Bariatric surgery causes a reduction in appetite that often leads to low intake of essential nutrients such as calcium. Mostly deficiency is caused by reduced absorption from intestine
that follows WLS.

Statistics have shown that about half of patients will develop calcium deficiency by 24 months after the surgery.
Supplements become an essential part of the post-op diet to prevent bones becoming brittle.

Absorption of CALCIUM

Calcium is absorbed from along the entire length of the small intestine. This is aided by the vitamin D known as calcitriol. However, the best sources of calcium are dairy products, eggs, fish, almonds, broccoli and especially sesame seeds + tahini.

Effects of obesity on CALCIUM

Many obese people have conditions such as high blood pressure, joint pain from osteoarthritis, heartburn from reflux. The use of drugs that may further compromise calcium levels by either reducing absorption or increasing loss in urine.
Some antacids used for heartburn block calcium absorption while steroid use in arthritis increases loss in the urine.

Why CALCIUM DEFICIENCY after bariatric surgery?

After surgery, the stomach is reduced significantly, and the appetite is also reduced. The surgery removes the cells that aid in calcium absorption. These are responsible for reduced calcium intake and absorption respectively.
Some patients may also want to move towards vegetable diets to accelerate weight loss and thus, take little or no dairy products that are rich in calcium.

Natural sources of CALCIUM

The recommended daily allowance for calcium is 1300-2500mg after WLS. Rich sources of calcium include milk, cheese, fish (sardines), yogurt, okra, and almond.


Calcium comes in different forms.
The most common over-the-counter calcium supplement is calcium carbonate which is not easily absorbed following bariatric surgery. A better supplement is calcium citrate which should be in chewable or liquid form.

You should take about 1500mg of elemental calcium per day.
This should be divided into smaller doses (200mg OFTEN)
Take the calcium citrate supplement with food to enhance absorption.

Consult your dietitian to find the best dose for you!