Bariatric weight loss surgery is growing in popularity as a treatment for moderate and severe obesity (body mass index ≥35 kg/m2). Although bariatric surgery induces significant weight loss and ameliorates cardiometabolic, mechanical, and psychosocial complications of obesity, evidence shows increased incidence of various nutrient deficiencies following surgery, including iron deficiency. Iron deficiency is the most common and widespread nutritional disorder in the world, known for its multifactorial etiology and its difficulty to treat. Iron deficiency is prevalent in obese candidates for bariatric surgery and appears to be exacerbated after surgery. Symptomatic manifestations of iron deficiency following bariatric surgery include disorders such as chronic anemia, fatigue, and even pica, a disorder characterized by the eating of nonfoods such as ice. The aim of this review is to explore the mechanisms associated with impaired iron status in obesity before and following bariatric surgery in order to understand the effects of bariatric surgery on iron nutriture. Understanding the underlying mechanisms that cause impairment of iron status may serve as a foundation for developing methods to prevent the common occurrence of iron deficiency following bariatric surgery.
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