People who've had weight-loss surgery may be at an increased risk for drinking problems, a new study suggests.
The percentage of participants reporting symptoms of alcohol abuse increased from 7.6 percent before surgery, to 9.6 percent two years after surgery, the researchers said.
While this 2 percent increase may seem small, it could equate to more than 2,000 additional people in the United States who are abusing alcohol each year, the researchers said.
The study cannot answer why the surgery might increase the risk of alcohol abuse. But some research suggests weight loss surgery may change a person's sensitivity to alcohol, so less alcohol is required to become intoxicated, and a longer time is needed to reach a sober state (perhaps because the patient now is a lighter weight).
The findings suggest patients should be educated about the potential for such surgery to increase the risk of alcohol problems, and about how to drink safely after surgery, said study researcher Wendy King, an epidemiologist at the University of Pittsburgh.
Alcohol abuse symptoms
Doctors have heard anecdotes from patients, saying they've experienced changes in their alcohol sensitivity after the surgery, King said. A few studies have tried to determine if there is a link, but were limited because they were small and asked patients to remember their alcohol consumption levels before the surgery, King said.
In the new study, King and colleagues analyzed information from 1,400 weight-loss surgery patients who were surveyed before and after their surgery. Participants were asked questions to assess their alcohol use within the past year and level of alcohol dependence, including how many drinks they consumed on a typical drinking occasion, and whether it was hard to stop drinking after they started.
A year before weight-loss surgery, 106 patients had symptoms of alcohol abuse. A year after the surgery, that number went down to 101 patients. But two years after the surgery, the number increased to 133 patients, a significant difference when compared to the earlier years.
Patients who had a specific surgery — called the Roux-en-Y gastric bypass — were at a higher risk for developing symptoms of alcohol abuse. Among this group of patients, 7 percent had symptoms of alcohol abuse before the surgery, compared with 10.7 percent after the surgery.
From one addiction to another?
The study validates what many bariatric surgeons and clinical psychologists have seen in their practice, said Sunil Bhoyrul, a weight-loss surgeon at Olde Del Mar Surgical in La Jolla, Calif.
One hypothesis for the phenomenon is that patients "transfer" their addiction from food to something else, Bhoyrul said.
"Some patients have an addiction towards eating. When you do the surgery, you take away their ability to eat, and so they develop a new addiction," Bhoyrul said.
Doctors have seen bariatric surgery patients develop other types of addictions, including gambling disorders and sex addictions, Bhoyrul said.
All patients should receive a psychiatric evolution before bariatric surgery, so that doctors can attempt to identify those at high risk of developing a new addiction, Bhoyrul said.
The new study will be published June 20 in the Journal of the American Medical Association. It will be presented on June 18 in San Diego at a conference for metabolism and bariatric surgery researchers.
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