(HealthDay News) — For many obese Americans, weight-loss surgery may lead to anemia, according to a research letter published online in JAMA Surgery.

The study of US veterans was led by Dan Eisenberg, MD, a bariatric surgeon at the Stanford School of Medicine in California. The research included 74 patients (78% men; average age, 51 years) who underwent Roux-en-Y gastric bypass (RYGB) at a single Veterans Affairs Medical Center.

The overall rate of anemia before surgery was 20%, the team noted, but by 10 years after surgery that number had risen to 47%. Follow-up care was crucial, however. Anemia was much more common among patients who did not have close follow-up with a weight-loss surgeon. For these patients, anemia rates rose from 22% before surgery to 57% a decade later. In comparison, for patients who did consult regularly with their weight-loss physician, anemia rates were 13% before surgery and 19% a decade later.

“Our study suggests that follow-up with bariatric specialists more than five years after surgery, rather than with specialists with no bariatric expertise, can decrease long-term anemia risk,” the authors write. “This finding may demonstrate the bariatric specialist’s specific understanding of the long-term risk for nutritional deficiency after RYGB and the importance of vitamin and mineral supplementation.”

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Chen GL, Kubat E, Eisenberg D. Prevalence of Anemia 10 Years After Roux-en-Y Gastric Bypass in a Single Veterans Affairs Medical Center. JAMA Surg. Published online September 20, 2017. doi:10.1001/jamasurg.2017.3158