ABSTRACT

Primary care physicians have a unique and important role in the continuum of a patient’s consideration of bariatric surgery and subsequent postsurgical course. The decision to have a bariatric surgical procedure is a complex one for the patient and the physician. In addition to weight loss, the effects of bariatric surgery on a patient’s mortality and medical comorbidities need to be evaluated. This chapter will help the primary care physician understand the surgical options available for morbidly obese patients, how to help patients select the appropriate type of surgery, how surgery alters appetite signaling, and what dietary and lifestyle changes are expected after surgery. In addition, this chapter identies lifelong changes in nutrient needs due to the physiologic changes in absorption. Evaluation of nutrient status of a patient who has undergone bariatric surgery even decades earlier may reveal treatable deciencies exacerbating seemingly unrelated medical conditions.