Weight-Loss Surgery Increases Risk of Alcohol Addiction
Experts say more patients need to understand their risk after surgery.
June 18, 2012— -- Andrew Kahn was only a social drinker before his weight-loss surgery. He never imagined he would develop problems with alcohol because he had bariatric surgery. But he did.
The 61-year-old from Fort Lauderdale, Fla., who had his gastric bypass surgery in 2003, eventually developed alcoholism and was treated at a rehabilitation facility for his addiction.
"I never had any guidance or education about that," said Kahn. "If I was given the choice between being obese and becoming an alcoholic, I would have thought about [my decision] more."
The American Society for Metabolic and Bariatric surgery estimates that approximately 72 million people are obese in the United States and 200,000 people have bariatric surgery each year.
Kahn's alcohol addiction may not be a unique result of gastric bypass surgery. New research suggests that having Roux-en-Y gastric bypass surgery, where the size of the stomach is reduced and the intestine is shortened, thus limiting how much a person can eat, can increase the risk of alcohol-use disorders.
The study, conducted by researchers at the University of Pittsburgh Medical Center, adds to mounting evidence of a link between have the popular gastric bypass surgery and the symptoms of alcohol-use disorders.
Before the surgery, the nearly 2000 study participants completed a survey developed by the World Health Organization that is used to identify symptoms of alcohol abuse.
The patients then completed the survey one and two years after their weight-loss surgery. The study found 7 percent of patients who had gastric bypass reported symptoms of alcohol use disorders prior to surgery. The second year after surgery, 10.7 percent of patients were reporting symptoms.
The findings were published Monday in the Journal of the American Medical Association.
"There have been previous studies that show there is a change in alcohol sensitivity in gastric bypass," Wendy King, a research assistant professor in the department of epidemiology at the University of Pittsburgh Medical Center, and the study's lead author.
King's study is the first to show that with this increased sensitivity there is also an increased risk of alcohol use disorders (AUD), the term used to describe alcohol abuse and dependence.
Dr. Mitchell Roslin, a bariatric surgeon at Lenox Hill Hospital in New York City, said the link between gastric bypass surgery and increased alcohol use has been attributed before to the shifting addiction theory and that this is false. The shifting addiction theory is that if a person has an impulsive drive to eat and the ability to eat large amounts of food is taken away, then he will shift his addiction to another addictive substance, like drugs or alcohol.
"A gastric bypass patient has a small pouch [for a stomach] so alcohol goes straight into the intestine and is absorbed rapidly," said Roslin. "When it is absorbed rapidly, there is a high peak and rapid fall."
The higher absorption rate makes alcohol more addictive, he added.
Indeed, before his surgery, Kahn would have two drinks, then feel sleepy and go to bed. After the surgery, he said he felt the alcohol would go through his system faster, which allowed him to drink more.
"It wears off so quickly so you can keep going and going," said Kahn.