Weight loss and vitamin deficiencies

 Jennifer Morris, MD MBA

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Weight loss often promotes health as BMIs approach "ideal." However, there are some health concerns that may evolve as a result of weight loss: Vitamin deficiencies can occur due to restrictive diets, insufficent food intake, inability to absorb nutrients, and surgical anatomy alterations. 

common vitamin losses:

• A
• B1
• B12
• D
• Folate
• Calcium
• Copper
• Iron
• Selenium
• Zinc

specific diets may play a role in select deficiencies. For example: 

• Dairy free diets --may be deficient in calcium and  vitamin D.  Replacing dairy  with milk alternatives such as almond, coconut, soy , oat, rice, hazelnut or hemp milk may raise iodine deficiencies (Staudacher)
• Paleo diets: are  limited,  especially  if a vegetarian paleo nutrition plan is undertaken, as these may have  inadequate protein. Without grains, athletes may not have enough training energy.  It may also  be harder to get calcium, vitamin D,  and B complex vitamins
• Gluten free: if gluten is replaced with alternatives like corn starch, potato starch or tapioca starch, these lack fiber which will need to be addressed
• Low carbohydrate diet: limited food selection may lead to nutritional deficiencies (Engel)

Nutrition status must be assessed and monitored during weight loss. These vitamins may become deficient 6-18 months after weight loss is pursued; therefore, careful monitoring for nutritional deficiencies should be pursued with your healthcare provider when engaged in medical weight loss. 

Staudacher, Heidi and Peter Gibson. How healthy is a gluten-free diet? British Journal of Nutrition, Volume 114, Issue 10, 28 Nov 2015, pp 1539-1541. 

Engel, Matthew et all. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans. Nutritient 2018 Jan; 10(1):108. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793336/  accessed 7/31/24. 

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