Poor clinical follow-up often equates to poor compliance with routine blood work and micronutrient supplements. Forgetfulness, poor education about the need for lifelong supplementation, or ironically deficiency states themselves (such as memory loss from vitamin B₁₂ deficiency) may contribute. Patients may believe that being at a healthy weight, and/or eating larger portions of food, months and years after surgery, translates to not needing to take supplements. Alternatively, they may believe that regaining weight after surgery means additional vitamins and minerals are no longer needed. Many are knowledgeable regarding the importance of supplementation, but find the frequency of taking pills hard to sustain, have difficulty swallowing (sometimes large) pills, or have run into financial difficulties and no longer purchase supplements. Methods of managing these patients and increasing compliance include routinely reaching out via email, telephone, or postcards to remind them of annual visits, blood work that is due, support group meeting schedules, and publications from your practice or third-party organizations. It is helpful to reinforce to patients that long-term follow-up with your office and attending support groups are predictive of their success [15, 17]. Another way to increase compliance is to educate patients on alternative ways to take supplements. Some patients prefer crushing or dissolving pills, selecting chewable, liquid, or powdered (or even injectable) forms, to swallowing them on a daily basis, but some are unaware of these options.