Incidence of vitamin deficiency after laparoscopic Roux-en-Y gastric bypass in a university hospital setting. Pathophysiology and significance of malabsorption after Roux-en-Y reconstruction. Metabolic/bariatric surgery worldwide 2008.
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Health outcomes of gastric bypass patients compared to nonsurgical, nonintervened severely obese. Long-term mortality after gastric bypass surgery. Effects of bariatric surgery on mortality in Swedish obese subjects. Type 2 diabetes mellitus-current therapies and the emergence of surgical options. Why is treating obesity so difficult? Justification for the role of bariatric surgery. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults-the evidence report. Obesity: preventing and managing the global epidemic.
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Health indicators in the European regions: expanding regional comparisons to the new countries of the European Union–ISARE III. R., Berghmans, L., Imbert, F., Ledésert, B. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. Prevalence and trends in obesity among US adults, 1999–2000. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. Diabetes type 2 pandemic in 21 st century. In the absence of such data, clinicians should inquire about and treat symptoms that suggest nutrient deficiencies. Further studies are required to determine the optimal levels of nutrient supplementation and whether postoperative laboratory monitoring effectively detects nutrient deficiencies. A major clinical concern is the relationship between vitamin D deficiency and the development of metabolic bone diseases, such as osteoporosis or osteomalacia metabolic bone diseases may explain the increased risk of hip fracture in patients after RYGB. Recognition of the clinical presentations of micronutrient deficiencies is important, both to enable early intervention and to minimize long-term adverse effects. Other disorders, including small intestinal bacterial overgrowth, can promote micronutrient deficiencies, especially in patients with diabetes mellitus. Deficiencies in micronutrients, which include trace elements, essential minerals, and water-soluble and fat-soluble vitamins, are common before bariatric surgery and often persist postoperatively, despite universal recommendations on multivitamin and mineral supplements.
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The major macronutrient deficiency after bariatric surgery is protein malnutrition. This Review summarizes the current knowledge on nutrient deficiencies that can develop after bariatric surgery and highlights follow-up and treatment options for bariatric surgery patients who develop a micronutrient deficiency. As a result, an increasing number of patients with obesity and related comorbidities undergo bariatric surgery, which includes approaches such as the adjustable gastric band or the 'divided' Roux-en-Y gastric bypass (RYGB). Lifestyle intervention programmes often produce insufficient weight loss and poor weight loss maintenance.