Cited by 106Bariatric Surgery and OutcomesIron Metabolism and DisordersNutrition and Health in Aging

The DOI matches its Crossref record; 93 of the 93 references it cites were found in a registry or an index.

Iron deficiency after bariatric surgery: what is the real problem?

Open access

Steenackers, Nele, Van der Schueren, Bart, Mertens, Ann, Lannoo, Matthias, Grauwet, Tara, Augustijns, Patrick, Matthys, Christophe·2018·Proceedings of the Nutrition Society

DOI 10.1017/s0029665118000149

Open this paper in CoChat — free account Open PDF

Abstract

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.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1017/s0029665118000149

Cites

93 of 93 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies
Prospective Studies Collaboration (2009) · The Lancet · doi:10.1016/s0140-6736(09)60318-4 · Cited by 4,807
Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects
Sjöström, L., Narbro, K., Sjöström, C. D., Karason, K., Larsson, B., Wedel, H., Lystig, T., Sullivan, M., Bouchard, C., Carlsson, B., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa066254 · Cited by 4,668
Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents
Di Angelantonio, E., Bhupathiraju, S. N., Wormser, D., Gao, P., Kaptoge, S., de Gonzalez, A. B., Cairns, B. J., Huxley, R., Jackson, C. L., Joshy, G., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30175-1 · Cited by 2,821
Review of the key results from the Swedish Obese Subjects ( SOS ) trial – a prospective controlled intervention study of bariatric surgery
Sjöström, L. (2013) · Journal of Internal Medicine · doi:10.1111/joim.12012 · Cited by 1,835
Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: Cosponsored by american association of clinical endocrinologists, The obesity society, and american society for metabolic & bariatric surgery*
Mechanick, J. I., Youdim, A., Jones, D. B., Garvey, W. T., Hurley, D. L., McMahon, M. M., Heinberg, L. J., Kushner, R., Adams, T. D., Shikora, S., et al. (2013) · Obesity · doi:10.1002/oby.20461 · Cited by 1,650
Bariatric Surgery Worldwide 2013
Angrisani, L., Santonicola, A., Iovino, P., Formisano, G., Buchwald, H., & Scopinaro, N. (2015) · Obesity Surgery · doi:10.1007/s11695-015-1657-z · Cited by 1,492
Management of obesity
Bray, G. A., Frühbeck, G., Ryan, D. H., & Wilding, J. P. H. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00271-3 · Cited by 1,036
The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration?
Beutler, E., & Waalen, J. (2005) · Blood · doi:10.1182/blood-2005-07-3046 · Cited by 971
Standardized outcomes reporting in metabolic and bariatric surgery
Brethauer, S. A., Kim, J. J., Chaar, M. E., Papasavas, P. K., Eisenberg, D., Rogers, A. M., Ballem, N., Kligman, M. D., & Kothari, S. N. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2015.02.003 · Cited by 970
Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery
Fried, M., Yumuk, V., Oppert, J., Scopinaro, N., Torres, A., Weiner, R. A., Yashkov, Y. I., & Frühbeck, G. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1079-8 · Cited by 768

