{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:54:44Z","timestamp":1787820884897,"version":"build-2784847793"},"reference-count":27,"publisher":"American Diabetes Association","issue":"2","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2005,2,1]]},"abstract":"<jats:p>Over the next several years, the number of patients who will have had bariatric surgery for morbid obesity will reach close to a million. Several well-described nutritional problems such as B12 and iron deficiency will be noted in these patients. Many of these patients will be lost to the original surgeon and will now be in the care of the \u201cother physicians.\u201d These and other mineral and vitamin problems will need to be screened and treated. If these problems are left undiagnosed, severe and irreparable problems can result. Early problems, such as vomiting and dumping syndrome, will be easily recognized and treated, but other long-term problems, such as changes in bone metabolism, will need to be monitored. Again, if some of these long-term problems are not addressed in a timely fashion, then eventual treatment becomes much more difficult. This commentary will cover the common as well newer problems that are now developing in the patient who has had bariatric surgery. Patients who have undergone bariatric surgery require medical follow-up for reasons that are often determined by the type of surgical procedure performed. The majority of this review will deal with patients who have had the standard Roux-en-Y gastric bypass, which is a primarily restrictive procedure with a mild component of noncaloric malabsorption. At the end of this report, a short section will be devoted to the problems associated with the malabsorptive procedures.<\/jats:p>","DOI":"10.2337\/diacare.28.2.481","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T17:51:27Z","timestamp":1173117087000},"page":"481-484","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":198,"title":["Follow-up of Nutritional and Metabolic Problems After Bariatric Surgery"],"prefix":"10.2337","volume":"28","author":[{"given":"Ken","family":"Fujioka","sequence":"first","affiliation":[{"name":"From the Department of Endocrinology, Scripps Clinic, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031215440874200_R1","unstructured":"Fujioka K, Toussi RH, Brunson ME, Mendes RA: Health care utilization before and after bariatric surgery, the managed care experience. Obes Res\u20089 (Suppl. 3):93S, 2001"},{"key":"2022031215440874200_R2","doi-asserted-by":"crossref","unstructured":"Kral JG: Surgical treatment of obesity. Med Clin North Am\u200873:251\u2013264, 1989","DOI":"10.1016\/S0025-7125(16)30702-7"},{"key":"2022031215440874200_R3","doi-asserted-by":"crossref","unstructured":"Huang CS, Forse RA, Jacobsone BC, Farraye FA: Endoscopic findings and their clinical correlations in patients with symptoms after gastric bypass surgery. Gastrointest Endosc\u200858:859\u2013866, 2003","DOI":"10.1016\/S0016-5107(03)02310-1"},{"key":"2022031215440874200_R4","doi-asserted-by":"crossref","unstructured":"Moize V, Geliebter A, Gluck ME, Yahav E, Lorence M, Colarusso T, Drake V, Flancbaum L: Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg\u200813:23\u201328, 2003","DOI":"10.1381\/096089203321136548"},{"key":"2022031215440874200_R5","unstructured":"Bolognia JL, Braverman IM: Skin manifestations of internal disease. In Harrison\u2019s Principles of Internal Medicine. 15th ed. Braunwald E, Ed. New York, McGraw-Hill, 2001, p. 315\u2013330"},{"key":"2022031215440874200_R6","doi-asserted-by":"crossref","unstructured":"Liddle RA, Goldstein RB, Saxton J: Gallstone formation during weight-reduction dieting. Arch Intern Med\u2008149:1750\u20131753, 1989","DOI":"10.1001\/archinte.149.8.1750"},{"key":"2022031215440874200_R7","doi-asserted-by":"crossref","unstructured":"Wudel LJ Jr, Wright JK, Debelak JP, Allos TM, Shyr Y, Chapman WC: Prevention of gallstone formation in morbidly obese patients undergoing rapid weight loss: results of a randomized controlled pilot study. J Surg Res\u2008102:50\u201356, 2002","DOI":"10.1006\/jsre.2001.6322"},{"key":"2022031215440874200_R8","doi-asserted-by":"crossref","unstructured":"Yale CE, Gohdes PN, Schilling RF: Cobalamin absorption and hematologic status after two types of gastric surgery for obesity. Am J Hematology\u200842:63\u201366, 1993","DOI":"10.1002\/ajh.2830420113"},{"key":"2022031215440874200_R9","doi-asserted-by":"crossref","unstructured":"Provenzale D, Reinhold RB, Golner B, Irwin V, Dallal GE, Papathanasopoulos N, Sahyoun N, Samloff IM, Russell RM: Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels. J Am Coll Nutr\u200811:29\u201335, 1992","DOI":"10.1080\/07315724.1992.10718193"},{"key":"2022031215440874200_R10","unstructured":"Brolin RE, Gorman RC, Milgrim LM, Kenler HA: Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral deficiencies. Int J Obes\u200815:661\u2013667, 