Original Contributions

Obesity Surgery

, Volume 24, Issue 10, pp 1639-1646

Nutrient Deficiencies Before and After Sleeve Gastrectomy

  • P. W. J. van RutteAffiliated withDepartment of Surgery, Catharina Hospital Email author 
  • , E. O. AartsAffiliated withDepartment of Surgery, Rijnstate Hospital
  • , J. F. SmuldersAffiliated withDepartment of Surgery, Catharina Hospital
  • , S. W. NienhuijsAffiliated withDepartment of Surgery, Catharina Hospital

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Obesity is associated with nutritional deficiencies. Bariatric surgery could worsen these deficiencies. Fewer nutritional deficiencies would be seen after sleeve gastrectomy compared to the Roux-en-Y gastric bypass, but sleeve gastrectomy would also cause further deterioration of the deficiencies. The aim of this study was to determine the amount of pre-operative nutrient deficiencies in sleeve gastrectomy patients and assess the evolution of the nutritional status during the first post-operative year.


Four hundred seven sleeve gastrectomy patients were assigned to a standardized follow-up program. Data of interest were weight loss, pre-operative nutrient status and evolution of nutrient deficiencies during the first post-operative year. Deficiencies were supplemented when found.


Two hundred patients completed blood withdrawal pre-operatively and in the first post-operative year. pre-operatively, 5 % of the patients were anemic, 7 % had low serum ferritin and 24 % had low folic acid. Hypovitaminosis D was present in 81 %. Vitamin A had excessive levels in 72 %. One year post-operatively, mean excess weight loss was 70 %. Anemia was found in 6 %. Low-ferritin levels were found in 8 % of the patients. Folate deficiency decreased significantly and hypovitaminosis D was still found in 36 %.


In this study, a considerable amount of patients suffered from a deficient micronutrient status pre-operatively. One year after surgery, micronutrient deficiencies persisted or were found de novo in a considerable amount of patients, despite significant weight loss and supplementation. Significant reductions were seen only for folate and vitamin D.


Sleeve gastrectomy Vitamin D Bariatric surgery Micronutrient deficiency