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Meeting nutritional needs after weight loss surgery

Patients who have undergone weight loss surgery (otherwise known as bariatric surgery) usually enjoy fantastic, and relatively quick, weight loss results afterwards. What is often overlooked though is the importance of ensuring that what they are taking in afterwards i.e. in food form and vitamins, meets their new nutritional needs to keep them feeling fit and well.

Types of weight loss surgery include, amongst others, gastric bypass, gastric bands and sleeve gastrectomy. All are different procedures and the patient’s surgeon would decide, together with the patient, which is the best option for them. Ultimately however, the aim of the procedures is to reduce the patient’s food intake, usually by reducing the size of their stomach, so that weight loss will occur.

It seems logical that when intake is reduced, it is of ultimate importance that what is consumed still meets the patient’s nutritional needs. Eating a balanced diet, including a full range of vitamins, essential fats and minerals etc. is necessary for health and wellbeing.

Weight loss patients are therefore at risk of malnutrition.

Why is good nutrition important?

The National Institute of Health and Care Excellence (NICE), defines malnutrition as “a state in which a deficiency of nutrients such as energy, protein, vitamins and minerals causes measurable adverse effects on body composition, function (including social and psychological) and clinical outcome.” (NICE, 2012)

In 2013 the Francis Report confirmed that “malnutrition and dehydration are both causes and consequences of illness, have significant impacts on health outcomes and are integral to all care pathways”.

As a result of the Report, NHS England drafted Guidance in October 2015: “Commissioning Excellent Hydration and Nutrition 2015-2018” with the intention of ensuring nutrition is given priority in healthcare. The Guidance quote NICE which stated in 2011 that “improving the identification and treatment of malnutrition is estimated to have the third highest potential to deliver cost savings to the NHS”.        

The particular concern of malnutrition following weight loss surgery

I am part of a niche team of solicitors who investigate medical negligence claims relating to weight loss (bariatric) surgery.

It is not uncommon for us to see cases of clients who have had weight loss surgery and, whilst the surgery was a success and they have lost weight, they are then extremely poorly following the events due to malnutrition. The surgeon/after care team/patient’s GP can be found to be negligent in not ensuring that these patients nutritional care needs are met and the patient can have a medical negligence claim if they suffer injury as a result.

Whilst this is not a medical blog and should not be taken as medical advice, from our experience in acting for patients in this situation, it is very important that patients considering or having had weight loss surgery discuss with their treating team about taking the correct supplements, the diet they should be eating and ensuring blood levels are regularly monitored for signs of malnutrition, as this can be just as important as the surgery itself.

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