Show all 93 references

Sorted by citations

Iron deficiency
Camaschella, C. (2019) · Blood · doi:10.1182/blood-2018-05-815944 · Cited by 702
Iron deficiency anaemia revisited
Cappellini, M. D., Musallam, K. M., & Taher, A. T. (2019) · Journal of Internal Medicine · doi:10.1111/joim.13004 · Cited by 591
Iron deficiency without anaemia: a diagnosis that matters
Al-Naseem, A., Sallam, A., Choudhury, S., & Thachil, J. V. (2021) · Clinical Medicine · doi:10.7861/clinmed.2020-0582 · Cited by 199
Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status
Ciobârcă, D., Cătoi, A. F., Copăescu, C., Miere, D., & Crișan, G. (2020) · Nutrients · doi:10.3390/nu12010235 · Cited by 194
Adaptations in gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass
Steenackers, N., Vanuytsel, T., Augustijns, P., Tack, J. F., Mertens, A. C., Lannoo, M., der Schueren, B. V., & Matthys, C. (2021) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(20)30302-2 · Cited by 151
Self-citation
The impact of weight loss on fat-free mass, muscle, bone and hematopoiesis health: Implications for emerging pharmacotherapies aiming at fat reduction and lean mass preservation
Stefanakis, K., Kokkorakis, M., & Mantzoros, C. S. (2024) · Metabolism · doi:10.1016/j.metabol.2024.156057 · Cited by 142
Effect of Bariatric Surgery on Metabolic Diseases and Underlying Mechanisms
Ji, Y., Lee, H., Kaura, S., Yip, J., Sun, H., Guan, L., Han, W., & Ding, Y. (2021) · Biomolecules · doi:10.3390/biom11111582 · Cited by 108
Iron Deficiency in Obesity and after Bariatric Surgery
Bjørklund, G., Peana, M., Pivina, L., Dosa, A., Aaseth, J., Semenova, Y., Chirumbolo, S., Medici, S., Dadar, M., & Costea, D.-O. (2021) · Biomolecules · doi:10.3390/biom11050613 · Cited by 99
“3% of patients, and iron deficiency anemia reaches 52–54% [28].”
BackgroundInfluential
Multidisciplinary Approach for Weight Regain—how to Manage this Challenging Condition: an Expert Review
Cambi, M. P. C., Baretta, G. A. P., Magro, D. D. O., Boguszewski, C. L., Ribeiro, I. B., Jirapinyo, P., & de Moura, D. T. H. (2021) · Obesity Surgery · doi:10.1007/s11695-020-05164-1 · Cited by 59
Bariatric surgery and its impact on fertility, pregnancy and its outcome: A narrative review
Baharuddin, D. M. P., Payus, A. O., Fahmy, E. H. A. M., Sawatan, W., Than, W. W., Abdelhafez, M. M., Leik, N. K. O., Daud, D. M. A., Daud, M. N. M., & Ahmad, Z. N. B. S. (2021) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2021.103038 · Cited by 63
Common Pitfalls in the Management of Patients with Micronutrient Deficiency: Keep in Mind the Stomach
Carabotti, M., Annibale, B., & Lahner, E. (2021) · Nutrients · doi:10.3390/nu13010208 · Cited by 56
Nutritional Deficiencies in Patients with Severe Obesity before Bariatric Surgery: What Should Be the Focus During the Preoperative Assessment?
Ben‐Porat, T., Weiss, R., Dagan, S. S., Nabulsi, N., Maayani, A., Khalaileh, A., Abed, S., Brodie, R., Harari, R., Mintz, Y., et al. (2019) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2019.10.017 · Cited by 55
Preventing and Managing Pre- and Postoperative Micronutrient Deficiencies: A Vital Component of Long-Term Success in Bariatric Surgery
Reytor-González, C., Frías-Toral, E., Núñez-Vásquez, C., Parise-Vasco, J. M., Zambrano-Villacres, R., Simancas‐Racines, D., & Schiavo, L. (2025) · Nutrients · doi:10.3390/nu17050741 · Cited by 59
“Common clinical presentations of iron deficiency anemia (IDA) in patients with obesity include low hemoglobin levels (below 13 g/dL for men and 12 g/dL for women), transferrin saturation (TSAT) below 20%, and ferritin concentrations below 30 ng/mL, typically without signs of inflammation [35,42].”
Role of Iron in the Molecular Pathogenesis of Diseases and Therapeutic Opportunities
Abbasi, U., Abbina, S., Gill, A., Takuechi, L. E., & Kizhakkedathu, J. N. (2021) · ACS Chemical Biology · doi:10.1021/acschembio.1c00122 · Cited by 48
Nutritional Deficiencies Before and After Bariatric Surgery: Prevention and Treatment
Argyrakopoulou, G., Konstantinidou, S. M., Dalamaga, Μ., & Kokkinos, A. D. (2022) · Current Nutrition Reports · doi:10.1007/s13668-022-00400-9 · Cited by 49
“Factors implicated in iron deficiency after BS include decreased intake, reduced secretion of hydrochloric acid, and reduction in the absorptive surface area imposed on a pre-BS predisposition for iron deficiency (low baseline ferritin levels) frequently found in people living with obesity [24, 25].”
