Bariatric Surgery or Medical Therapy for Obesity

Abstract

Mingrone et al. and Schauer et al. (April 26 issue) report the results of rigorous randomized, controlled trials comparing various types of bariatric surgery with medical therapy for obesity-associated type 2 diabetes. However, we would like to raise the important issue of micro-nutrient assessment and management in pa-tients undergoing bariatric surgery. The risk of deficiency (of thiamine; vitamins B6, B12, and D; calcium; iron; or copper, zinc, or both) is increasingly recognized after malabsorptive bariatric surgery, but these deficiencies may be inadequately diagnosed. For example, we recently described the incidence and prevalence of copper deficiency after Roux-en-Y gastric bypass surgery as 18.8% and 9.6%, respectively.