Our Summary

This research paper discusses the issue of zinc deficiency in patients who have undergone gastric bypass surgery, a common procedure for weight loss. Up to half of these patients may have a zinc deficiency before surgery, and the surgery itself can make this deficiency worse by reducing both the intake and absorption of zinc. The British Obesity and Metabolic Surgery Society suggests that patients should be regularly tested for zinc levels after surgery. However, American guidelines do not agree with this and only recommend testing for patients who show specific signs. The research concludes that serious zinc deficiency is uncommon after gastric bypass surgery, so routine testing for all patients is unnecessary. Instead, testing should only be done for patients who have skin lesions, hair loss, unusual eating habits, taste abnormalities, sexual dysfunction in males, and unexplained anemia.

FAQs

  1. What is the prevalence of zinc deficiency in patients prior to bariatric surgery?
  2. Why does the British Obesity and Metabolic Surgery Society recommend routine monitoring of zinc levels after gastric bypass?
  3. Are routine zinc level checks necessary for all patients after Roux-en-Y gastric bypass according to American guidance?

Doctor’s Tip

A helpful tip a doctor might give a patient about gastric bypass is to be aware of the potential for zinc deficiency post-surgery. It is important to monitor zinc levels regularly, especially if experiencing symptoms such as skin lesions, hair loss, pica, dysgeusia, hypogonadism, erectile dysfunction, or unexplained iron deficiency anemia. Routine monitoring may not be necessary for asymptomatic patients, but it is important to be aware of the signs and symptoms of zinc deficiency and communicate with your healthcare provider if any concerns arise.

Suitable For

Patients who are typically recommended for gastric bypass surgery are those with morbid obesity, defined as having a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related comorbidities such as type 2 diabetes, hypertension, sleep apnea, or heart disease. These patients have often tried and failed to lose weight through diet and exercise alone and are at high risk for serious health complications due to their obesity. Additionally, patients with a history of unsuccessful weight loss attempts through other methods may also be considered for gastric bypass surgery.

Timeline

Before gastric bypass surgery:

  • Patient meets with a healthcare provider to discuss the risks and benefits of the procedure
  • Patient undergoes pre-operative evaluations including physical exams, blood tests, and imaging studies
  • Patient may be required to follow a specific diet and exercise regimen to prepare for surgery
  • Patient attends pre-operative counseling sessions to discuss lifestyle changes and support post-surgery

After gastric bypass surgery:

  • Patient is closely monitored in the hospital for potential complications such as infection or blood clots
  • Patient follows a strict liquid diet for the first few weeks post-surgery before gradually transitioning to solid foods
  • Patient attends regular follow-up appointments with healthcare providers to monitor weight loss progress and overall health
  • Patient may experience rapid weight loss in the months following surgery
  • Patient may need to take vitamin and mineral supplements to prevent deficiencies, including zinc
  • Patient may experience changes in appetite, taste preferences, and digestion
  • Patient may need to make long-term lifestyle changes including dietary modifications and regular exercise to maintain weight loss and overall health.

What to Ask Your Doctor

  1. How common is zinc deficiency in patients undergoing gastric bypass surgery?
  2. What are the symptoms of zinc deficiency that I should watch out for?
  3. How often should my zinc levels be monitored after gastric bypass surgery?
  4. Are there any specific risk factors that may increase my likelihood of developing zinc deficiency after surgery?
  5. How can I ensure that I am getting enough zinc in my diet post-surgery?
  6. Are there any supplements or medications that can help prevent zinc deficiency after gastric bypass surgery?
  7. What should I do if I start experiencing symptoms of zinc deficiency?
  8. Are there any other nutrients or vitamins that I should be monitoring or supplementing after gastric bypass surgery?

Reference

Authors: Mahawar KK, Bhasker AG, Bindal V, Graham Y, Dudeja U, Lakdawala M, Small PK. Journal: Obes Surg. 2017 Feb;27(2):522-529. doi: 10.1007/s11695-016-2474-8. PMID: 27885534