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Patients considering creatine after gastric sleeve surgery are strongly encouraged to: Consult their bariatric dietitian before starting any new supplement Ensure protein targets are being met before adding performance-focused supplements Have renal function and routine bloods checked as part of postoperative monitoring, and inform their clinician they are taking creatine Be aware of the transient water-weight gain associated with creatine and discuss this with their team Choose reputable, third-party tested products (e.g., Informed Sport certified) to reduce contamination risk Report any new or concerning symptoms such as oedema, changes in urine output, or persistent GI disturbance to their GP promptly In summary, while creatine may offer some benefits for muscle preservation and physical performance in post-bariatric patients, the evidence base in this specific population remains limited

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