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The dramatic increase in the incidence of obesity has resulted in an overwhelming increase in the number of bariatric, or weight loss, operations performed in the United States. These operations induce long-term weight loss through a combination of volume restriction, hormonal changes, and alterations in nutrient absorption. As a result, bariatric surgery patients may suffer from nutritional deficiencies over the long term and need to be followed closely before, during, and after pregnancy. Bariatric patients are given regimens of nutritional supplementation that are specific for their type of operation. This chapter describes the different types of bariatric operations and the nutritional disturbances associated with each one. Additionally, the standard recommendations for supplementation and follow-up are reviewed. Alterations to these regimens during pregnancy are discussed. Pregnancy outcomes after bariatric surgery are reviewed.