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Weight-loss surgery may raise risk of alcohol abuse
A new study shows weight-loss surgery patients are at risk for alcoholism about two years after the procedure.
June 19th, 2012
09:22 AM ET

Weight-loss surgery may raise risk of alcohol abuse

Certain patients who undergo weight-loss surgery may have a heightened risk of developing a drinking problem, but the risk is only apparent two years after the procedure and only with one type of surgery.

A new study, published today on the website of the Journal of the American Medical Association, examined the drinking habits of almost 2,000 obese adults before and after bariatric surgery.

Before the surgery, 7.6% of the study participants met the criteria for an alcohol-use disorder. One year after the procedure that number had actually declined slightly, to 7.3%, but by the end of the second year it had risen to 9.6% - a 57% increase from the pre-surgery rate.

The risk of developing an alcohol-use disorder was twice as high among patients undergoing Roux-en-Y gastric bypass surgery — which accounted for 70% of the procedures in the study — than among patients undergoing laparoscopic gastric banding (also known as lap band surgery).

But the risk wasn't appreciably higher with other types of weight-loss surgery, such as gastric banding or gastric sleeve surgery.

Health.com: Weight-loss surgery may lower heart attack, stroke risk

The researchers can only speculate why the uptick in alcohol-use disorders was restricted to Roux-en-Y patients and took two years to become apparent. The most likely culprit is an increased sensitivity to alcohol, coupled with a gradual return to pre-surgery drinking habits, says lead author Wendy King, Ph.D., an assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

Roux-en Y bypass involves reducing the size of the stomach and bypassing part of the small intestine, both of which cause alcohol to pass into the bloodstream more quickly, King explains.

In addition, Roux-en-Y patients are advised not to drink for 30 minutes after eating, which increases the likelihood that they'll consume alcohol on an empty or near-empty stomach. "The switch to drinking without food could also impact sensitivity," says King, who presented her findings today at the annual meeting of the American Society for Metabolic and Bariatric Surgery, in San Diego.

Health.com: Are you more drunk than you think?

Replacing one addiction with another (in this case, food for alcohol), a phenomenon known as addiction swapping, seems not to have played a role here. Binge eaters, who are comparable in many ways to binge drinkers, were no more likely than other people to develop an alcohol-use disorder, King says.

Other factors were associated with increased risk, however. Men, younger people, smokers, regular drinkers (including moderate drinkers), recreational drug users, and people who feel like they don't belong — a marker of poor social support — were all at increased risk relative to their peers.

Overall, 1 in 8 study participants reported drinking at least three alcoholic drinks per typical drinking occasion two years post-surgery.

"That level of drinking, independent of any relationship to alcohol-use disorder, may have negative implications for weight loss, for liver health, and vitamin and mineral absorption," King says. "Those who undergo Roux-en Y surgery already have compromised absorption, and heavy drinking could make it worse."

Health.com: Surgery is no quick fix for obese teens

The study had some limitations. It shows only an association, not cause and effect, and the participants may have underreported their alcohol consumption, especially since people with alcohol-use disorders are generally advised against bariatric surgery.

Candidates for weight-loss surgery should be aware of the risk of alcohol problems, but the new findings by themselves shouldn't dissuade anyone from considering the surgery, King says.

"This is the best treatment we have today for severe obesity," King says. "With any medical procedure, there are risks and benefits."

Copyright Health Magazine 2011

Post by:
Filed under: Addiction • Alcohol • Diet and Fitness • Health.com • Obesity • Weight loss

soundoff (31 Responses)
  1. Dave

    If you are so powerless over your eating that you need bariatric surgery -- then you should not be surprised if you have trouble controling your drinking too

    Over eating is a behavioral problem, not a surgical problem

    June 19, 2012 at 12:14 | Report abuse | Reply
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    • fighting irish

      Clearly you are a fool.

      August 5, 2013 at 01:19 | Report abuse |
  2. Harel

    Be nice, Dave. A waist is a terrible thing to mind!

    June 19, 2012 at 22:05 | Report abuse | Reply
  3. Coop

    Having had the surgery myself 6 years ago, I can understand the problem. I know first hand that drinking a shot of alcohol for me is probably akin to IV drugs. I was not aware of this before the surgery. I am not an alcoholic, but I can understand why the risk is high. I would still have had the surgery, even if I'd known the risks. I limit my alcohol intake.

