The Most Common Nutrient Deficiency in Bariatric Patients

If you’ve had bariatric surgery, congratulations on the new you! Now its time to learn to take care of the different nutrition needs brought on by your surgery. Though surgery will help you take and keep weight off, it also increases your risk of developing several nutrient deficiencies. And, because the best defense is a good offense, it is wise to talk to your physician and dietitian about the nutrient deficiencies common in bariatric patients.

The most common nutrient deficiency you are likely to experience is iron deficiency anemia. And, a related issue to this deficiency is pica – a condition where a person craves and eats non-food substances such as laundry starch, ice, dirt, clay, cigarette ashes and more. Patients who have undergone operations such as Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BD), with or without duodenal switch are at an increased risk of developing pica.

Additional reasons bariatric surgery increases your risk of developing iron deficiency anemia and pica include:

• Immediately post surgery your intake of iron rich foods may be minimal
• Surgery means decreased hydrocholoric acid production in the stomach and this acid is essential for the absorption of some micronutrients
• Food and supplements now bypass the typical iron absorption sites in the small intestine
• There are fewer receptors to transport iron and change iron to the form that is absorbed best by the body

All of these issues make it essential that you talk to your physician about getting checked for iron deficiency anemia and how best to supplement if you are low in iron.


Reference: Bariatric Times 2010;7(11)22–23

China Girl Eats Pounds of Dirt Daily

This morning I found myself drawn in to a rather odd, yet interesting story my good friend Joey Antonio posted on facebook this morning. Joey has a knack for finding the strangest of strange news. And this story was no different.

A 19 year old Chinese girl named Bao Bao, tried eating soil, aka dirt, at age 7 and hasn't been able to stop since. In the brief article, she said "It gives me energy. I can live without rice but not soil." She only eats a yellowish, soft powdery soil and consumes about 1/2 to 2 pounds of dirt daily to "keep going." And apparently her boyfriend doesn't mind since she is a cheap date.

As odd as it sounds, Bao Bao is not alone in her dirt eating habit. She has what is callled pica, a pattern of eating non-food materials such as dirt, clay, animal feces, paint, sand or paper. If you are starting to have clear memories of the strange little kid from your pre-K who ate mudpies, you aren't alone, pica is most common in children than young adults like Bao Bao. In fact, an estimated 10-32% of kids aged 1-6 eat dirt. Pica can also occur in pregnant women or adults who crave a certain texture that they apparently can't get from food.

Aside from the obvious issues with eating non-fresh dirt, people with pica often have iron deficiency anemia and zinc deficiency. If you or someone you know has pica, it's time to visit a doctor and get tested for blood levels of iron and zinc and also check for other medical problems such as lead exposure.

Munching on dirt is a cheap habit but could be a sign of other medical issues and of course, it may result shame or at the least, odd stares from your friends and family.