People who undergo the most popular weight-loss surgical procedure are at increased risk of developing problems with alcohol, according to researchers at the University of Pittsburgh Graduate School of Public Health.
The study is the first to link Roux-en-Y gastric bypass (RYGB) surgery and symptoms of alcohol use disorders, such as alcohol abuse and alcoholism, say the researchers.
They note that this finding could have implications for patient screening before surgery, as well as clinical care after surgery.
“Patients should be educated about the potential effect of bariatric surgery, in particular RYGB surgery, to increase the risk of alcohol use disorders,” said lead author Wendy King, Ph.D., assistant professor in epidemiology. “Alcohol screening should be included in routine pre- and post-operative care.”
King and her colleagues investigated alcohol consumption and alcohol use disorder symptoms in the Longitudinal Assessment of Bariatric Surgery study, a study of patients undergoing weight-loss surgery at one of 10 hospitals across the United States. Within 30 days before surgery and again one and two years after surgery, 1,945 study participants completed the Alcohol Use Disorders Identification Test, developed by the World Health Organization, to identify symptoms of alcohol use disorders.
Nearly 70 percent of study participants underwent the popular RYGB surgery, which reduces the size of the stomach and shortens the intestine, limiting food intake and the body’s ability to absorb calories.
Another 25 percent had laparoscopic adjustable gastric banding, where a surgeon inserts an adjustable band around the patient’s stomach, lessening the amount of food it can hold. The remaining 5 percent of patients had one of three less-popular weight-loss surgeries.
Among participants who had the RYGB procedure, 7 percent reported symptoms of alcohol use disorders prior to surgery. One year after surgery, there was not a significant increase in alcohol use disorders.
However, by the second post-operative year, there was greater than a 50 percent relative increase, with 10.7 percent of patients reporting symptoms of alcohol use disorders.
In contrast, there was not a significant increase in alcohol use disorders following laparoscopic adjustable gastric banding.
“Among RYGB patients, there was a significant decrease in alcohol consumption in the first year after surgery, compared to the year before surgery, but not in the second year,” King said.
“The increase in alcohol use disorder symptoms following RYGB surgery was likely a result of an increase in alcohol sensitivity following surgery combined with resumption of higher levels of alcohol consumption in the second post-operative year.”
Safe levels of alcohol consumption have yet to be established for post-operative patients. Previous studies on the effect of alcohol following bariatric surgery suggest that patients feel intoxicated more rapidly and for longer after drinking less.
King’s study also found that one in eight participants reported consuming at least three drinks per typical drinking day by the second post-operative year. “This is concerning, given the negative impact heavy drinking may have on vitamin and mineral status, liver function and weight loss,” she said.
The study also found several patient characteristics that could help predict whether a patient is more likely to develop alcohol problems following surgery, including smoking, recreational drug use, consumption of alcohol at least two times per week, and prior alcohol use disorders.
However, over half of patients with post-operative alcohol use disorders did not report the illness in the year prior to surgery, the researchers note. Men and younger adults also were more likely to develop alcohol use disorders.
Symptoms of depression, binge eating and having received treatment for psychiatric issues prior to surgery were not independently related to an increased likelihood of alcohol use disorders following surgery, the researchers add.
Source: University of Pittsburgh