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Preventing Bone Loss after Bariatric Surgery

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The benefits of bariatric surgery go beyond just losing weight and keeping it off, there is also convincing data that many patients are cured of obesity-related diseases, notably type 2 diabetes mellitus.
There are also studies that show that weight loss surgery offers financial benefits as it may pay for itself within a few years by reducing medical costs due to obesity-related diseases. Best of all, the long-term death rate seems to be lower for morbidly obese patients. But, bariatric surgery also comes with potential potential short-term and long-term side effect from having rapid weight loss surgery. One of these unwanted side effects is Bone Loss after Bariatric Surgery.

Preventing bone loss with calcium and supplements

Appropiate supplementation with vitamins and calcium is essential to prevent bone loss after bariatric surgery. Calcium, which is the most abundant mineral in the body, is stored in bones and teeth making them dense and strong. Calcium absorption is less efficient and supplementation with Calcium and Vitamin D is essential.

Proper supplementation includes 1500 to 2000 mg daily with no more than 600 mg at a time. Dietary calcium intake is also very important and patients should aim to consume low fat dairy foods and beverages in addition to supplements, up to 3 servings daily.

Taking a complete multivitamin/mineral supplement daily is also required after bariatric surgery as there are many other micronutrients, such as magnesium and vitamin D, which play important roles in bone health.

Tips to Prevent Bone Loss After Bariatric Surgery

  • Bariatric surgery patients need to be increasingly aware of bone health and take measures to prevent bone loss associated with rapid weight decline.
  • Combined dietary and supplemental calcium intake may be required to prevent bone loss during rapid weight loss.
  • Choose calcium citrate rather than calcium carbonate- this is the form that post-op bariatric patients can absorb.
  • Consume a diet rich in calcium.
    • Milk, cheese and other dairy foods.
    • Green leafy vegetables – such as curly kale, okra but not spinach (spinach does contain high levels of calcium but the body cannot digest it all).
    • Soya drinks with added calcium.
    • Bread and anything made with fortified flour.
    • Fish where you eat the bones – such as sardines and pilchards
  • Follow vitamin/mineral supplementation regimen prescribed My New Body Obesity Multidisciplinary bariatric team.

Resources

Stein, E. M., & Silverberg, S. J. (2014). Bone loss after bariatric surgery: causes, consequences, and management. The lancet. Diabetes & endocrinology, 2(2), 165–174. https://doi.org/10.1016/S2213-8587(13)70183-9

Katrien Corbeels, Lieve Verlinden, Matthias Lannoo,Caroline Simoens,Christophe Matthys, Annemieke Verstuyf, Ann Meulemans, Geert Carmeliet, Bart Van der Schueren (2018). Thin Bones: Vitamin D and Calcium handling after bariatric surgery. https://www.sciencedirect.com/science/article/pii/S235218721830007X
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