Nutritional issues in obese patients submitted to bariatric surgery. Re. “Bariatric surgery may not achieve intended outcomes in all patients”

In light of current knowledge, one can infer that more effective weight loss is associated with greater nutritional damage. [...]when considering adaptations of surgical bariatric techniques in an attempt to increase the efficacy of excess weight loss and to reduce the usual complications, questions should also be raised regarding the specificity of nutrient absorption sites in different intestinal segments in order to reduce nutritional deficiencies. An additional consideration is that the usual doses of medications may be less effective for the treatment of various diseases after bariatric surgery. Since most drugs are absorbed in the small intestine, the reduction of serum levels in patients undergoing the surgical procedure may mean that the normally prescribed dosages of different medications may be ineffective for patients with intestinal malabsorption after bariatric surgery.