A recent study has revealed that those undergoing bariatric surgery risk nutritional deficiencies like Wernicke’s encephalopathy for the rest of their life. Researchers from the First Affiliated Hospital of Jinan University in Guangdong, China concluded that many weight loss surgery patients face nutritional challenges even before their surgery and that the key to success and health lies in lifelong nutritional support.
The researchers, led by surgical specialist Wah Yang, MD, analyzed nutritional health of 668 adults who were about to have gastric bypass and sleeve gastrectomy procedures and found that the majority of them were already at nutritionally deficient, making it all the more likely that Wernicke’s encephalopathy would follow their surgery. More than two-thirds of patients had some type of deficiency, with 25.1% showing signs of thiamine (vitamin B1) deficiency, 21.4% deficient in vitamin C, and 19.7% showing low levels of vitamin E. Patients were also deficient in micronutrients like zinc.
Supplementation is the Key to Preventing Wernicke’s Encephalopathy
Wernicke’s Encephalopathy was shown to be the most common adverse outcome of the nutritional deficiencies suffered by pre- and post-operative weight loss patients. Sangeeta Kashyap, MD, associate professor of medicine at Cleveland Clinic Lerner College of Medicine and staff physician in the department of endocrinology at Cleveland Clinic said that patients and physicians should be alerted to this risk even when there are no overt symptoms. Kashyap said, “It is very important for these patients to, at least twice a year, get their vitamin levels checked because sometimes they do not have any symptoms. I think [vitamin deficiency] is under-recognized because [after] losing the weight and improvements of comorbidities, patients generally feel good after having the surgery. … They do not understand that there are permanent changes to their bodies, and they are not able to absorb and process vitamins.”
The thiamine deficiency that precedes Wernicke’s encephalopathy is a particular concern because the body does not manufacture its own thiamine, and when there is an intake deficiency or loss of thiamine due to post-surgical nausea or vomiting, the body loses half of its thiamine every ten to twenty days.