Background
Nutritional status following One Anastomosis Gastric Bypass
Kessler, Y., Adelson, D., Mardy-Tilbor, L., Ben‐Porat, T., Szold, A., Goitein, D., Sakran, N., Raziel, A., & Dagan, S. S. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2019.03.008 · Cited by 43
The True Story on Deficiencies After Sleeve Gastrectomy: Results of a Double-Blind RCT
Heusschen, L., Schijns, W., Ploeger, N., Deden, L. N., Hazebroek, E. J., Berends, F. J., & Aarts, E. O. (2019) · Obesity Surgery · doi:10.1007/s11695-019-04252-1 · Cited by 38
Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity
Sandvik, J., Bjerkan, K. K., Græslie, H., Hoff, D. A. L., Johnsen, G., Klöckner, C. A., Mårvik, R., Nymo, S., Hyldmo, Å. A., & Kulseng, B. E. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.679066 · Cited by 41
“Iron is essential in hemoglobin synthesis, and in a number of cellular processes in muscles, neurons, and other organs (7).”
Background
Development and complications of nutritional deficiencies after bariatric surgery
Steenackers, N., der Schueren, B. V., Augustijns, P., Vanuytsel, T., & Matthys, C. (2022) · Nutrition Research Reviews · doi:10.1017/s0954422422000221 · Cited by 32
Self-citation
How Sustained is Roux-en-Y Gastric Bypass Long-term Efficacy?
Guimarães, M., Osório, C., Silva, D., de Almeida, R. F., Reis, A., Cardoso, S., Pereira, S. S., Monteiro, M. P., & Nora, M. C. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05458-y · Cited by 31
“5%, prevalence of iron deficiency after RYGB, which is higher than the 18 to 53% prevalence reported in the literature [30].”
Background
Nutritional Challenges and Treatment After Bariatric Surgery
Moize, V. L., Laferrère, B., & Shapses, S. A. (2024) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-061121-101547 · Cited by 33
“It is likely related to the type of surgery and the duration reported after surgery (134) but may be related to the presence of iron deficiency prior to surgery (55).”
The relationship between anemia and obesity
Saad, R. A., & Qutob, H. M. H. (2022) · Expert Review of Hematology · doi:10.1080/17474086.2022.2131521 · Cited by 33
Analysis of the Efficacy of Diet and Short-Term Probiotic Intervention on Depressive Symptoms in Patients after Bariatric Surgery: A Randomized Double-Blind Placebo Controlled Pilot Study
Komorniak, N., Kaczmarczyk, M., Łoniewski, I., Kley, A. M., Nalian, A. G., Wroński, M., Kaseja, K., Kowalewski, B., Folwarski, M., & Stachowska, E. (2023) · Nutrients · doi:10.3390/nu15234905 · Cited by 24
The safety and efficacy of ferumoxytol in the treatment of iron deficiency: a systematic review and meta‐analysis
Abdulrehman, J., Tang, G. H., Auerbach, M., Santesso, N. A., & Sholzberg, M. (2019) · Transfusion · doi:10.1111/trf.15587 · Cited by 21
Prevalence of Nutrient Deficiencies Following Bariatric Surgery—Long-Term, Prospective Observation
Humięcka, M., Sawicka, A., Kędzierska, K., Binda, A., Jaworski, P., Tarnowski, W., & Jankowski, P. (2025) · Nutrients · doi:10.3390/nu17162599 · Cited by 21
“Iron intake is often suboptimal after bariatric surgery compared to estimated average requirements [28].”
ACQUIRED REFRACTORY IRON DEFICIENCY
Amicis, M. M. D., Rimondi, A., Elli, L., & Motta, I. (2021) · Mediterranean Journal of Hematology and Infectious Diseases · doi:10.4084/mjhid.2021.028 · Cited by 18
Micronutrients in Pregnancy after Bariatric Surgery: A Narrative Review
Lesmes, I. B., Ballesteros-Pomar, M. D., Calle‐Pascual, A. L., Alvarez-Sala, L. A., & Rubio, M. Á. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12165429 · Cited by 19
Gut HIF2α signaling is increased after VSG, and gut activation of HIF2α decreases weight, improves glucose, and increases GLP-1 secretion
Evers, S. S., Shao, Y., Ramakrishnan, S. K., Shin, J. H., Bozadjieva-Kramer, N., Irmler, M., Stemmer, K., Sandoval, D. A., Shah, Y. M., & Seeley, R. J. (2022) · Cell Reports · doi:10.1016/j.celrep.2021.110270 · Cited by 18
“Clinically, bariatric surgeries result in lower circulating iron levels, and this has largely been deemed a result of malabsorption from an altered GI tract that is physically less capable of absorbing iron (Ruz et al., 2009; Steenackers et al., 2018; Gowanlock et al., 2020).”
The impact of the interplay of the intestinal microbiome and diet on the metabolomic and health outcomes of bariatric surgery
