A reader emailed My Bariatric Life and asked bariatric dietician Elizabeth Anderson about nutritional needs for persons more than 12-months post-op. Learn how to get your question answered.
Dear Elizabeth,
I’m almost a decade out from having weight loss surgery. Are my nutritional needs the same now as early post-op? What should I be eating, drinking and taking for supplements more than 12-months post-op?
Thanks so much, Naomi
Bariatric Vitamins Beyond 12-Months Post-Op
Thanks for the question, Naomi; it’s a great one. You need to build all the answers to this question around one vital piece of information. Keep reading…
Love Those Labs!!
I think one of the most common things I hear from post-ops is, ‘It’s not that important to keep having labs done more than 12-months post-op, is it?’
Cue Meg Ryan here: “YES! YES! YES!”
The only way you can know what your body needs, if it’s working optimally, if you’re low or too high in a vitamin, mineral or nutrient—is to get lab work done at least annually. That begins in your second-year post-op.
What many folks don’t realize is that deficiencies get worse over time. Yup. The farther out from surgery you are, the more likely you are to have a deficiency.
Some of these deficiencies have serious side-effects.
One size never fits all. Once you have your unique results—THEN you and your bariatric dietitian, [find a provider via the ASMBS] can plan any changes you might need to make in your diet and supplement routine.
Normal Labs? What’s Next
Assuming everything comes back ‘normal’ here are 10 questions to ask yourself before heading off to your bariatric dietitian to get an individual nutrition check-up.
The Top 10 List
(for those 12 months-post-op)
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Are you eating at least 60 but no more than 80 grams of protein per day?
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Are you drinking at least 64 ounces of calorie-free drinks per day?
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Are you eating whole vegetables and fruits every day?
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Are you avoiding alcohol?
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Are you eating 3 meals per day and portioned snacks?
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Are you taking at least 20 minutes to eat a meal?
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Are you waiting 30 minutes after eating before drinking?
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How often do you eat when you’re not hungry?
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Are you taking a daily multivitamin recommended for your surgery type?
| Supplement | Gastric Band | Gastric Bypass | D/S and BPD | Gastric Sleeve |
| Multivitamin/mineral | 100% of daily value | 200% of daily value | 200% of daily value | 100% of daily value |
| B12 | Nothing additional to multivitamin | 350-500 mcg/day | Nothing additional to multivitamin | 350-500 mcg/day |
| Calcium (take no more than 600 mg at a time) | 1500 mg/day (from food and supplements combined) | 1500-2000 mg/day
(from food and supplements combined) | 1800-2400 mg/day
(from food and supplements combined) | 1500 mg/day
(from food and supplements combined) |
| Iron | Nothing additional to multivitamin | 18-27 mg/day | 18-27 mg/day | Nothing additional to multivitamin |
Chart from ASMBS Textbook for Bariatric Surgery Vol 2. Learn about the ASMBS.
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Does your multivitamin/mineral contain the following?
| Copper | 90 mcg |
| Iron | Women 18 mg / Men 8 mg |
| Zinc | Women 9 mg / Men 11 mg |
| Thiamin/B1 | 1.2 mg |
| Folic Acid | 400 mcg |
| Biotin | 30 mcg |
| Vitamin K | Women 90 mcg / Men 120 mcg |
Chart adapted from Academy of Dietetics and Nutrition Pocket Guide to Bariatric Surgery 2nd Edition Cummings et al.
Have I mentioned at least three times that you need to check in with your bariatric dietitian to get the most complete and personalized nutrition checkup?
Good, I thought so.
Until next time, be GOOD to you!
Elizabeth
Content is the opinion of the author and does not constitute or is a replacement for medical advice.
