Iron deficiency after bariatric surgery: What is the real problem?
Open accessAbstract
The growing prevalence of obesity explains the rising interest in bariatric surgery. Compared with non-surgical treatment options, bariatric surgery results in greater and sustained improvements in weight loss, obesity associated complications, all-cause mortality and quality of life. These encouraging metabolic and weight effects come with a downside, namely the risk of nutritional deficiencies. Particularly striking is the risk to develop iron deficiency. Postoperatively, the prevalence of iron deficiency varies between 18 and 53 % after Roux-en-Y gastric bypass and between 1 and 54 % after sleeve gastrectomy. Therefore, preventive strategies and effective treatment options for iron deficiency are crucial to successfully manage the iron status of patients after bariatric surgery. With this review, we discuss the risks and the contributing factors of developing iron deficiency after bariatric surgery. Furthermore, we highlight the discrepancy in the diagnosis of iron deficiency, iron deficiency anaemia and anaemia and highlight the evidence supporting the current nutritional recommendations in the field of bariatric research. In conclusion, we advocate for more nutrition-related research in patient populations in order to provide strong evidence-based guidelines after bariatric surgery.
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In the long-term postoperative period, the prevalence of iron deficiency is detected in 18.0-53.3% of patients, and iron deficiency anemia reaches 52-54%.
“in the long-term postoperative period, the prevalence of iron deficiency is detected in 18.0–53.3% of patients, and iron deficiency anemia reaches 52–54% [28].”
From Iron Deficiency in Obesity and after Bariatric Surgery (2021) · cites this paper as [28]
Different factors of anemia and iron deficiency after bariatric surgery are attributed to reduced food intake and frequent occurrence of meat intolerance.
“Together with decreased secretion of hydrochloric acid, different factors of anemia and ID are attributed to the reduced food intake and frequent occurrence of meat intolerance [28,117,118].”
From Iron Deficiency in Obesity and after Bariatric Surgery (2021) · cites this paper as [28]
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Федорова, Т. А., Strelnikova, E. V., & Gurbanova, S. R. (2024) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2024-481
Rossi, M. M., Signorini, F. J., Veliz, R. L., Andrada, M., Zoela, N., Ramirez, S., & Moser, F. (2024) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2024.11.020
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Arora, G., Via, M. A., & Mechanick, J. I. (2025) · Springer eBooks · doi:10.1007/978-3-031-77690-8_63-1
Significance of Different Salts in Nutritional Supplementation After Metabolic and Bariatric Surgery
Palaniappan, R., Siam, M., Khokhare, B., & Krishna, N. (2025) · Springer eBooks · doi:10.1007/978-981-96-5099-6_11
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Wu, T.-L., Tsao, L., Chen, Y.-Y., Wang, B., & Yen, H. (2025) · BMC Surgery · doi:10.1186/s12893-025-03469-5
- Authors
- Steenackers, N., Van der Schueren, B., Mertens, A., Lannoo, M., Grauwet, T., Augustijns, P., & Matthys, C.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- KU Leuven (BE)
- Corresponding author
- Matthys, Christophe
- ORCID
- Venue
- Proceedings of the Nutrition Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-04-05
- Volume
- 77
- Issue
- 4
- Pages
- 445-455
- ISSN
- 0029-6651 (ISSN-L)
- 1475-2719
- OpenAlex
- W2796155825
- Cited by
- 106
- References
- 93
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 18 · 2023: 17 · 2022: 13 · 2021: 17 · 2020: 6 · 2019: 8 · 2018: 2
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of The Nutrition Society (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Lirias (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- iron deficiency, bariatric surgery, Roux-en-Y gastric bypass, sleeve gastrectomy, iron deficiency anemia, anemia, nutritional deficiency, obesity, iron status, postoperative nutrition, iron supplementation
- MeSH terms
- Iron Deficiencies, Gastrectomy, Humans, Nutritional Status, Obesity, Gastric Bypass, Anemia, Iron-Deficiency, Bariatric Surgery
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