Original Research Article http://doi.org/10.18231/j.jpmhh.2019.002 Journal of Preventive Medicine and Holistic Health, January-June, 2019;5(1):4-12 4 Prevalence and determinants of postoperative deficiencies secondary to bariatric surgery among patients in king fahad general hospital in Jeddah 2019 Abeer Alhussaini 1* , Majedh Hakami 2 , Nouran Aleyeidi 3 , Mahmood Sadagah 4 , Osama Fida 5 1,2 Resident, 3 Consultant Community Medicine, 5 Consultant, 1,2 Joint Program of Saudi Board in Family Medicine, Jeddah, 4.5 Prince Sultan Center for Bariatric Surgery, Jeddah, Saudi Arabia *Corresponding Author: Abeer Alhussaini Email: abir.m.h20@gmail.com Abstract Introduction: Presently, bariatric surgery is considered the most compelling treatment modality for morbid obesity patient and one of the most effective procedures. The study aimed to identify the prevalence and determinants of patients’ compliance to the recommended vitamin and mineral supplements and to identify the prevalence and determinants of post-bariatric surgery nutritional deficiencies in King Fahad General Hospital in Jeddah city so as to improve the patients’ health. Materials and Methods: This is a cross-sectional study wherein a validated questionnaire was used to collect data and were encoded and analyzed using IBM SPSS version 23, (IBD Corp., Armonk, NY). Results: The findings of the study showed that nutritional deficiency is more likely to happen to female gender who is working. The study also revealed that deficiencies are common in HB, Vit D, Vit B12, calcium, iron and folate. The longer the period of intensive fluid taken following surgery increases the risk of vitamin deficiency. Furthermore, there’s low compliance t o vitamins and supplements and patients who underwent bariatric surgery only become adherent to vitamins/minerals when they discover complications. Conclusion: This study concluded that there are various factors causing and affecting nutritional deficiencies preoperatively and postoperatively such as gender, work status, complications, and vitamins and supplements compliance. Overall, the present study concluded that it is imperative for the patients to adhere to vitamins and supplements intake according to the recommendation of the clinicians and dieticians. Keywords: Obesity, Bariatric surgery, Nutritional deficiency. Introduction Being overweight or most commonly known as obesity has been a worldwide epidemic and an increasing problem ever since. World health organization has always mentioned obesity as a major new global epidemic. 1 Over ingesting of food and absence or lack of exercise or any physical activities were named as main risk factors why people become overweight. 2 In order to overcome obesity, procedures, surgical or non-surgical processes to lose body fats were initiated. However, due to energy homeostasis, non-surgical procedures are known particularly ineffective at accomplishing major and long-term weight drop. Generally, not more than 5-10% is being reduced over dieting, exercising, and other few anti-obesity medications. 3- 6 Significantly, minor weight loss even deliberates uneven health benefits, in terms of bettering obesity-associated comorbidities. 7 Nonetheless, additional considerable and resilient weight reduction would mend these predicaments effectively and even reduce the stigmatization as well as emotional distress repeatedly suffered by obese folks. Bariatric surgery is deliberated to be the most compelling treatment modality for morbid obesity patient who has "BMI > 40 kg/m, BMI > 35 kg/m with metabolic syndrome or diabetes mellitus. It has become the most operational procedure in the attainment of long-term weight loss. 8, 9 Three types of surgery were applied in Saudi Arabia namely laparoscopic gastric sleeve, laparoscopic Roux-en-Y gastric bypass, mini gastric bypass. There are increasing trend of numbers of bariatric surgery and approximately 500,000 bariatric surgeries are and being performed in the world. 10 Nevertheless, studies showed a high prevalence of vitamins and minerals deficiencies post-surgery. The most frequent postsurgical paucities are iron (47%-66%), vitamin B12 (37%-50%), folic acid (15%-38%), vitamin D (15%- 20%), and calcium (10%). 11-27 In order to decrease the prevalence of malnutrition and vitamin deficiency after surgery, multivitamins supplementation was deemed as the most important recommendation by clinicians. Moreover, the preoperative deficiency may contribute in increasing risk of vitamins deficiency postoperative, thus, vitamins deficiency should be treated even before surgery and an austere follow-up is dire essential to prevent vitamins deficiency. 28 If the patient loses weight with vitamin deficiency, this will affect the patients future quality of life. Therefore, the authors are interested in studying and learning prevalence and determinant deficiencies subordinate to bariatric surgery because of the limitations of studies in Jeddah, moreover, a lot of patients come to Jeddah, as one of the largest city in Saudi Arabia, to do bariatric surgery. Bariatric surgery aspirants are always at risk of acquiring vitamin and mineral nutritional deficits in the post-operative stage caused by several factors, comprising of reduction in food consumption, vomiting, diminution of gastric secretions and bypass of absorption zone. 29,30 Thus, it is necessary to have daily multivitamins supplementation for optimal patient care following bariatric surgery, 31,32 and must be tailored to patients basing on their intermittent laboratory examinations and dietary necessities. 33