Mika, A., Janczy, A., Waleron, K., Szymański, M., Kaska, Ł., & Śledziński, T. (2022) · Obesity Reviews · doi:10.1111/obr.13455 · Cited by 16
Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy
Shirazi, N., Beglaibter, N., Grinbaum, R., Ahmad, W. A., & Aronis, A. (2022) · Nutrients · doi:10.3390/nu14132597 · Cited by 16
“Iron status is commonly disrupted among obese individuals [22], and, according to the evidence, depletes after bariatric surgery [23].”
Background
Iron Deficiency Anemia Following Bariatric Surgery: A 10-Year Prospective Observational Study
Kędzierska, K., Dymkowski, M., Niegowska, W., Humięcka, M., Sawicka, A., Walczak, I., Jędral, Z. M., Wąsowski, M., Bogołowska-Stieblich, A., Binda, A., et al. (2025) · Nutrients · doi:10.3390/nu17020339 · Cited by 17
Functional iron deficiency anemia in patients with cancer
Koh, J. S., & Song, I. (2024) · Blood Research · doi:10.1007/s44313-024-00030-w · Cited by 15
“In regions such as Korea and Japan, where gastric cancer is prevalent, gastrectomy is a common procedure that has recently been used to treat obesity using procedures such as sleeve gastrectomy [12, 13].”
Background
Nutritional Management for Chronic Kidney Disease Patients who Undergo Bariatric Surgery: A Narrative Review
Ben‐Porat, T., Weiss-Sadan, A., Rottenstreich, A., Dagan, S. S., Schweiger, C., Levi, I. M.-Y., Weiner, D., Azulay, O., Sakran, N., Harari, R., et al. (2019) · Advances in Nutrition · doi:10.1093/advances/nmy112 · Cited by 14
“Iron status is determined by serum transferrin saturation and by serum ferritin (22, 105).”
Background
Evolution of Hematological Parameters During the First 2 Years After Laparoscopic Sleeve Gastrectomy: Results of a Retrospective Study
Kyio, N. H., Turgut, S., Özkan, T., & Çetin, G. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04528-x · Cited by 11
Immunometabolism, Micronutrients, and Bariatric Surgery: The Use of Transcriptomics and Microbiota-Targeted Therapies
Galyean, S., Sawant, D., & Shin, A. C. (2020) · Mediators of Inflammation · doi:10.1155/2020/8862034 · Cited by 11
“The consequences of anemia after BS can be abnormal functions of tissues, such as blood, brain, and muscles, making prevention and treatment of iron deficiency imperative [105].”
Background
Single-Anastomosis Sleeve Jejunal (SAS-J) Bypass as Revisional Surgery After Primary Restrictive Bariatric Procedures
Sewefy, A. M., Atyia, A. M., Kayed, T., & Hamza, H. M. (2022) · Obesity Surgery · doi:10.1007/s11695-022-06123-8 · Cited by 10
“7% after OAGB, and 1–54% after sleeve gastrectomy [34, 35].”
Background
Weight Loss, Type 2 Diabetes, and Nutrition in 355 Patients with Obesity Undergoing Sleeve Gastrectomy with Transit Bipartition: Two-Year Outcomes
Al, M., & Taşkın, H. E. (2022) · Obesity Facts · doi:10.1159/000526718 · Cited by 9
Anemia and iron metabolism disorders after single anastomosis sleeve ileal (SASI) bypass. Is it a real problem?
Parkitna, J., Binda, A., Gonciarska, A. I., Jaworski, P., Kudlicka, E., Barski, K., Wawiernia, K., Jankowski, P., Wąsowski, M., Kuryłowicz, A., et al. (2024) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-024-03384-y · Cited by 8
“Conversely, anemia following bariatric surgery can be attributed to nutritional deficiencies stemming from reduced food intake, dietary habits, impaired iron absorption, diminished gastric acid production, decreased gastric intrinsic factor secretion, and rapid weight loss [3].”
BackgroundInfluential
Predicting iron absorption from an effervescent iron supplement in obese patients before and after Roux-en-Y gastric bypass: a preliminary study
Gesquiere, I., Steenackers, N., Lannoo, M., Foulon, V., Mertens, A. C., Gils, A., Hoon, J. N. J. M. D., Augustijns, P., Matthys, C., & der Schueren, B. V. (2018) · Journal of Trace Elements in Medicine and Biology · doi:10.1016/j.jtemb.2018.12.002 · Cited by 8
Self-citation
The potential for the use of leghemoglobin and plant ferritin as sources of iron
Świątek, M., Antosik, A., Kochanowska, D., Jeżowski, P., Smarzyński, K., Tomczak, A., & Kowalczewski, P. Ł. (2023) · Open Life Sciences · doi:10.1515/biol-2022-0805 · Cited by 7
“Preoperative anemia increases the risk of blood transfusion and is correlated with a negative course of recovery and postoperative mortality [15].”
Background
Nutrient Deficiency-Related Dermatoses after Bariatric Surgery
