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Guidelines fall short on bariatric surgery

Appropriate guidance is lacking in long-term nutritional monitoring and support

The National Health and Medical Research Council (NHMRC) Clinical practice guidelines for the management of overweight and obesity were released in early June 2013, replacing the 2003 version, intended for use by specialists and general practitioners.1 A multidisciplinary committee oversaw the guideline development process, aiming to systematically identify and evaluate evidence. In my view, this process has failed with regard to the section dealing with bariatric surgery, thereby failing severely obese Australians and those caring for them.

My greatest concern is the section about nutrition and supplementation after bariatric surgery. Nutritional issues are a critical downside to bariatric surgery and should be front of mind whenever doctors, nurses, dietitians or any other health professionals interact with a patient after surgery. High-quality guidance is required in the care of the thousands of patients who have had bariatric surgery. After bariatric surgery, energy intake is markedly reduced, food choices and diet quality often change, absorption of micronutrients such as iron, calcium, vitamin D and vitamin B12