    June 19, 2012 at 23:56 | Report abuse | Reply
    • Manu

      Joy, while to many people, the souitlon to losing weight is simple – don't eat as much and exercise regularly – the reality is that eating disorders are complex and multi-layered. Unravelling the root cause involves examining everything from genes to environment to emotional issues. Eating is so intricately woven into the fabric of our daily lives that extricating that which is emotional unhealthy eating from that which fuels our bodies is a difficult task.Statistics show that for the morbidly obese, there is a less than 2% chance of sustaining weight loss from diet and lifestyle change alone and I think it is irresponsible to keep giving that message to someone like myself who has lost and regain large amounts of weight, each time gaining more than I started with. That is the reality, we are doing more harm to our bodies by continuing this pattern while developing life threatening co-morbidities. We don't need education, we are already very knowledgeable about how to eat properly from years of dieting.Perhaps if the health care system would pay for extensive therapy to help deal with the deep seated and long term emotional issues that many have, it might help, but that can takes years – years that many obese individuals don't have. I also had the Vertical Sleeve Gastrectomy and have lost 164 pounds. I have a new life, renewed health and will be costing the health care system a lot less money.Lorraine

      September 11, 2012 at 18:49 | Report abuse |
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    June 20, 2012 at 11:21 | Report abuse | Reply
  5. kit4wit

    Let's not only deal with the alcohol consumption. Let us also deal with the 5 year success rate that Roux-En-Y patients must accept. Everything goes along great until the 5 year threshhold, at which point the success of the surgery goes away, and the weight, despite total conformance to the rules, piles on like never before!!! My weight gain prior to surgery was caused by medications blowing me up by 150 lbs! I was not, and have never been, an overeater. But the 5 year threshhold took me down with it, despite my exercise and food limitation. Let us give prospective patients the truth about THAT!

    June 20, 2012 at 14:51 | Report abuse | Reply
  6. nobody n particular

    kit4wit, somehow I doubt that if you kept your calorie consumption below 2000 and you kept you activity level high with 30-60 minute workouts 6 days a week that you would just start gaining weight. Our bodies are fairly simple, if calories burned is greater than calories consumed, then you will lose weight. The only exception to this, is if the calorie consumption is too low and the body starts operating in starvation mode, in which case the body will resist shedding of weight. If you have bariatric surgery and you want to maximize your weight loss, then you need to consume no more than 1300 calories per day, at least 70g of protein per day, keep starches below 150g, and about 64 fl oz of water per day. Also, monitor your weight, there will always be some day to day fluctuation but over a 7 day period you should be trending down and if not, see a doctor (assuming you did stick to the diet).

    June 20, 2012 at 17:34 | Report abuse | Reply
  7. Goingforit

    @Kit4wit, also if you were 150 pounds over weight. If at any time you were a plus size person those fat cells don't leave and go running away it is said and my doctors told me this. If you are a plus sized person you have to work out a minimum of 90 minutes a day to keep the weight off. If your not excerising everyday and doing about 90 minutes and adjusting your calorie intake accordingly your body is going to think your straving. no matter what diet plan or surgery you did.

    June 21, 2012 at 04:22 | Report abuse | Reply
  8. kareena Shaikh

    Hello,

    Alcohol consumption cause weight gain. also so many other disease also. After having surgery we should take so care to avoid alcohol and other oily food also.

    July 12, 2012 at 05:09 | Report abuse | Reply
  9. Weight Gain

    Weight loss is a risky task!!After the surgery We should not consume the alcohol it may cause many side effects;it may even lead to death some times!! We should be very careful after the surgery!! We should take the advice of doctor after the surgery to reduce the weight!!

    Weight Gain

    October 1, 2012 at 01:46 | Report abuse | Reply
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    October 30, 2012 at 12:56 | Report abuse | Reply
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    December 6, 2012 at 20:05 | Report abuse | Reply
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    December 9, 2012 at 11:33 | Report abuse | Reply
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    I had the gastric sleeve surgery in 2009. I lost weight and struggle to keep weight on. I began to drink beer again about a year ago. My body craves it once I start drinking. I don't eat sweets but I believe my body craves the sugars in the beer. Has anyone else had this same problem?

    January 24, 2013 at 15:38 | Report abuse | Reply
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