Chu, A. S., Mataga, M. A., Krueger, L. D., & Barr, P. A. (2019) · Advances in Skin & Wound Care · doi:10.1097/01.asw.0000579688.97532.18 · Cited by 7
The impact of preoperative anemia on postoperative anemia and related nutritional abnormalities after bariatric surgery: a multicenter cohort study
Nie, Y., Ping, A., Liu, B., & Meng, H. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1616340 · Cited by 6
“Ferritin, a specific measure of iron storage, is commonly used with TS to diagnose iron deficiency, identified as the primary cause of postoperative anemia in previous literature (40–42).”
Post bariatric surgery complications, nutritional and psychological status.
Majida, N. L. A., Vanoh, D., Zainuddin, N. S., & Hashim, M. N. M. (2024) · PubMed Central · doi:10.6133/apjcn.202406_33(2).0003 · Cited by 6
Association Between SGLT-2 Inhibitors Use and Incidence of Anemia in Female Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Study
Hung, K., Chang, L.-C., Ho, C.-N., Yu, C., Lai, Y., & Chen, I. (2025) · Obesity Surgery · doi:10.1007/s11695-025-08262-0 · Cited by 5
Prevalence and Risk Factors of Anemia in Patients After Bariatric Surgery in Qassim Region, King Fahad Specialist Hospital
Assakran, B. S., Khalid, R., Bennasser, T., Alsaif, M., Alsawyan, W. A., Alsaleem, H. N., & Alsalhi, A. (2023) · Cureus · doi:10.7759/cureus.40131 · Cited by 4
“Many factors contribute to the development of iron deficiency after bariatric surgery such as reduced iron intake, reduced secretion of hydrochloric acid and a reduction in the surface area for absorption [8].”
Background
Effect of Dietary Patterns on Long‐Term Weight Maintenance of Patients After Sleeve Gastrectomy
Zheng, S., Li, A., Yang, Y., Zhao, D., & Ke, J. (2025) · Food Science & Nutrition · doi:10.1002/fsn3.70834 · Cited by 4
“Gastric volume reduction directly affects nutrient intake, digestion, and absorption, as well as gut hormone secretion (Steenackers, Van der Schueren, et al. 2018).”
An Overview on the Effect of Bariatric Surgery on Type 2 Diabetes Mellitus Patients: Literature Review
Quwayd, M. A., Alluhaydan, A., Alsam, A., Alferaih, A., Oukda, A. H., Alagha, B. B., Alosaimi, A. I., Fahmy, H. E., Binmushayt, T. H., & Alotaibi, A. G. (2021) · International Journal Of Pharmaceutical Research And Allied Sciences · doi:10.51847/slrvrjy9jn · Cited by 4
Women with Anemia Refractory to Oral Iron Treatment Following Bariatric Surgery: a Short-Term Analysis
Vargas, C. A., Gómez, D., Madrigal, V., Guilbert, L., Sepúlveda, E. M., Rodríguez, F. M., & Zerrweck, C. (2023) · Obesity Surgery · doi:10.1007/s11695-022-06447-5 · Cited by 5
Nutrition and Patient Follow-up in Bariatric Surgery
Binnetoğlu, K. (2023) · Eurasian Journal of Medicine · doi:10.5152/eurasianjmed.2023.23333 · Cited by 4
Behavior of Iron and Ferritin After Bariatric Surgery in Patients With and Without Hepatic Steatosis
Júnior, G. D. C. L., Lacerda, M. D., Alencar, T. A. L. B., Café, M., & Giuffrida, F. M. A. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05629-x · Cited by 4
Changes in the Protein Profile of Saliva from People with Obesity Treated with Bariatric Surgery and Physical Exercise
Monserrat-Mesquida, M., Pérez‐Jiménez, M., Bouzas, C., García, S., Mendes, C., Carvalho, M., Bravo, J., Martins, S., Raimundo, A. M. D. M., Tur, J. A., et al. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26125622 · Cited by 3
A Contemporary Perspective on Long-Term Complications of Bariatric Surgery
Skossyrskiy, V. S., Stepochkin, D., Zaharova, E., Mamedov, R., Muraviev, S. Y., Александровна, П. Р., German, E., Nikolaev, A. V., Berikkhanov, Z. G. M., Markov, I., et al. (2025) · Obesity Surgery · doi:10.1007/s11695-025-08398-z · Cited by 3
“Clinically, iron deficiency manifests as anemia, presenting with fatigue, pallor, and dyspnea [122 ].”
Preoperative Iron Status and the Risk of Severe Postoperative Anemia After Metabolic and Bariatric Surgery
Benotti, P. N., Wood, G. C., Kaberi‐Otarod, J., Still, C. D., Gerhard, G. S., & Bistrian, B. R. (2026) · American Journal of Hematology · doi:10.1002/ajh.70191 · Cited by 3
Iron Deficiency Related to Obesity
Clark, P. (2024) · Journal of Infusion Nursing · doi:10.1097/nan.0000000000000546 · Cited by 3
“23, 39, 54 Furthermore, many patients fail to adhere to recommended dietary guidelines, with rates of nonadherence increasing over time.”
BackgroundMethod
Efficacy and Tolerability of Oral Iron Protein Succinylate in the Treatment of Iron Deficiency Anemia in Adults with Gastrointestinal Diseases
