PD624 - NUTRITIONAL FOLLOW-UP PATTERNS IN BARIATRIC SURGERY PATIENTS WITH SUBOPTIMAL WEIGHT OUTCOMES: A RETROSPECTIVE EXPLORATORY ANALYSIS

PD624

NUTRITIONAL FOLLOW-UP PATTERNS IN BARIATRIC SURGERY PATIENTS WITH SUBOPTIMAL WEIGHT OUTCOMES: A RETROSPECTIVE EXPLORATORY ANALYSIS

M. A. Perez Benajas^1,*, I. Torrijo Gómez², R. Cánovas de Lucas²

¹NUTRICIÓN, ²HOSPITAL ARNAU DE VILANOVA, VALENCIA, Spain

Rationale: Defining success after bariatric surgery: %EWL ≥50% is highly dependent on baseline BMI, while %TWL ≥25% provides BMI-independent thresholds. This distinction is clinically relevant because the criterion applied determines which patients receive active nutritional follow-up. Whether non-responders present differential micronutrient and cardiometabolic profiles, actionable through targeted dietary protocols before nutrigenomic evaluation, remains poorly characterised.

Methods: Retrospective cross-sectional study (Hospital Arnau de Vilanova, Valencia, 2023–2025) of 12 adults classified as Success (EWL ≥70%, institutional criterion; n=4) or Non-Success (EWL <70%; n=8). Success was additionally evaluated against the international standard %TWL ≥25% (ASMBS 2015). Preoperative clinical history and postoperative biochemical panels were compared descriptively.

Results: Preoperative profiles were similar between groups. Postoperatively, Success patients showed higher 25-OH vitamin D (40.7 vs 23.0 ng/mL), folate (15.8 vs 6.2 ng/mL), and B12 (649 vs 450 pg/mL). HDL increase was greater in Success (+15.3 vs +2.7 mg/dL) and triglyceride reduction more pronounced (−79.3 vs −56.7 mg/dL). Hepatic steatosis was present preoperatively in 75% of Non-Success vs 25% of Success. Non-Success patients maintained higher IBP and lipid-lowering drug use postoperatively. 

Conclusion: Non-responders show persistent fat-soluble vitamin insufficiency and incomplete cardiometabolic remission detectable in nutritional outpatient follow-up. These findings support enhanced monitoring protocols targeting vitamins D, B12, and folate in this subgroup, and provide a rationale for individualised dietary intervention and nutrigenomic profiling (German et al., 2025).

References: Grover et al. Obes Surg. 2019;29:3493-3499.

Van Laar et al. Obes Surg. 2018;28:2297-2304.

German et al. Nat Med. 2025;31:2269-2276.

Disclosure of Interest: None declared