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Weight Loss Surgery and Alcohol Problems
Does weight loss surgery lead to alcoholism? Researchers have found that one in five people who undergoes bariatric surgery for weight loss develops problems with alcohol dependency and abuse. In some cases, patients don’t show symptoms of alcoholism until years after their weight-loss surgery, but the research indicates that alcohol use disorders may be triggered or exacerbated by these procedures, particularly in people who are at high risk for alcohol abuse.
In one of the longest-running U.S. studies of adults receiving weight-loss surgeries, including Roux-en-Y gastric bypass (RYGB) and gastric banding procedures, scientists found that among the 2,000 patients studied over a seven-year post-surgery period, a significant number developed problems with alcohol. They found that more than 20% of RYGB patients developed an alcohol use disorder within five years of surgery, and roughly 11.3% of gastric banding patients developed these problems in that time period.
Connections Between Abuse of Alcohol and Weight Loss Procedures
How are problems with alcohol and weight loss surgery connected? Researchers involved in this and other studies have found that RYGB, which drastically reduces the size of the stomach and changes connections with the small intestine, is associated with higher and quicker elevation of alcohol in the blood. Although researchers have not investigated all of the possible reasons why the RYGB procedure may lead to alcohol dependency, it is hypothesized that the procedure increases alcohol reward sensitivity in the brain as a result of surgery-related changes in genetic expression and the hormone system.
Gastric banding, which also reduces the size of the stomach and the amount of food it can hold, uses a less invasive surgical technique to insert an adjustable band around the stomach. It is possible that the gastric banding procedure has less of an impact on a patient’s other body systems and therefore less of an impact on alcohol reward sensitivity in the brain.
An Ounce of Prevention: Screen for Alcohol Problems Before & After Bariatric Surgery
Wendy C. King, PhD, lead researcher of the national study involving the 2,000 patients treated at 10 hospitals across the United States, advises that all doctors who perform bariatric surgery screen patients for pre-existing alcohol problems before they undergo the procedure.
Because the study showed that even patients who had not had alcohol problems in the year prior to RYGB surgery had a higher risk of developing alcohol problems after the surgery, King also advises that all doctors routinely ask patients if they have had bariatric surgery. If they do, she advises they also screen them for alcohol use disorder and refer them for alcohol addiction treatment, if needed.
Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. WC King, PhD, et al. Surgery for Obesity and Related Diseases, May 2017. http://www.soard.org/article/S1550-7289(17)30152-1/fulltext
Popular weight-loss surgery linked to alcohol problems. Robert Preidt. HealthDay, CBS News, May 18, 2017.