Between 2010-2013 around 26% of bariatric patients had gastric bands fitted (NBSR, 2015). With the updated NICE Guidelines (November 2014) recommending that in order to tackle the Type 2 diabetes epidemic the NHS should offer bariatric surgery to thousands more people each year, this will have a significant impact on the number of gastric band wearers in the UK.
Many articles and reviews on bariatric surgery suggest that nutritional support is needed for those who have had a gastric bypass or gastric sleeve, yet gastric band wearers are generally fine. Is this true? Or is more awareness needed regarding nutritional support for band wearer’s pre and post surgery?
Many obese individuals are deficient in nutrients prior to weight-loss surgery. These are unlikely to improve after surgery without due care and attention. Data shows many gastric band wearers become deficient in:
Thiamin (B1). Especially if patent has frequent vomiting (Dixon, 2001; Chavallier, 2010).
Folate (B9). Folate levels decline by 44% within 2 years post surgery (Gasteyger et al., 2006)
Iron (Fe) Between 30-57% of patients are low prior to surgery, rising to 72% of patients within 18-months of surgery (Harris & Barger, 2010).
Protein (Coupaye et al., 2009).
Selenium (Freeth et al., 2012).
Vitamin C. Up to 35% of patients are deficient 12-24 months post op (Clements et al., 2006).
Vitamin D. Up to 80% of pre-bariatric patients are vitamin D deficient (Xanthakos, 2009).
Vitamin K. Especially if the patient has prolonged vomiting (Van Mieghem et al., 2008).
Nicola and Claudia have extensively researched nutritional factors related to obesity, bariatric surgery and specifically nutrition to support gastric band wearers. Their book has been written as a practical tool for the gastric band wearer but uses a scientific approach so that nutrition and bariatric professionals can use it with confidence, knowing that it’s evidence based.
“Pearson & Williamson (2015) Nutrition for Gastric Band Wearer’s: A Practical Handbook” is available now on Amazon. Click here for more details.
“Stomach capacity is limited so every mouthful needs to nourish”.
Chavallier J (2010) Gastric banding using adjustable silastic ring in 2010. Techniques, indications, results and management. Journal of Visceral Surgery 147:5:e21-e29.
Clements R, Katasani V, Palepu R, Leeth R, Leath T, Roy B, Vickers S (2006) Incidence of vitamin deficiency after laparoscopic Roux-en-Y gastric bypass in a university hospital setting. American Journal of Surgery 72: 1196–1204
Coupaye M, Puchaux K, Bogard C, Msika S, Jouet P, Clerici C, Larger E, Ledoux S (2009) Nutritional Consequences of Adjustable Gastric Banding and Gastric Bypass: A 1-year Prospective Study. Obesity Surgery 19:1:56-65
Dixon J, Dixon M, O'Brien P (2001) Elevated homocysteine levels with weight loss after Lap-Band surgery: higher folate and vitamin B12 levels required to maintain homocysteine level. International Journal of Obesity 25: 219-227
Freeth A, Prajuabpansri P, Victory J, Jenkins P (2012) Assessment of Selenium in Royx-en-Y Gastric Bypass and Gastric Banding Surgery. Obesity Surgery 22: 11: 1660-1665
Gasteyger C, Suter M, Calmes JM, Gaillard RC, Giusti V. (2006) Changes in body composition, metabolic profile and nutritional status 24 months after gastric banding. Obesity Surgery 16 (3): 243-250
Harris & Barger (2010) Specialised Care for Women Pregnant After Bariatric Surgery. Journal of Midwifery & Women’s Health 55: 529-539
National Bariatric Surgery Register (2015). The United Kingdom National Bariatric Surgery Register. Second Registry Report 2014. Available at: [http://nbsr.co.uk].
NICE Guidelines (2014) Obesity: identification, assessment and management of overweight and obesity in children, young people and adults
NICE guidelines [CG189]. Available at: [https://www.nice.org.uk/guidance/cg189/chapter/1-recommendations].
Xanthakos S (2009) Nutritional Deficiencies in Obesity and After Bariatric Surgery. Pediatric Clinical North America 56:5: 1105–1121.
Van Mieghem T, Van Schoubroeck D, Depiere M, Debeer A, Hanssens M (2008) Fetal cerebral hemorrhage caused by vitamin K deficiency after complicated bariatric surgery. Obstetrics and Gynecology 112:2:2:434-6.