Gastric bypass is the most commonly performed bariatric surgery in the United States and represents 70 percent of all surgeries performed during the study. Laparoscopic gastric banding, where an adjustable band in placed around a patient's stomach and limits how much food the stomach can hold, did not have an associated risk with increases in alcohol problems.
King said this is to be expected as gastric banding does not change the anatomy and thus the metabolism of alcohol like gastric bypass does.
The study also found that the increase in alcohol-use disorders was not seen until the second post-operative year as opposed to the first year after surgery.
"This emphasizes that continuing education about alcohol use is needed until the second year after surgery. With follow up [patients] need to hear about consumption and what is appropriate," said King.
Dr. Leslie Heinberg, the Director of Behavioral Services for the Bariatric and Metabolic Institute of the Cleveland Clinic, thinks these increases are causes for caution more so than concern. Patients should be educated before their surgery about the changes that will occur in how they will absorb and metabolize alcohol.
"Given that the increased rates of alcohol use disorders post-operatively are equivalent to what is seen in the general population, it shouldn't be a reason to avoid a life-saving procedure," said Heinberg. "Rather, it points to the importance of education, informed consent and continued monitoring."
King said her study highlights one of the risks of the surgery but it is important for patients to take in context all of benefits and risks and work with doctors to determine what is the best option for them.
"Bariatric surgery is the most effective treatment we have for obesity. It would be shame if people walked away thinking gastric bypass was a bad procedure based on this [study]," said King.
Andrew Kahn said that he did not have the opportunity to know that alcohol addiction may occur after his surgery and he wants other patients to be informed about these risks. He initially lost over 70 pounds after his surgery, but in the six months he was heavily drinking, he gained 35 of those pounds back and became depressed. He eventually attended a detoxification program and has been sober since 2010.
Kahn said he would not have had an alcohol problem if he did not have gastric bypass. Still, he wouldn't have traded in the surgery if given a second chance.
"Gastric bypass saved my life," he said.