A review highlights nutritional deficiencies associated with GLP-1 medications and bariatric surgery that may affect wound healing and recovery.
Patients undergoing body contouring surgery after significant weight loss may benefit from pre-surgical nutrition screening and personalized diet plans to support healing and reduce complications, according to a review in Plastic and Reconstructive Surgery.
“Good nutrition is essential for good wound healing,” says J. Peter Rubin, MD, MBA, chair of the Department of plastic surgery at the University of Pittsburgh School of Medicine and senior author of the review, in a release. “Patients who are undergoing very significant weight loss tend to have some nutritional deficiencies.”
Shared Nutritional Challenges Across Weight-Loss Strategies
Patients pursuing significant weight loss have several options, including GLP-1 medications, bariatric surgery, or a combination of the two. While each strategy presents distinct nutritional challenges, all meaningfully restrict caloric intake, making it difficult for patients to obtain adequate protein, vitamins, and minerals to support surgical recovery.
The review cited complication rates of 20% to 70% after body contouring in patients with major weight loss, with nutrition deficiencies linked to impaired healing. Body contouring surgery after weight loss has a strong safety record, and the majority of complications are related to wound healing. While most wound healing issues are managed through office-based care, the risk can be mitigated through attention to nutrition.
“The most common complication we see is a problem with wound healing,” says Rubin in a release. “That may involve a higher rate of infection. That may involve opening or breakdown of incisions, even though we close the skin very precisely because a patient’s healing capacity may be reduced.”
Pre-Surgical Recommendations
The review recommended lab tests before surgery to determine patients’ nutrient levels, with protein, B vitamins, and vitamin D identified as key concerns. A standard multivitamin may not be sufficient to correct every deficiency, and specialized supplement regimens may be warranted for patients who have undergone bariatric surgery and/or are using GLP-1 medications.
To address reduced appetite, the review suggested smaller, more frequent servings of concentrated protein, with food timed to periods when appetite is stronger. An individualized diet plan developed with a nutritionist or dietitian could help prepare patients for surgery and support postoperative healing.
Timing of Nutritional Support
Enhanced nutrition should begin at least several weeks before surgery and continue during recovery, when the body requires additional nutrients to heal, according to the review.
“It is 100% vital that patients maintain that rigor and diligence around good nutrition after the surgery because that is the time when their body is healing from the stress of the surgery, when nutritional demands are the highest and when it’s very important to keep fueling the body with what it needs to heal,” says Rubin in a release.
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