Izquierdo, L. (2021) · International Journal of Gastroenterology · doi:10.11648/j.ijg.20210502.11 · Cited by 2
“…related to the above studies, IPS capacity to remain insoluble within the stomach might also offer a competitive treatment advantage for bariatric surgery patients in whom the diminished hydrochloric acid secretion would hamper the reduction of ferric iron into the absorbable ferrous forms [49].”
Effect of COVID-19 pandemic on hospital admission rates of patients with malnutrition and/or neuromuscular complications after bariatric surgery
Abdulrazzaq, S., Ansari, W. E., & Al-Ahbabi, T. (2022) · Neurosciences · doi:10.17712/nsj.2022.3.20220021 · Cited by 2
Hepcidin: a New Serial Biomarker for Iron Deficiency Anemia in Bariatric Surgery
Baig, S. J., & Priya, P. (2023) · Indian Journal of Surgery · doi:10.1007/s12262-023-03690-7 · Cited by 2
Oral iron replacement vs. IV iron treatment in bariatric surgery patients with anemia
Connors, A., & Watkins, E. J. (2023) · JAAPA · doi:10.1097/01.jaa.0000911240.72750.c3 · Cited by 2
Problems of Iron Deficiency in Children and Adolescents: Diagnosis, Quality of Life, Treatment (Literature review)
Marushko, Y. V., & Moskovenko, O. D. (2023) · Family medicine European practices · doi:10.30841/2786-720x.2.2023.282494 · Cited by 2
Positive Program Evaluation and Health Maintenance among Post-Metabolic and Bariatric Surgery Patients Following a 6-Week Pilot Program
McIntosh, S., Hayes, M., & Barr, M. L. (2024) · Obesity Surgery · doi:10.1007/s11695-023-07013-3 · Cited by 2
“However, although recommended by previous research and MBS-related organizations, there are no requirements to meet with a registered dietitian during the post-operation period [16].”
Background
Outcomes After Duodenoduodenostomy for Superior Mesenteric Artery Syndrome
Ang, D. N., Hofmann, A., Attili, A., Sang, W., Soltani, T., Richards, W. T., Ferber, L., & Taylor, D. (2024) · The American Surgeon · doi:10.1177/00031348241300361 · Cited by 2
“26 Our results suggest that the DD does restore this anatomy by the signi ﬁ cant improvement of low iron levels pre-surgery (45 mcg/dL) at 3 months (130 mcg/dL), P -value = 0.046.”
Influential
Enhancing nutritional health and patient satisfaction five years after metabolic bariatric surgery with targeted supplementation
Gorini, S., Camajani, E., Franchi, A., Cava, E., Gentileschi, P., Bellia, A., Karav, S., Sbraccia, P., Caprio, M., & Lombardo, M. (2025) · Journal of Translational Medicine · doi:10.1186/s12967-025-06224-9 · Cited by 2
“Duodenum bypass in RYGB and reduced gastric acid production both contribute to iron absorption problems [36].”
Perinatal Outcomes Including Breastfeeding after Bariatric Surgery in Women with Grade 3 Obesity
Cordero, L., Stenger, M., Mb, L., NEEDLEMAN, B. J., Noria, S., & Ca, N. (2023) · Journal of Nursing and Women s Health · doi:10.29011/2577-1450.100091 · Cited by 1
“Iron deficiency in obese persons or individuals with Type 2 DM may be due to low absorption and poor tolerance to iron rich food [47], The prevalence of iron deficiency anemia after BS varies from 18 to 53% for RYGB and between 1 and 54% for SG [48].”
Background
Iron homeostasis in obesity and metabolic and bariatric surgery: a narrative review
Benotti, P. N., Kaberi‐Otarod, J., Wood, G. C., Gerhard, G. S., Still, C. D., & Bistrian, B. R. (2024) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2024.08.018 · Cited by 3
The Presence of Food Addiction in Patients with Binge Eating Disorder Was Associated with Higher Weight, Poor Body Composition Outcomes, Lower Serum Level of Magnesium and Higher Ferritin 2 Years Post-LSG Surgery
Mousavi, M., Tabesh, M. R., Balam, F. H., Jahromi, S. R., & Saeedirad, Z. (2024) · Obesity Surgery · doi:10.1007/s11695-024-07627-1 · Cited by 1
“For this reason, magnesium, iron, and zinc are among three important minerals specially in obesity surgery and often have been monitored for eating disorders after the operation [25, 26].”
Physical activity in patients after bariatric surgery - a literature review
Śliwińska, M., Podraza, A., Wirkijowska, M., Wirkijowski, J., Wójtowicz, K., Walczak, A., Gajek-Flanczewska, W., Flanczewski, S., Woźniak, P., Wietrzykowska, E., et al. (2025) · Quality in Sport · doi:10.12775/qs.2025.37.57448 · Cited by 1
Factors associated with anemia after bariatric surgery
