Systematic Review of Micronutrient Deficiency One Year or More After Bariatric Surgery

Abstract

Obesity is a global epidemic and a public health challenge. Currently more than one third of adults in the United States are obese (Center for Disease Control and Obesity, 2015). Although diet, lifestyle modification, and medications are minimally effective, bariatric surgery has demonstrated long-term weight loss and reduction of complications in obese populations. Bariatric surgery has become the recommended treatment option for morbid obesity and obesity with comorbid disease (Buchwald et al., 2004). Studies on long-term follow up — beyond one-year post-surgery — demonstrate that bariatric surgery and extreme weight loss can cause co-morbid problems due to micronutrient deficiencies (Alvarez-Leite, 2004). Bariatric surgery and subsequent extreme weight loss can lead to malabsorption and serious complications from deficiencies in micronutrients — vitamins, minerals, and trace elements. The consequences of micronutrient deficiencies can be serious: disease, functional impairment, and decreased quality of life. Advanced-practice nurses may not be familiar with bariatric surgeries or symptoms of micronutrient deficiency; however, they need to develop competency to provide evidence-based primary care to the rapid growing population of patients with a history of bariatric surgery. This practice inquiry conducts an evidence-based problem-solving approach using a systematic review to develop practice guidelines for advance practice nurses to assess and prevent complications in patient’s one year or more after bariatric surgery. Results from this systematic review indicate that providers should consider screening for micronutrient deficiencies in pre- and post-operative bariatric surgery patients and that this population be routinely monitored for supplement adherence.