A study found that patients with vitamin D deficiency are the most common before undergoing obesity metabolic surgery. There were many cases of deficiency of vitamin B1, folic acid, and iron. Accordingly, it was pointed out that it is necessary to carefully examine and manage these nutrients before surgery.
The research results, conducted by Professor Young-Seok Park of Surgery at Seoul National University Bundang Hospital, were published in the recent issue of Obesity Surgery, an SCI-level international academic journal of the World Federation of Obesity Metabolism Surgery.
Among the treatments for obesity, there is’obesity metabolism surgery’, which reduces the amount of food and restricts the absorption of nutrients such as sugars into the body. This surgery is also called’diabetic surgery’ because it is effective not only for weight loss but also for blood sugar control. In Korea, it was recognized as an official treatment for obesity in 2019, and national health insurance benefits were provided.
The problem is that since the intake or absorption of nutrients is reduced overall after surgery, care must be taken not to deplete essential micronutrients such as vitamins and iron. In particular, the lack of nutrients before surgery can become more severe after surgery. It means that it is important to identify this in advance and prevent it through management. However, there are still no studies on the nutritional status of patients before and after obesity metabolic surgery in Korea, so it is difficult to prepare standard guidelines.
Accordingly, Prof. Young-Seok Park’s team conducted a study to investigate the state of nutrient deficiency of patients before surgery using data from 215 people who underwent obesity metabolic surgery in hospitals in 2019.
As a result, the most common nutrient deficiency before obesity metabolic surgery was vitamin D, 80% of all patients were’deficient’ and 14% were found to be’insufficient’. If postoperative weight and muscle mass are decreased and at the same time, a decrease in bone density due to vitamin D deficiency is accompanied, the risk of fracture may increase. In addition, caution is required because it can affect the onset of chronic cardiovascular diseases including myocardial infarction.
After vitamin D, vitamin B1 (18.3%), folic acid (14.2%), iron (11.8%), and zinc (7.6%) were in the order of high deficiency. These are all essential nutrients for our body, and when deficient, beriberi disease, anemia, and reduced immunity can occur, so they must be managed continuously. In particular, folic acid deficiency is also related to the onset of congenital neurological disorders in children, so it is necessary for women of childbearing age to check and supplement the deficiency before surgery.
The results of this study are expected to become an important basis for preparing standard preoperative and postoperative nutritional management guidelines for Koreans in the future.
Professor Young-Seok Park said, “There is a perception that obese patients are overnutritive, but they have little physical activity and their eating habits are tilted to one side, so there are rather many deficient nutrients.” After the obesity metabolic surgery, it is possible to achieve healthy weight loss and blood sugar reduction goals while minimizing nutritional deficiencies.”
Obesity metabolic surgery is a’gastric sleeve resection’ that reduces the size of the stomach according to the method,’Louwai gastric bypass graft’, which directly connects the small intestine with a small amount of the stomach left near the esophagus, and’duodenal replacement surgery, which performs both gastrectomy and duodenal bypass Conversion)’, etc. If weight loss is the main goal, reducing the amount of meals with gastric sleeve resection can have a great effect. In the case of obesity accompanied by severe diabetes, etc., it is recommended to perform Ruwai gastric bypass surgery or cholangiopancreatic diversion. By bypassing the intestine and shortening the length of the small intestine through which food passes, it is the principle that even if you eat the same amount, it is absorbed less.