Long-term nutritional/metabolic sequelae of bariatric surgery

Although weight loss is an important outcome after bariatric surgery, metabolic-related comorbid diseases commonly improve after these procedures. These desirable effects have led to the birth of "metabolic" surgery. Impressive and long-lasting weight loss is one of the successes of these procedures. However the metabolic effect goes beyond weight loss; bariatric surgery leads to the control and remission of type 2 diabetes (T2D), one of the most impactful medical comorbidities of severe obesity affecting quality and length of life, making bariatric surgery a valid option for the treatment of this disease. Additionally, improving hypertension and lipid profile; reducing the risk for myocardial infarction, stroke, and adverse cardiovascular events; yielding profound improvements in obstructive sleep apnea and quality of life; and greatly decreasing risk for cancer and overall adjusted mortality, bariatric surgery has life-changing benefits. Nevertheless, the profound metabolic impact of bariatric surgery can carry sequelae and alter nutritional parameters too. Practitioners caring for bariatric patients in the long term need to be aware of frequently reported complications, including hypoglycemia, neuropathies, and nutrient deficiencies.