There is a paucity of studies examining nutritional deficiencies in patients with bariatric surgery over time and by surgery type.


Adult patients undergoing bariatric surgery in the US IBM MarketScan commercial claims database (2005 - 2016) with continuous enrollment from 1 year before to 3 years after the index surgery date were included. Bariatric surgery included Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), laparoscopic adjustable gastric band (LAGB), and biliopancreatic diversion-duodenal switch (BDDS). Nutritional deficiencies included: anemia, protein malnutrition, and deficiencies in vitamins D, A/E/K, B12, B1/Niacin, folic acid, and minerals. Descriptive analyses were conducted to examine nutritional deficiency trends over time.


A total of 83,635 patients (mean (SD) age of 44.5 (9.5) years) were identified, 78% of whom were females. RYGB was the most common type of surgery (38.7%), followed by SG (32.9%) and LAGB (28.0%). Age-adjusted prevalence of any nutritional deficiency within 1, 2, and 3 years after bariatric surgery ranged from 24%, 34%, and 43% respectively (in 2006) to 45%, 55%, and 62% respectively (in 2016). The most common 3-year nutritional deficiencies were anemia (28%), vitamin D deficiency (25%), protein malnutrition (9%), and vitamin B12 deficiency (9%). Anemia was more common after RYGB (36%) compared to SG (28%) and LAGB (17%). Vitamin D deficiency was more prevalent after SG (33%).


Our findings suggest increasing trend of nutritional deficiencies after bariatric surgery since 2006. Personalized post-operative nutritional counseling of patients is needed to prevent nutritional deficiencies after their bariatric surgery.