1991"},{"key":"2022031215440874200_R11","doi-asserted-by":"crossref","unstructured":"Amaral JF, Thompson WR, Caldwell MD, Martin HF, Randall HT: Prospective hematologic evaluation of gastric exclusion surgery for morbid obesity. Ann Surg\u2008201:186\u2013193, 1985","DOI":"10.1097\/00000658-198502000-00009"},{"key":"2022031215440874200_R12","unstructured":"Halverson JD: Micronutrient deficiencies after gastric bypass for morbid obesity. Ann Surg\u200852:594\u2013598, 1986"},{"key":"2022031215440874200_R13","doi-asserted-by":"crossref","unstructured":"Sharabi A, Cohen E, Sulkes J, Garty M: Replacement therapy for vitamin B12 deficiency: comparison between the sublingual and oral route. Br J Clin Pharmacol\u200856:635\u2013638, 2003","DOI":"10.1046\/j.1365-2125.2003.01907.x"},{"key":"2022031215440874200_R14","unstructured":"Neville J: Sublingual vitamin B12 (Letter). J Fam Pract\u200842:342, 1996"},{"key":"2022031215440874200_R15","unstructured":"Avinoah E, Ovnat A, Charuzi I: Nutritional status seven years after Roux-en-Y gastric bypass surgery. Surgery\u2008111:137\u2013142, 1992"},{"key":"2022031215440874200_R16","doi-asserted-by":"crossref","unstructured":"Coates PS, Fernstrom JD, Fernstrom MH, Schauer PR, Greenspan SL: Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab\u200889:1061\u20131065, 2004","DOI":"10.1210\/jc.2003-031756"},{"key":"2022031215440874200_R17","doi-asserted-by":"crossref","unstructured":"Collazo-Clavell ML, Jimenez A, Hodgson SF, Sarr MG: Osteomalacia after Roux-en-Y gastric bypass. Endo Pract\u20081:195\u2013198, 2004","DOI":"10.4158\/EP.10.3.195"},{"key":"2022031215440874200_R18","doi-asserted-by":"crossref","unstructured":"von Mach MA, Stoeckli R, Bilz S, Kraenzlin M, Langer I, Keller U: Changes in bone mineral content after surgical treatment of morbid obesity. Metabolism\u200853:918\u2013921, 2004","DOI":"10.1016\/j.metabol.2004.01.015"},{"key":"2022031215440874200_R19","doi-asserted-by":"crossref","unstructured":"Shaker JL, Norton AJ, Woods MF, Fallon MD, Findling JW: Secondary hyperparathyroidism and osteopenia in women following gastric exclusion surgery for obesity. Osteoporos Int\u20081:177\u2013181, 1991","DOI":"10.1007\/BF01625450"},{"key":"2022031215440874200_R20","doi-asserted-by":"crossref","unstructured":"Goode LR, Brolin RE, Hasina A: Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res\u200812:40\u201346, 2004","DOI":"10.1038\/oby.2004.7"},{"key":"2022031215440874200_R21","unstructured":"Fujioka K, Lee M, Dailey GE: Secondary hyperparathyroidism after bariatric surgery for morbid obesity (Abstract). Obes Res\u200812:A37, 2004"},{"key":"2022031215440874200_R22","doi-asserted-by":"crossref","unstructured":"Consensus Development Conference Panel: NIH conference: gastrointestinal surgery for severe obesity. Ann Intern Med\u2008115:956\u2013961, 1991","DOI":"10.7326\/0003-4819-115-12-956"},{"key":"2022031215440874200_R23","doi-asserted-by":"crossref","unstructured":"Chapin BL, Lemar HJ Jr, Knodel DH, Carter PL: Secondary hyperparathyroidism following Biliopancreatic diversion. Arch Surg\u2008131:1048\u20131052, 1996","DOI":"10.1001\/archsurg.1996.01430220042009"},{"key":"2022031215440874200_R24","doi-asserted-by":"crossref","unstructured":"Slater GH, Ren CJ, Siegel N, Williams T, Barr D, Wolfe B, Dolan K, Fielding GA: Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg\u20088:48\u201355, 2004","DOI":"10.1016\/j.gassur.2003.09.020"},{"key":"2022031215440874200_R25","doi-asserted-by":"crossref","unstructured":"Newbury L, Dolan K, Hatzifotis M, Low N, Fielding G: Calcium and vitamin D depletion and elevated parathyroid hormone following biliopancreatic diversion. Obes Surg\u200813:893\u2013895, 2003","DOI":"10.1381\/096089203322618722"},{"key":"2022031215440874200_R26","doi-asserted-by":"crossref","unstructured":"Papadia F, Marinari GM, Camerini G, Adami GF, Murelli F, Carlini F, Stabilini C, Scopinaro N: Short-term liver function after biliopancreatic diversion. Obes Surg\u200813:752\u2013755, 2003","DOI":"10.1381\/096089203322509336"},{"key":"2022031215440874200_R27","doi-asserted-by":"crossref","unstructured":"Stocker DJ: Management of the bariatric surgery patient (Review). Endocrinol Metab Clin North Am\u200832:437\u2013457, 2003","DOI":"10.1016\/S0889-8529(03)00002-1"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/28\/2\/481\/665941\/zdc00205000481.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/28\/2\/481\/665941\/zdc00205000481.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,11]],"date-time":"2024-02-11T08:08:33Z","timestamp":1707638913000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/28\/2\/481\/23978\/Follow-up-of-Nutritional-and-Metabolic-Problems"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,2,1]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2005,2,1]]}},"URL":"https:\/\/doi.org\/10.2337\/diacare.28.2.481","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,2,1]]}}}