Can Bariatric Surgery Lead to Alcohol Abuse?

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The Health Hound is not a big fan of surgical procedures to deal with body image issues, especially weight loss. I am generally opposed to bariatric surgery except in the case where a person is so morbidly obese that his or her health is severely at risk, and all other methods have failed.

For many years, conventional medical wisdom seemed to agree with me, and most responsible doctors reserved bariatric bypass surgery only for people severely overweight, with a BMI of 45 and over. However, in recent years, with the procedures becoming more “advanced” and able to be done less invasively with a laparoscope, they are being done more frequently as an elective surgery on people that are far from morbidly obese.

Not only is this taking an attitude of a “short cut” to healthy weight loss through a regimen of proper diet and exercise, a just released study by National Institutes of Health (NIH) indicated that such surgery, can lead to greater risk of alcohol abuse post-surgically. The majority of those in the study had gastric bypass surgery, which reduces the stomach to about the size of a Ping-Pong ball, and also shortens the intestines. A smaller percentage in the study had what is commonly called “lap-band” surgery, which makes the stomach smaller using an adjustable rubber band. Both groups in the study showed a marked increase in alcohol abuse two years post-operatively.

The reasons for the increased risk of alcohol abuse are both psychological and physical. Many suggest that those who abuse alcohol after bariatric surgery are addictive personalities, who have merely traded one addiction – to food – for another. This could very likely be true in many of the cases, however there is also a physical reason. When the stomach is shrunk as it is in weight-loss surgery, its capacity to produce acid, which helps to metabolize alcohol, is also reduced, so molecules of alcohol in the stomach are more potent, increasing their effects. In other words, post surgery barratrics are more susceptible to all the effects of alcohol, including the propensity to abuse it.

Two years after surgery the patients in the study typically related increased symptoms of alcohol abuse — such as needing a “pick-me up” drink soon after they get up, and more alcohol-dependence related problems than they had before surgery such as blackouts, guilt feelings, or doing injury to themselves or others. More than half of the patients in the study that developed a drinking problem said they had no problem with alcohol prior to surgery.

So what do we need to take away form this study? Simply this – that there are no “short cuts” to healthy weightloss. Surgery, any surgery has risks, and now here is another one specific to bariatric surgery that potential patients and their doctors need to consider. Weightloss surgery like any surgery should only be considered as the “court of last resort,” for morbidly obese people who have tried and failed at all other methods, and even then, only after they have weighed all other risks. For anyone else who needs to shed a few extra pounds, they should be looking towards the weight room — and not the Operating Room!

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