All bariatric surgical procedures compromise nutrition to varying extent, and have the potential to cause clinically significant deficiencies. 

Micronutrient replacement during the immediate post-operative period falls under the remit of specialist follow-up. All patients should have been given a long-term management plan by the specialist centre, including guidance on vitamin, mineral and trace element supplementation. Patients will be required to stay on life-long nutritional supplements in addition to having a balanced diet and have life-long monitoring of their nutritional status.

The British Obesity and Metabolic Surgery Society (BOMSS) has issued updated post-bariatric surgery nutritional guidance for GPs: see here.

Guidance from local bariatric surgery centres on supplementation following surgery may differ from BOMSS guidance.

Preconception and pregnancy

Seek specialist advice on nutritional supplementation for women who have undergone bariatric surgery and are planning to become pregnant or who are pregnant.

Women, as part of preconception care, are advised to avoid vitamin and mineral preparations which contain vitamin A in the retinol form in the first 12 weeks of pregnancy. Supplements containing retinol may increase the teratogenic risk especially in the first trimester. Prescribers should check that any supplements contain vitamin A in the beta carotene and not retinol form. Forceval capsules contain vitamin A in the beta carotene form and may be taken preconception and during pregnancy. Forceval soluble tablets contain vitamin A in the retinol form and should not be taken preconception and during pregnancy.