Spetz, K., Sandsveden, M., Ottosson, J., Stenberg, E., Aardal, E., Olbers, T., & Andersson, E. (2026) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2026.03.008 · Cited by 1
Mechanisms of weight recurrence after bariatric surgery
Yadav, R. K., Zhang, Y., Lv, Y., Liu, S., Yang, J., Wang, Y., & Gang, X. (2026) · Nutrition & Metabolism · doi:10.1186/s12986-026-01115-2 · Cited by 2
“Correcting iron deficiency before BS may reduce fatigue and improve physical activity, and ultimately enhance weight loss [153, 154, 174, 175].”
Bariatric Procedures: Anatomical and Physiological Changes
RAMOS, A. C., Carraso, H. V. C. J., & Bastos, E. L. D. S. (2021) · Springer eBooks · doi:10.1007/978-981-33-4702-1_4 · Cited by 1
DOES SLC11A2 GENE MUTATION ASSOCIATE WITH IRON-REFRACTORY IRON-DEFICIENCY ANEMIA AFTER BARIATRIC SURGERY?
Piatto, V. B., Ferdinando, D. L. T., & Funes, H. L. X. (2022) · ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) · doi:10.1590/0102-672020210002e1645 · Cited by 1
Pharmacotherapeutics for iron deficiency anemia in adults
Koh, J. S., & Song, I. (2024) · Journal of Korean Medical Association · doi:10.5124/jkma.2024.67.1.48 · Cited by 1
Cirugía bariátrica, determinantes que conllevan al fracaso. Revisión bibliográfica
Castillo, J. D. C., Cordero, S. J. P., & Sarmiento-Rojas, P. A. (2023) · Salud ConCiencia · doi:10.55204/scc.v2i2.e56 · Cited by 1
The Efficacy of Roux-en-Y Gastric Bypass in Young-Onset Diabetes Mellitus: A Narrative Review
Bhatnagar, R., Hingway, S. R., & Bawiskar, D. (2024) · Cureus · doi:10.7759/cureus.67562 · Cited by 1
“A Danish questionnaire-based study by Grabsholt et al. found that 52.4% of 1,429 participants who had RYGB 4.7 years prior reported experiencing one or more dumping syndrome-related symptoms [33,34].”
BackgroundInfluential
The Short-Term Effect of Laparoscopic Sleeve Gastrectomy on Hematological Parameters
Karaca, F. C. (2020) · Laparoscopic Endoscopic Surgical Science · doi:10.14744/less.2020.48379
Surgical and Medical Follow-Up
El-Kadre, L. J., Faria, S. L., & RAMOS, A. C. (2020) · Springer eBooks · doi:10.1007/978-3-030-28936-2_11
Nutritional recommendations after hypoabsorptive procedures: OAGB, duodenal switch, SADI-S
Antozzi, L., Latini, G. P., Marchesini, J. C., Precybelovicz, T., Sánchez-Pernaute, A., & Rubio, M. Á. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822922-4.00007-7
Non-anaemic iron deficiency: validity as a therapeutic target in the peri-operative setting
Miles, L. F. (2020) · Minerva Access (University of Melbourne)
Introductory Chapter: Bariatric Surgery - Not Alone on This Long Road
Sáiz‐Sapena, N., & Oviedo, J. M. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.100228
Effectiveness of a Daily-Balanced Multivitamin Product After Sleeve Gastrectomy: Results from a High-Volume Bariatric Center
Pennestrì, F., Prioli, F., Sessa, L., Crea, C. D., Gallucci, P., Ciccoritti, L., Greco, F., Princi, P., Revelli, L., Salvi, G., et al. (2022) · Bariatric Surgical Practice and Patient Care · doi:10.1089/bari.2021.0113
“31,40 Although we did not report any cases of iron deﬁciency during the study period, according to the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines, 41 the present dose of 30 mg of elementary iron in Provisioneat should be increased to prevent post-SG iron deﬁciency.”
P3-20-02 - Pre and postoperative deficiencies in iron, ferritin and B12 vitamin among portuguese patients undergoing bariatric surgery
Lopes, M. S. (2019) · doi:10.26226/morressier.5d5e5187bedcf39b76636982
POST-OPERATIVE EFFECTS IN REDUCING ROUX-Y GASTROPLASTY: VITAMIN DEFICIENCY AND OTHER CONSEQUENCES
Mota, A. A. B., SOUSA, C. R. B. D., Eduardo, A. M. D. L. E. N., & Lima, A. D. L. (2022) · International Journal of Health Science · doi:10.22533/at.ed.1592282207061
Bariyatrik Cerrahi ve Uzun Dönem Beslenme Sorunları Bariatric surgery and long-term nutrition problems
Erim, B., Ergene, E., & Hecer, C. (2005) · Anadolu bil meslek yüksekokulu dergisi · doi:10.17932/iau.abmyod.2006.005/abmyod_v16i63001
Assessment of Serum Copper in Patients with Anemia after Bariatric Surgery
Fathy, A., Mohammed, E., Ateya, A. A. Y., & Hussein, S. (2023) · The Egyptian Journal of Hospital Medicine · doi:10.21608/ejhm.2023.280189
DEFICIÊNCIAS NUTRICIONAIS DE MICRONUTRIENTES NO PACIENTE PÓS BARIÁTRICA E SUAS PRINCIPAIS FORMAS DE TRATAMENTO
do Nascimento, A. M. A., & Leite, D. R. D. S. (2023) · RECIMA21 - Revista Científica Multidisciplinar · doi:10.47820/recima21.v4i3.2819
