Post-bariatric surgery nutritional supplementation: An evaluation of compliance and nutrient adequacy in the Indian patients

Introduction: Bariatric surgery (BS) is the most effective treatment for morbid obesity. Despite a high number of BS performed in India, there is limited research on post-operative nutritional follow-up. The study aimed to assess patient compliance and adequacy of nutritional supplementation protocols in the post-operative period. Patients and Methods: This prospective, single-centre observational study (August 2022–July 2023) assessed post-operative nutritional status in the Indian patients undergoing BS. Baseline and follow-up nutritional assessments (serum albumin, ferritin, B12, calcium and D3) were performed, and patients were given a supplementation regimen based on the American Society for Metabolic and BS guidelines. Compliance with prescribed supplementation was monitored. Patients were considered compliant if they took ≥80% of the prescribed doses. Results: The study involved 32 patients, with 65.6% (21) undergoing sleeve gastrectomy and 34.4% (11) undergoing Roux-en-Y gastric bypass. Over 6 months, the mean body mass index decreased from 47 to 36.1 kg/m 2 . Compliance rates for supplementation varied, with high rates for iron (96.9%) but lower rates for protein (28.1%) and Vitamin B12 (43.7%). However, compliance with supplements did not statistically affect deficiencies for most nutrients, except for Vitamin B12. After 6 months post-surgery, Vitamin B12 deficiency was significantly higher in non-compliant patients than in compliant ones (50% vs. 0%, P = 0.001). Conclusion: This study suggests that the prescribed supplements are adequate in maintaining nutrient levels post-surgery. Compliance is particularly important in preventing Vitamin B12 deficiency, as non-compliant patients tend to show persistent deficiency. The level of other nutrients improved regardless of compliance.