Weight-Loss Surgery Creates High Rate of Anemia

A new long-term study reports a high rate of anemia 10 years after patients receive Roux-en-Y gastric bypass (RYGB) bariatric surgery.

Researchers at Palo Alto Veterans Affairs (VA) Health Care System (CA, USA) and Stanford University (Stanford; CA, USA) conducted a study that involved 74 patients (78% men; average age 51 years) who underwent RYGB at the Palo Alto VA Medical Center and survived to 10-year follow-up. Mean BMI before the procedure was 46.1 kg/m2, and ten years later it stood at 33.7 kg/m2.


The average rate of preoperative anemia was 20%, which increased 10 years later to 47%. During the same time period, the anemia rate in the RYGB group without bariatric specialist follow-up increased to 57% percent, from 22% before surgery. The rate of anemia in those with bariatric specialist follow-up did not increase as significantly 10 years after surgery, rising from 13% preoperatively to 19% at 10 years, after adjusting for preoperative anemia. The study was published on September 20, 2017, in JAMA Surgery.

“Our study suggests that follow-up with bariatric specialists more than five years after surgery, rather than with specialists with no bariatric expertise, can decrease long-term anemia risk,” concluded senior author Dan Eisenberg, MD, MSc, of Stanford. “This finding may demonstrate the bariatric specialist's specific understanding of the long-term risk for nutritional deficiency after RYGB, and the importance of vitamin and mineral supplementation.”

The RYGB procedure has been the gold standard for surgical weight loss intervention for many years. The procedure usually involves laparoscopic minimally invasive surgery to create a stomach pouch from the larger stomach body, which is then connected to a section of the small intestine, leaving just a small opening for food. The result is a rapid sensation of satiety or fullness. Various medical, nutritional, and surgical symptoms requiring treatment may occur after RYGB surgery and may impair patients' quality of life.

Related Links:
Palo Alto Veterans Affairs
Stanford University