g of protein daily for all patients to maintain lean body mass during weight loss and for the long term. This is especially important in those treated with malabsorptive procedures to prevent protein malnutrition and its effects (1|⊕⊕⊕ ). Î The ES recommends that long-term vitamin and mineral supplementation be considered in all patients undergoing bariatric surgery, with those who have had malabsorptive procedures requiring potentially more extensive replacement therapy to prevent nutritional deficiencies (1|⊕⊕⊕ ). Î The ES recommends periodic clinical and biochemical monitoring (Table 1) for micro- and macronutritional deficiencies after bariatric surgery (1|⊕⊕⊕ ). Figure 1. Diagram of Surgical Options AGB RYGB GS BPD

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