Obesity Surgery

, Volume 28, Issue 1, pp 152–160 | Cite as

Health and Nutritional Status of Vegetarian Candidates for Bariatric Surgery and Practical Recommendations

  • Shiri Sherf-Dagan
  • Keren Hod
  • Assaf Buch
  • Limor Mardy-Tilbor
  • Ziva Regev
  • Tair Ben-Porat
  • Nasser Sakran
  • David Goitein
  • Asnat Raziel
Original Contributions



Data on vegetarianism and bariatric surgery (BS) are scarce. We herein describe the health and nutritional status of vegetarian patients who plan to undergo BS and propose combined recommendations for vegetarian patients who undergo BS, based on our clinical experience and current scientific literature in both nutrition fields.


Cross-sectional analysis of a prospectively maintained database of all primary laparoscopic sleeve gastrectomies (LSG) performed at a bariatric center of excellence between January 2014 and November 2016 was carried out querying patients who declared a vegetarian or vegan lifestyle before surgery. Preoperative data collected included demographics, anthropometrics, dietary patterns, supplementation use, physical activity, smoking habits, co-morbidities, and blood tests. Each vegetarian was matched to five different omnivores based on age, gender, and BMI.


During the study period, 1470 patients underwent primary LSG surgery (63.7% females). Twenty-one declared a vegetarian or vegan lifestyle (1.4%) pre-surgery. Most were classified as lacto-ovo (57.1%) and were driven from ethical reasons (85.7%). No differences were found between vegetarian and omnivore LSG candidates regarding co-morbidities and nutritional deficiencies, except for lower prevalence of impaired fasting glucose (14.3 vs. 47.1%;P = 0.007), lower ferritin levels (54.3 ± 50.5 vs. 96.8 ± 121.8 ng/ml; P = 0.052) and higher transferrin levels (313.9 ± 42.7 vs. 278.4 ± 40.4 mg/dl; P = 0.009) among the vegetarian cohort. Preoperative use of vitamin B12 and iron supplementation was higher among vegetarian LSG candidates than their omnivore counterparts (57.1 vs. 6.7%;P < 0.001 and 23.8 vs. 6.7%; P = 0.015, respectively).


Vegetarians have comparable health status and nutritional deficiencies, lower iron stores, and higher supplementation use before surgery compared to omnivore LSG candidates.


Obesity Bariatric surgery Omnivore Vegetarian Vegan 


Compliance with Ethical Standards

Conflict of Interest

The authors declare they have no conflict of interest.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Statement of Informed Consent

For this type of study formal consent is not required.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of NutritionAssuta Medical CenterTel-AvivIsrael
  2. 2.Research Division, Epidemiological serviceAssuta Medical CenterTel-AvivIsrael
  3. 3.Institute of Endocrinology, Metabolism and HypertensionTel-Aviv Sourasky Medical CenterTel-AvivIsrael
  4. 4.School of Nutritional SciencesThe Hebrew University of JerusalemRehovotIsrael
  5. 5.Maccabi Healthcare ServicesTel-AvivIsrael
  6. 6.Department of NutritionHadassah-Hebrew University Medical CenterJerusalemIsrael
  7. 7.Assia Medical Group, Assuta Medical CenterTel-AvivIsrael
  8. 8.Department of Surgery A, Emek Medical Center, Afula, affiliated with Rappaport Faculty of MedicineTechnion Israel Institute of TechnologyHaifaIsrael
  9. 9.Department of Surgery CSheba Medical CenterTel HashomerIsrael
  10. 10.Sackler Faculty of MedicineTel-Aviv UniversityTel-AvivIsrael

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