The true story on deficiencies after Sleeve Gastrectomy; results of a double-blind RCT with the first version of WLS Optimum
For a long time, professionals have stated that a Sleeve Gastrectomy (SG) procedure has minimal impact on the nutrient status. However, studies have found that deficiencies are as common in SG patients as in Roux-en-Y Gastric Bypass patients. To prevent vitamin and mineral deficiencies after an SG, lifelong supplementation is recommended. In 2009, FitForMe developed a specialized multivitamin supplement specifically for SG patients, based on scientific research: The first version of WLS Optimum.
Serum blood values of WLS Optimum 1.0 versus standard multivitamin supplements
In a double-blind randomized controlled trial, the effectiveness of WLS Optimum 1.0 on deficiency prevention after SG was compared to a standard multivitamin supplement (sMVS). For 12 months, 69 SG patients received WLS Optimum 1.0, whereas 70 SG patients in the control group obtained sMVS. Serum blood values of the most common deficiencies were determined preoperatively, and at 6 and 12 months after surgery.
High deficiency rates for SG patients
This study illustrates that, despite common belief, nutritional deficiencies are highly prevalent after SG. Between groups, the prevalence of several nutritional deficiencies was comparable. Even though WLS Optimum 1.0 contained elevated doses of vitamins and minerals, the prevalence of micronutrient deficiencies remained high. WLS Optimum only significantly affected mean serum levels of folic acid, PTH and vitamin B1, and led to lower anemia rates compared to sMVS.
The relatively high deficiency levels may be explained by the low compliance. Even though WLS Optimum was provided free of charge, after one year about half of all patients was incompliant in their daily supplementation. Noncompliance with multivitamin supplements remains a key issue in the prevention of deficiencies after SG and needs to be taken into consideration in post-operative advice.
The need for optimization of WLS Optimum 1.0
The results of this study clearly showed the importance of supplementation after SG and the need for further increase of the dosages of the first version of WLS Optimum, specifically for iron, folic acid, vitamin B12, vitamin D, vitamin B1 and zinc. The results of this and other studies have led to an optimization of WLS Optimum in December 2017.
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Heusschen, L., Schijns, W., Ploeger, N. et al. The True Story on Deficiencies After Sleeve Gastrectomy: Results of a Double-Blind RCT. OBES SURG (2019) doi:10.1007/s11695-019-04252-1
Link to full text: https://link.springer.com/article/10.1007%2Fs11695-019-04252-1