[Nutritional recommendations, supplementation, and physical activity program following Roux-en-Y gastric bypass for morbid obesity].

The number of gastric bypass operations (RYGB) needed worldwide is increasing annually due to the obesity epidemic.Yet the success of this treatment is only guaranteed if an appropriate exercise therapy, a corresponding change of diet, and an adequate supplementation take hold in the aftercare program.Subject to pre-existing musculoskeletal diseases, exercise therapy should start about 4 weeks after the operation and comprise alternating cardiovascular and connective tissue-restitution training. The required change of diet focuses on small portions of calorie-reduced as well as protein- and vitamin enriched food. The standard daily intake should be between 800 and 1,200 kcal. However, after RYGB, nutritive deficiencies have been registered for proteins in 1-3%, for iron in 45-52%,vitamin B12 in 33-37%, folic acid in about 35%, calcium in 10-12%, and vitamins in 10-45% of the patients. For this reason,laboratory analysis at regular intervals is necessary in the follow-up and an appropriate supplementation of minerals, vitamins,and trace elements must be implemented.