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“Despite billions of dollars spent on weight loss treatment, the number of morbidly obese patients continues to increase. The only treatment option shown to have any type of success in this population is bariatric surgery.”

Surgical procedures have shown to decrease reliance on obesity-related pharmaceutical interventions (ie: diabetes, hypertension, etc.), but they have also been shown to increase serious metabolic and nutritional complications which limit the overall long-term success of these procedures.

Quite often obese patients tend to have vitamin and mineral deficiencies, even before surgery due to a diet largely devoid of lean protein, fruits and vegetables and an over-reliance on carbohydrates, sugar and processed food.

Furthermore, it has been reported that more than 50% of gastric bypass surgery patients show major nutritional deficiencies, especially within the first year post-surgery.  While some of the issues are responses to anatomical changes as a result of the procedure, many are due to inadequate nutritional intake and supplementation.


What are the Post- Surgery Nutritional Deficiencies?

It has been well-established which micronutrients are missing in post-surgical patients.  The most common deficiencies are iron, vitamins A, B1, B9, B12, D, E, and K, copper, protein and calcium. Neurological problems, such as peripheral neuropathy, have also been routinely observed.  Widespread inflammation, due to surgery, also exacerbates nutrient loss, and a pro-inflammatory environment can impair the immune system and disrupt energy and metabolic processes.

Oftentimes obese people have anxiety and mood disorders and have a history of taking SSRIs to control these issues.  It has been shown that gastric bypass surgery affects the absorption and bioavailability of this class of drugs, and as such their effectiveness is decreased, leaving these patients with psychiatric issues unresponsive to pharmaceutical interventions.

There are many oral supplements which are prescribed to Gastric Bypass Surgery patients to avoid these serious nutritional complications.   Oftentimes these supplements contain hundreds of times more than the RDA of particular compounds, even up to 500% more, to try to counteract the impaired gastro-intestinal system and with the hope that the patient will absorb even a fraction of the total amount.


WHY don’t current interventions work?

Although traditional nutritional supplementation improves the probability of nutritional adequacy for some vitamins, for most it does not and for many there are several key nutrients (protein, iron, B vitamins) that oral nutritional supplementation does not correct and even exacerbate over time.

B12 and iron deficiency are two of the most common problems and often do not respond to typical multivitamin supplementation. Some (up to 10%) patients will not respond to high-dose sublingual or oral B12 and will require monthly intramuscular B12 injections.

The risk for development of anemia necessitating IV iron therapy following Gastric Bypass Surgery is highest in menstruating women and continues to increase for many years, even in post-menopausal women.  These procedures are not only expensive, but can be dangerous long-term.

Additionally, many oral supplements have major problems:

  • First, many are not palatable (bad tasting) as they are commonly given in a liquid or ODT (Orally Dissolving Tablet) form.
  • Second, many oral nutritional supplements have limited absorption and bioavailability, even in healthy patients! For those with compromised gastro-intestinal systems (such as gastric bypass patients), absorption is exponentially lower, and for some compounds, non-existent.
  • Third, some supplements (ie: Iron) produce their own side effects which significantly decrease patient compliance and consistency, and are thus essentially useless.


Thinking ‘outside the traditional box’ MUST happen for Long-Term Success

Even though surgical techniques have drastically improved over the last decade for these patients, the evolution towards more effective nutritional supplementation has not, and is a key reason why many people undergoing gastric bypass do not succeed long-term or without major medical complications.

If the necessary nutritional supplementation is to be successful for these patients, the solution must be thought of outside the traditional box.  The end goal is to prevent the research-proven nutritional deficiencies almost all Gastric Bypass patients face, but also to be effective long-term to increase the overall success for these patients in achieving a healthier life.  Ineffective solutions do not solve problems.

Rectal suppositories are the newest development in medicine’s attempt to resolve the deficiencies that occur with Bariatric surgery. Rectal suppositories appear to be the most logical and efficient means to prevent or resolve the nutrient deficiencies in the Bariatric Patient population since this route of delivery completely avoids the bypassed intestines and deliver the most bioactive nutrient forms available directly into the body’s bloodstream.


Zetpil™ has solutions, NOW!

What’s the Zetpil difference?  The difference is giving the most bioactive forms of key nutrients, along with the necessary co-factors to optimize absorption so that the required therapeutic dosages can be absorbed and utilized systemically.  They aren’t “different” nutrients, just delivered in a way that a compromised system can utilize them efficiently to prevent deficiencies and other sometimes severe complications.

Since both macronutrient and micronutrient deficiencies occur, and can be life-threatening, shifting treatment to a cost-effective, patient-friendly, and superior form of nutrient supplementation quite simply increases the chance of overall surgical and survival success.  Zetpil™ products are poised to be the most innovative nutrient product line for the Gastric Bypass patient population.

Please visit or contact Karen at [email protected] for more details, product selection, and for special coupon codes.



Nutritional and Protein Deficiencies in the Short Term following Both Gastric Bypass and Gastric Banding
Judith Aron-Wisnewsky, et al
PLoS One 2016; 11(2): e0149588


Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis
Ting-Chia Weng, et al
BMJ Open 2015; 5(7): e006964


Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation
Mingyi Chen, et al
Biomed Res Int 2013; 2013: 205467


Screening and diagnosis of micronutrient deficiencies before and after bariatric surgery
Kimberly A. Gudzune, MD, MPH, et al
Obes Surg. 2013 Oct; 23(10): 1581–1589


Anemia and the Need for Intravenous Iron Infusion after Roux-en-Y Gastric Bypass
Adam Kotkiewicz, et al
Clin Med Insights Blood Disord. 2015; 8: 9–17


Mineral Malnutrition Following Bariatric Surgery
Nana Gletsu-Miller, et al
Adv Nutr 2013 Sep; 4(5): 506–517


Vitamin, Mineral, and Drug Absorption Following Bariatric Surgery
Ronald Andari Sawaya, MD, et al
Curr Drug Metab. 2012 Nov; 13(9): 1345–1355


Endocrine and Metabolic Complications After Bariatric Surgery
Anwar A. Jammah
Saudi J Gastroenterol 2015 Sep-Oct; 21(5): 269–277


Iron Deficiency and Bariatric Surgery
Ignacio Jáuregui-Lobera, et al
Nutrients 2013 May; 5(5): 1595–1608


For more information and peer-reviewed research, please visit:

Zetpil, Thinking “Outside the Nutritional
Industry Box” to Formulate Products
that Actually Work