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The Journal of the American Medical Association published a new study about weight-loss surgery and the risk of those patients developing a drinking problem. The study examined about 2,000 obese adults before and after weight loss surgery. The study specifically saw an increase in alcohol-use disorder (AUD) in some procedures such as Roux-en-Y gastric bypass surgery (RYGB) and sleeve gastrectomy. RYGB and sleeve gastrectomy alter the pharmacokinetics of alcohol which can be the reason why some people feel intoxicated faster and longer than when they did pre operation. These feelings of intoxication are not due to binge drinking either, when given just a standardized quantity of alcohol, patients reach a higher peak alcohol level after surgery compared with case-controls or their preoperative levels. Patient surveys have revealed similar changes in alcohol sensitivity following RYGB (feeling intoxicated more rapidly, after drinking less, for longer as well as more difficulty controlling alcohol intake.  Alcohol sensitivity studies have not been performed in patients who have received LAGB, most likely because the anatomical and physiological changes from this procedure are less likely to affect alcohol absorption and metabolism. Some important things to consider about this study are:

  • The study was limited to a small sample of only 2,458 obese U.S adults
  • Of the 2,458 participants only 1945 completed preoperative and postoperative (at 1 year and/or 2 years) assessments between 2006 and 2011.
  • 78.8% Female; 87% Caucasian
  • The prevalence of AUD symptoms did not significantly differ from 1 year before to 1 year after bariatric surgery (7.6% vs. 7.3%; P = .98), but was significantly higher in the second postoperative year (9.6%; P = .01).
  • Higher rates in the second postoperative year were associated with male sex, younger age, and numerous preoperative variables such as smoking, regular alcohol consumption, AUD, recreational drug use, and lower interpersonal support and undergoing a RYGB bypass procedure.

[Reported by Journal of the American Medical Association]

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.[Health, 2012]

It’s important to note that this study just shows a correlation not direct cause and effect so people should not be alarmed. It’s also important to note that alcoholics are generally advised against gastric bypass surgery. There needs to be more extensive studies done to find out more about exactly what type of surgery and patients are at a high risk (if there’s any) of developing AUD after bypass surgery.

Read more about the study here.

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