If you or someone you know has undergone metabolic and bariatric surgery (MBS), you know it’s common to occasionally experience joint pain, hair loss, loose skin, and brittle nails. But did you know there is a relatively easy and non-invasive way to provide the comfort and support you seek? It’s called multi-collagen protein!* In this article, we discuss the types of collagen and how collagen peptides can support healthy skin, joint health, and nail strength in bariatric patients.* What is Collagen? Collagen is a protein found throughout the body as a component of bones, tendons, skin, muscles, and cartilage. There are various types of collagen, but the body mainly consists of types I, II, and III. (1) While collagen is made up of different amino acids, it is specifically high in glycine, proline, and hydroxyproline. (2) These are non-essential amino acids that can be consumed through food sources and are naturally produced by the body. The body does not absorb the whole form of collagen, so for proper absorption, it is broken down into collagen peptides. These peptides serve as the building blocks of collagen and other proteins in the body to support the body where it is most needed. This can include joint mobility, wound and tissue healing, skin elasticity, and bone and cardiovascular health. (2)* Collagen After Weight Loss Surgery* There are multiple articles regarding the benefits of collagen supplements in supporting joint health, hair appearance, healthy skin, and nail strength, which are all common concerns that metabolic and bariatric surgery patients face during their weight loss journey. (3,4,5,6,7,8)* Research from 2019 suggests that using collagen supplements for metabolic and bariatric surgery patients may help to support natural collagen formation in the body. (9)* Collagen peptides (hydrolyzed collagen) are easily absorbed and may benefit metabolic and bariatric surgery patients with absorption issues due to weight loss surgery. (10)* Common Types of Collagen While 28 different types of collagen have been identified, your body mainly consists of types I, II, and III. Here, we discuss the most common types of collagen and what they do in the body: Type I: Skin Type I is the most common type of collagen in the human body. It is an essential component of the skin. If there is decreased production of type I collagen in the body or increased breakdown, then wrinkles and skin aging can occur. (11) For this reason, collagen supplements containing type I collagen support skin health and appearance. (11)* Collagen supplements that contain type I collagen are generally sourced from bovine, fish (marine), and chicken eggshell membrane. Type II: Joint & Cartilage This collagen type is predominantly found in tissues and cartilage that make up the human body. Collagen supplements that contain type II support cartilage and joint health. (12)* In a collagen supplement, this type is typically sourced from chicken (avian) and bovine. Type III: Bones, Heart, Eyes & Skin Type III collagen works alongside type I collagen in the body. Where you find type III, you will also find type I. It plays a supportive role in bone formation and strength, cardiovascular health, and skin appearance. (11)* A collagen supplement containing type III is usually sourced from bovine and porcine. Type V: Connective Tissues This fiber-like collagen is commonly found in connective tissues, such as the skin, cornea, and skeletal muscle. Mutations to type V collagen have been related to connective tissue disorders. (13) Collagen supplements that contain type V support bone durability, muscle, and corneal tissue health. (11)* You can typically find type V sourced from chicken eggshell membrane and bovine. Type X: Bones, Joints & Cartilage Type X collagen is a component of bone structure, growth, and formation. It supports cartilage structure, joint, and bone health. (14)* You can find this type sourced from chicken eggshell membrane. Natural Collagen Formation For the body to naturally synthesize collagen, specific amino acids and select vitamins are consumed through food sources. A healthy, balanced diet would provide sufficient nutrients for the body to produce collagen.* Unfortunately, weight loss surgery patients have difficulty consuming various foods due to restriction and taste changes. When you can no longer rely on food as the sole source of nutrition, supplements become necessary in your daily routine.* Nutrients that play a role in natural collagen synthesis include: Amino Acids The body utilizes specific amino acids from food to support collagen formation.* Vitamin C Vitamin C supports a healthy inflammatory response and is required for natural collagen synthesis and skin regeneration. This micronutrient is found in many chewable vitamins for bariatric patients.* Vitamin E, Zinc & Biotin A study involving a hydrolyzed collagen supplement with vitamin C, vitamin E, zinc, and biotin reported improved skin appearance, specifically hydration, elasticity, and roughness. (15) These additional vitamins support natural collagen synthesis in the body.