ALB and nutritional disorder: Massive weight loss patients have an increased risk of impaired wound healing and an increased prevalence of medical comorbidities including diabetes and hypertension.1,16 Preoperative optimization of the patient’s nutritional status, including iron, calcium, and vitamin B12 levels is recommended.16 Low albumin levels, iron deficiency, and vitamin A, D, E, and K deficiency are common.17 Postbariatric patients, particularly those who have had malabsorbtive procedures (eg, gastric bypass and duodenal switch), are often anemic.1 Preoperative iron supplementation is frequently recommended.1