A patient blood management perspective on Anemia in the obese patient journey
Duarte, G. D. C., Wei, W., & Cho, G. (2023) · Frontiers in Anesthesiology · doi:10.3389/fanes.2023.1172018
“Some patients having bariatric surgery have impaired iron absorption because of anatomical changes, blood loss and red meat intolerance, however, around 65% can still benefit from oral iron formulations (56).”
Background
Ernährungsmedizinische Betreuung bariatrischer Patienten
Rubin, D., & Elfert, L. (2023) · Springer Reference Medizin · doi:10.1007/978-3-662-61724-3_106-1
Winning by losing? : Nutritional consequences of bariatric surgery
Heusschen, L. (2023) · doi:10.18174/588217
Efeito da cirurgia bariátrica sobre a sobrecarga de ferro em indivíduos com obesidade
de Jesus, R. N. (2022) · doi:10.47749/t/unicamp.2022.1265708
Side Effects of Gastric Cancer Surgery: Prevention and Treatment
Chevallay, M., Marcelis, J., & Mönig, S. (2023) · Springer eBooks · doi:10.1007/978-3-030-93702-7_29-1
Let-7b miRNA expression in Patients with Iron Deficiency Anemia after Bariatric surgery.
Gad, S. A., Arafa, A. F., Hussein, S., Abdelazem, A. S., Ateya, A. A. Y., & Mousa, M. M. (2024) · african journal of gastroenterology and hepatology · doi:10.21608/ajgh.2024.254932.1046
A influência da má absorção pós-cirurgia bariátrica no desenvolvimento da depressão
Zinidarcis, A. C. F., Alves, B. B., Hakim, B. F., Kuriki, F. D. J. A., Inácio, G. C., & Andrade, J. M. (2024) · Revista Científica do Iamspe · doi:10.59752/rci.v13i1.183
Os principais desafios nutricionais após a cirurgia bariátrica: estratégias de prevenção e intervenção
Dolenkei, N., Carrijo, V. S., Leonel, G. O., Resende, I. L., Patricio, A. C. D. R., de Barros, M. M., Jubé, A. R. M., & Chitolina, B. C. (2024) · Contribuciones a las Ciencias Sociales · doi:10.55905/revconv.17n.5-107
An Unusual Complication of Internal Hernia Post-laparoscopic Sleeve Gastrectomy: A Video Case Report
Albeiti, T., Khogeer, A., & Elbahrawy, A. (2024) · Cureus · doi:10.7759/cureus.71146
Obesity and iron deficiency: what is the connection and how to treat?
Федорова, Т. А., Strelnikova, E. V., & Gurbanova, S. R. (2024) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2024-481
Gestational diabetes and other maternal and neonatal-associated conditions could improve after bariatric surgery
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
The Korean Society for Metabolic and Bariatric Surgery (KSMBS) Position Statement on Female Candidates of Reproductive Age for Metabolic Bariatric Surgery
Chung, Y., Cho, I., Choi, Y. S., Kim, Y. M., Lee, Y., Park, S., Jung, M. R., Kwon, I. G., Kim, J., Lee, S. E., et al. (2025) · Journal of Metabolic and Bariatric Surgery · doi:10.17476/jmbs.2025.14.1.1
“Post-bariatric women are encouraged to follow the supplementation guidelines summarized in Table 3 [40,130-133].”
Perioperative Nutritional Management of Patients Undergoing Bariatric Surgery: How to Apply the AACE-TOS-ASMBS-OMA-ASA Guidelines
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
Medical, nutritional, and behavioral characteristics of patients experiencing weight regain following sleeve gastrectomy
Kessler, Y., Churi, G., Boaz, M., Mardy-Tilbor, L., Raziel, A., Sakran, N., & Dagan, S. S. (2025) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2025.07.016 · Cited by 1
Endoscopic sleeve gastroplasty versus single anastomosis sleeve ileal bypass: a single-center experience
Wu, T.-L., Tsao, L., Chen, Y.-Y., Wang, B., & Yen, H. (2025) · BMC Surgery · doi:10.1186/s12893-025-03469-5
“It is well-documented that nutritional deficiencies, such as iron deficiency anemia and bone loss, often manifest one year or more after bypass procedures [16–18].”

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: Steenackers, Nele
Mertens, Ann
Lannoo, Matthias
Grauwet, Tara
Augustijns, Patrick
Matthys, Christophe
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
DOI: 10.1017/s0029665118000149
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
Licence: www.cambridge.org/core/terms (unspecified)
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 (medical) › 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

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Iron deficiency after bariatric surgery: what is the real problem?

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks