Obesity is a serious and costly disease—one that affects more than 34.9% of adults in the US. One medical option for some obese patients is weight loss surgery, also known as bariatric surgery, a voluntary operation to help qualified patients lose weight.
Who qualifies? Most candidates typically have a body mass index (BMI) greater than or equal to 40 or be more than 100 pounds overweight (BMI of 35 if you have obesity-related health issues). An inability to achieve a healthy weight loss over time despite efforts to lose weight is also a factor.
Among other positive benefits, the weight loss from bariatric surgery may eventually allow you to discontinue certain medications for chronic conditions like diabetes, high blood pressure, heart disease, arthritis, and high cholesterol. However, depending on the type of surgery, the procedure can lead to absorption issues for various nutrients and medications.
Here’s what you need to know when it comes to taking medications after a bariatric surgery:
What dosage forms are best?
Liquids are the ideal form for medications after bariatric surgery. You may not be able to absorb whole tablets and capsules as well as you did before surgery.
If necessary, tablets should be crushed and capsules opened and sprinkled on food, but ONLY if appropriate according the manufacturer.
Is there a preference for immediate-release or extended-release medications after bariatric surgery?
Immediate-release forms are preferred, because many of these medications can be crushed and given orally.
If possible, your doctor may recommend switching all of your extended-, sustained-, controlled-, or time-release medications to an immediate-release counterpart which will be taken more frequently.
Will any of my medication doses need to be adjusted?
Yes. The absorption and distribution of medications depends on various factors including fat tissue, blood volume, blood flow, lean body mass, and organ size. After surgery, your doctor may continue to adjust and reduce the dose for many of your medications.
Will I need to use dietary supplements?
Yes. Only your doctor can determine which supplements will be right for you, but your body will absorb vitamins, minerals, and medications differently after surgery.
You may have nutritional deficiencies due to vomiting, decreased food intake, food intolerance, reduction of stomach acid, and a smaller surface area where absorption typically occurs.
Some common supplements your doctor may suggest: a multivitamin, calcium, vitamin D, vitamin B12, folate, iron, and zinc.
Are there any new medications that I may be prescribed after surgery?
Yes. Your doctor may prescribe certain medications to prevent complications. Some examples include:
- Acid-reducing medications (e.g. Prilosec) to precent ulcers
- Ursodiol to prevent gallstones
- Birth control to preven pregnancy (there may be a possibility of increased fertility)
Are there any medications I should avoid after surgery?
Yes. There are some medications that may have unfavorable side effects It is best to avoid or limit the use of certain medications after having bariatric surgery due to unfavorable side effects as well as efficacy. The following are examples of medications that should be avoided after bariatric surgery:
- Anti-inflammatory medications like ibuprofen, naproxen, and Celebrex
- Extended-release, sustained-release, controlled-release, or time-released medications like Effexor XR, Wellbutrin XL, or Adderall XR
- Bisphosphonates like Fosamax or Boniva
For more information on medication and nutrition after bariatric surgery, please reference this website from The American Society for Metabolic and Bariatric Surgery.