Increased Alcoholism Rates Seen in Gastric Bypass Patients

Increased Alcoholism Rates Seen in Gastric Bypass Patients
European researchers have found gastric bypass patients have an increased risk for postoperative alcohol dependence. Based on a retrospective cohort of bariatric surgery patients, the investigators are calling for clinicians to examine gastric bypass patients for postoperative alcohol-related diagnoses.

“The results of this study clearly indicate the need for physicians to screen for alcohol abuse as part of the workup prior to bariatric surgery and to follow patients who undergo this operation carefully for signs of alcohol abuse," said Craig Fisher, MD, MPH, associate professor in the Department of Surgery, Weill Cornell Medical College of Cornell University, in New York City, who was not involved in the study.

According to investigator Magdalena östlund, MD, a researcher in the Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, patients’ increased risk for acute alcohol intoxication, dependence, and weight gain after gastric bypass surgery may come from greater alcohol absorption in the small intestine and a more immediate spike in blood alcohol levels.

In light of previous research that showed substance abuse and mental illnesses were more common among obese patients, Dr. östlund’s team set out to investigate whether bariatric surgery might reduce the frequency of these illnesses. She and her colleagues examined data from 12,277 Swedish gastric bypass and restrictive surgery patients treated between 1980 and 2006 and followed for a mean of 8.9 years postoperatively. The researchers compared data between these patients and 122,770 age- and gender-matched controls who did not undergo bariatric surgery; they did not control for obesity in the matched group.

Compared with controls, bariatric surgery patients had significantly higher rates of psychosis, depression, attempted suicide and alcohol-related diagnoses, such as acute alcohol intoxication, and alcohol dependence before surgery. Preoperative rates of these illnesses were similar among patients undergoing restrictive and gastric bypass procedures; however, patients undergoing gastric bypass were 2.3 times more likely than those receiving banding procedures to get inpatient treatment for alcohol-related diagnoses postoperatively (odds ratio, 2.3 for bypass vs. banding). The only other diagnosis that changed in frequency after surgery was psychosis, which decreased in both groups.

“Patients need to be warned of the risks of alcohol consumption following gastric bypass," Dr. östlund said at the 2011 Digestive Diseases Week (abstract 266).

Dr. Fisher said the strengths of the study’s design make the findings exceptionally reliable. “These data are unique in that they capture a population with very complete follow-up information," said Dr. Fisher. “In the U.S., researchers often find it difficult to follow patients continuously, since they sometimes receive initial treatment at one center but go elsewhere for follow-up care. As there are a limited number of bariatric surgery centers in Sweden, the researchers were able to track all of the patients who underwent surgery."

Drs. Fisher and Ostlund had no relevant information to disclose.

Source - General Surgery News

Via - http://www.meltingmama.net/wls/2011/11/increased-alcoholism-rates-seen-in-gastric-bypass-patients-.html

 I've read enough of both studies and personal accounts to believe that drinking alcohol post-op is a big risk  and one that I"m not willing to take.  I have a friend that is over two years out who is consuming alcohol regularly and I've tried to warn her about the risks but she doesn't want to hear them.  Why bother taking the risk of developing alcohol dependence?  Plus, I would much rather eat my calories than drink them.  
There should be more pre-op education on this matter because once a pattern of alcohol conusmption is established post-op, its hard to break through people's denial about the risks.

Thanks for posting this!

 You're welcome.

I have many friends that have developed alcoholism after WLS, and it's downright scary how fast/hard it hits.

I have seen it happen.  We had a lady in our support group who passed away from her transfer addiction (ALCOHOL).  She did massive damage to her liver and passed away just a few years out from surgery.  It was very sad.  I went to her wake, and her sister spoke with those of us there from support group and told us what had caused her death and wanted it to be a warning.   Heartbreaking for sure.   

One of my good friends had RNY 10 years ago. Her starting weight was over 400 pounds and she currently weighs 150 at 5'7. Sounds good, right? All except for the fact she transferred to alcohol and has a shot liver and had a stroke last year and can't talk very well and has trouble recalling short term memories. She was up to a liter of whiskey a day when she stroked out.

No kidding.  As one who developed alcoholism after RNY, I can attest to the severity, progression and insidiousness of this disease.  Reading the other posts here makes me even more grateful to have found recovery in AA.  It took me 2 years to get 90 days sober and I know I am extremely fortunate not to have died during those 2 years, either by accident or from related health problems. 

I co-lead a Board here on OH for people with transfer addictions.  It is a very slow board.  There are hundreds of members, but very few posters.  This problem is steeped in guilt and shame.  We need to give it serious attention.

http://www.obesityhelp.com/group/crossingtotransferaddiction s/discussion/

 I was worried about this also, I do seem to be drinking more then I did before. I try not to, but when I get stressed, I just can't help it. any suggestions for other coping mechanisms

 I haven't got an issue with alcohol -- but sugar - is my drug.

The only way I can refrain -- is NOT HAVING ANY OF IT near me.  

Do not keep alcohol in your house if you cannot control yourself.  I know it's harsh - but it's a start.

As a ten year post op veteran I've seen the articles and the stories about alcoholism post op for weight loss patients. I have been around many post ops - friends, support grouup members - we have a lot of get togethers with post ops and have for years so I've been around many. In all that time I've seen a few who bacame alcohol dependent, abused alcohol or became full blown alcoholics. The one trait they all shared was they were ALL compulsive before surgery. Let's face it - we don't get to be 100, 200 or 300 pounds overweight without some sort of compulsion in the first place. Many replace an addiction - food for alcohol, food for gambling, food for sex, food for shopping,,,,, the list goes on and on. Some choose alcohol as their drug of choice-it's not guaranteed that you'll have a problem with alcohol if you have weight loss surgery. There is a chance you will have another addiction - that can be anything. You have to be compulsive before surgery to be compulsive after. Many aren't. Many of us have surgery, lose weight, don't start shopping, buying pull tabs or drinking our lunches because we don't have that compulsive gene to begin with. Many post ops are black or white. It's all or nothing. No chocolate in the house or a full bag of chocolate in the house. Many can't have one potato chip-they eat the whole bag if it's available. Those are the people with compulsion problems and can have a problem with alcohol. If you poll people who don't have any compulsions before weight loss surgery, you will find they don't become alcoholics after surgery either. It's not because of the surgery ! It's genetic, a mental health issue or whatever you want to call it. This surgery doesn't make us become something we wouldn't otherwise. Many post ops go on to happy, healthy maintenance without an alcohol or chocolate or shopping problem. They don't have the compulsion to start with. Researchers and poll takers need to use a broader base for their studies. I've seen this for years and am still convinced once a compulsion always a compulsion -what it is just changes.
Jen 10 yrs post op

I agree with you 100% Jenni.  I get a little bristled when I read on here that we all have food addictions etc and that's why we were fat!   We are all individuals and have different histories.  I do believe that alcohol addicition is a possibility, although by no means a certainty, for those that are food addicted and in remission with this surgery.

I have never had a food addiction and have not had problems with other transfer addictions after surgery.