Follow-up After Bariatric Surgery
Annual Blood Tests
These are required on a YEARLY basis to monitor vitamin deficiencies, bone health, kidney, and liver function.
Laparoscopic Sleeve Gastrectomy
FBC
Electrolytes
Albumin
Ferritin
B12
Folate
Calcium
Vitamin D
PTH
HbA1c
Laparoscopic RY/Loop Gastric Bypass
As for sleeve gastrectomy plus,
Vitamin A
Zinc
Copper
Multivitamins/Medication Advice
Bariatric Multivitamin + Calcium Citrate in divided doses - further blog post on multivitamins to come
NSAIDs (ibuprofen, neurofen, celecoxib, neuromol, maxigesic, voltaren, diclofenac, naproxen, mefenamic acid etc.) - For gastric bypass patients - AVOID FOR LIFETIME
Oral contraceptive pills – Use with caution, may have reduced efficacy in gastric bypass
Immediate release preparations are preferred over extended release
Weight Re-gain
Please also visit our Weight re-gain after bariatric surgery page for further information.
We encourage you to monitor your patient’s weight regularly.
Significant weight re-gain is difficult to define but 25% of total weight lost is an acceptable definition.
Patients who have a sleeve gastrectomy are at a greater risk of weight re-gain.
Early recognition and intervention is key – even if patients do not reach ‘significant weight re-gain’, returning hunger, feelings of loss of control, and increasing fear of gaining weight back can be a sign that the patient requires further treatment.
Patients who experience weight re-gain (and their GPs) may perceive their surgery has failed, and often go into a cycle of helplessness by blaming themselves. It is important to sensitively address this issue and explain that it is normal, or sometimes inevitable that weight re-gain happens and that further treatment options are available.
It is important that patients continue to follow the post-surgery nutrition plan/multivitamin intake and continue to monitor their regular blood tests.
Early referral back to bariatric services may save the patient from further distress and further weight regain.
Pregnancy
Pregnancy should be avoided before one year post bariatric surgery, as it is associated with a higher rate of fetal loss.
Standard bariatric multivitamins should be substituted for prenatal multivitamins to reduce vitamin A intake. Multivitamins which contain vitamin A in the retinol form should be avoided as retinol may increase teratogenic risk. Vitamin A should be in the form of beta-carotene in multivitamin supplements. All patients who have had bariatric surgery should consult a bariatric dietitian before contemplating pregnancy.