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The American Society for Metabolic and Bariatric Surgery, the premier national society for metabolic and bariatric surgery and the definitive authority on nutritional guidelines for medically supervised weight loss, has documented that patients in significant calorie deficits commonly present with preexisting micronutrient deficiencies before treatment even begins, reinforcing that proactive nutrient density is a clinical priority, not a secondary concern, for anyone eating substantially less than their maintenance calorie needs