Scottsdale – An issue to be considered in bariatric surgery and in plastic surgery after major weight loss is the Wernicke-Korsakoff syndrome, which is caused by an acute thiamine deficiency when the refeeding of patients precipitates increased thiamine demand. The syndrome of acute neurological abnormalities comprises one or more of the following:

• apathy and disorientation
• nystagmus, opthalmoplegia, or other eye movement disorders
• ataxia
• severe impairment of short-term memory often with confabulation.

Although classically associated with alcoholism, Wernicke-Korsakoff syndrome is a concern in bariatric patients due to complications with chronic vomiting, anastomatic stricture, band slippage, and anastomatic ulcers often present with protracted vomiting over a lengthy period.

Unfortunately, many people perceive obese individuals as having appropriate nutrition. That is not the usual case, in fact! Many bariatric patients have chronic malnutrition and may experience acute thiamine deficiency syndrome after body lift, thigh lift, and arm lift or arm tuck. Careful monitoring and oral or intravenous supplementation of thiamine will treat this problem. For a complete review, I refer you to the journal Bariatric Times.