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American Society for Metabolic and Bariatric Surgery ...

Surgery for Obesity and Related Diseases](2017) 00 00 Review articleAmerican Society for Metabolic and Bariatric Surgery Integrated HealthNutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: MicronutrientsJulie Parrott, , ,*, Laura Frank, , , , ,Rebecca Rabena, , , Lillian Craggs-Dino, , , ,Kellene A. Isom, , , , Laura Greiman, , for Fitness, Morganville, New JerseybMultiCare Health System (MHS), Tacoma, WashingtoncEXOS Performance Dietitian, Philadelphia, PennsylvaniadCleveland Clinic Florida, Weston, FloridaeCenter for Metabolic and Bariatric Surgery , Brigham and Women s Hospital, Boston, MassachusettsfSurgical Weight Loss Program, Sharp Memorial Hospital, San Diego, CaliforniaReceived December 20, 2016; accepted December 20, 2016 AbstractBackground:Optimizing postoperative patient outcomes and nutritional status begins pre-operatively. Patients should be educated before and after weight loss Surgery (WLS) on the expectednutrient deficiencies associated with alterations in physiology.

Vitamin B12 (cobalamin) Routine pre-WLS screening of B12 is recommended for all patients. (Grade B, BEL 2) ☑ Serum MMA is the recommended assay for B12 evaluation for symptomatic or asymptomatic patients and in those with history of B12 deficiency or preexisting neuropathy. (Grade B, BEL 2) ☑ Prevalence of B12 deficiency is reported to be

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