* What Affects Collagen Production? Aging can lead to decreased collagen production, resulting in wrinkles and loose skin. UV light exposure can break down collagen at a faster rate than aging. An inadequate diet lacking a variety of protein sources can result in a limited intake of nutrients that can help the body synthesize collagen. Rapid weight loss after metabolic and bariatric surgery can diminish skin elasticity. It is always recommended to get nutrients through food first and then supplement when needed. Always consult your healthcare provider before starting a new supplement to ensure it is suitable for your individual needs, and only take supplements as directed. Supplementation for metabolic and bariatric surgery patients has evolved to provide bariatric-specific products to support a healthy weight loss journey and target areas of concern, such as hair loss, GI issues, vitamin/mineral deficiency, and skin changes.* Other Benefits of Collagen Supplementation* Extensive research has been conducted on the benefits of collagen supplementation. (3,4,5,6,7,8)* The top three researched uses for collagen supplements are: Joint Support* Individuals with functional knee pain found substantial relief with consistent collagen peptide supplementation. (6)* Specifically, type II collagen has shown promise in directly targeting joint pain. Changes in movement and discomfort have been seen within three months of consistent type II collagen peptide use. (8)* Skin Appearance* Collagen supports skin integrity, firmness, and wound healing. Significant weight loss has been associated with damage to the skin, specifically elastin and collagen fibers. The collagen production that occurs after rapid weight loss is an immature collagen form with less therapeutic capacity. (16)* It was shown that four weeks of consistent collagen supplementation improved skin elasticity. (15) That being said, it is possible that consuming collagen peptide supplements during rapid weight loss can support collagen levels in the skin that may become damaged.* Collagen supports the tightening of loose skin, but if you're looking for serious body contouring to remove excess skin, you may consider post-bariatric plastic surgery.* Hair & Nail Health* It is common for metabolic and bariatric surgery patients to experience brittle nails, various skin conditions, and temporary hair loss after weight loss surgery. Dealing with hair loss after metabolic and bariatric surgery can be scary, but it is essential to know that this is usually a temporary issue. For those experiencing hair-thinning, supplementing with a marine collagen blend with vitamins and minerals to aid natural collagen formation have proven beneficial for limiting hair shedding and supporting growth. (7) Collagen peptide supplements may also benefit nail growth and strength. (4)* Hair loss is relatively common after metabolic and bariatric surgery. Some things you can do to support healthy hair include:* Staying consistent with your bariatric-specific multivitamin* Reach daily protein goals (minimum of 60g - 80g protein/day, follow protein recommendations provided by your dietitian)* Daily water intake (48-64oz) Consume a variety of whole foods Blood work (this will show if a vitamin/mineral deficiency is the cause of hair loss) Collagen vs. Other Protein Sources Protein intake is crucial after metabolic and bariatric surgery to support muscle mass, wound healing, healthy hair, and a healthy metabolism.* When protein powder supplements become your main source of dietary protein initially following weight loss surgery, choose a product that contains all essential amino acids.* Collagen-based protein supplements do not contain a sufficient amount of all the essential amino acids and, therefore, should not be used as a sole source of protein after metabolic and bariatric surgery.* A collagen-based supplement should be used with high-quality protein such as egg, soy, or whey protein.* Summary The world of bariatric supplements is continuously expanding. It’s essential to stay updated on the products that may be further recommended after surgery.* Collagen has shown promise in many aspects of healthy living. Consult your healthcare provider about incorporating collagen supplements into your routine after metabolic and bariatric surgery.* Bariatric Fusion has a wide variety of delicious High Protein Meal Replacement flavors and Multi Collagen with Joint Support. Shop all Bariatric Supplements Here References StatPearls Publishing. 2021 Today’s Dietitian. 2019; 21(3) Nutrition Research. 2018; 57 Journal of Cosmetic Dermatology. 2017; 16(4) Skin Pharmacology and Physiology. 2014; 27(1) Applied physiology, nutrition, and metabolism. 2017; 42(6) Journal of Cosmetic Dermatology. 2016; 15(4) J Int Soc Sports Nutr. 2013; 10(1) Laparoscopic Endoscopic Surgical Science. 2019; 26 Nutrients. 2021;13(5) Polymers (Basel). 2021; 13(22) J Am Nutr Assoc. 2022; 21 Biochemistry of Collagens, Laminins, and Elastin. 2019; 51-57 Biochemistry of Collagens, Laminins, and Elastin. 2016; 73-76 Nutrients. 2019; 11(10) Anais Brasileiros De Dermatologia. 2015; 90(2) *This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs. *These statements have not been evaluated by the Food and Drug Administration (FDA). These products are not intended to diagnose, treat, cure, or prevent any disease.