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May 28, 2017

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Weight surgery tied to drinking rise: study

Reuters--People who had weight loss surgery reported greater alcohol use two years after their procedures, according to a U.S. study.

The researchers, whose findings appeared in the Archives of Surgery, said it's possible that some patients may turn to drinking if the surgery successfully stops their ability to overeat without addressing underlying issues.

In addition, the effect of certain stomach-shrinking procedures on alcohol tolerance may play a part.

"This is perhaps a risk," said Alexis Conason, who worked on the study at the New York Obesity Nutrition Research Center at St. Luke's-Roosevelt Hospital Center.

"I don't think it should deter people from having surgery, but you should be cautious to monitor (alcohol use) after surgery," Conason told Reuters Health.

The study didn't show whether people were drinking in a dangerous way, and there was no clear increase in drug use or smoking after surgery.

Her team's study involved 155 people getting gastric bypass or gastric banding surgery, mostly women. Participants started the study with an average body mass index, or BMI, of 46 — equivalent to a 168 cm (five foot six inch) person weighing 129 kilograms (285 pounds).

Surgery is typically recommended for people with a BMI of at least 40, or at least 35 if they also have health problems such as diabetes or severe sleep apnea.

Alcohol use dropped immediately after surgery, from 61 percent of people who initially reported drinking to 20 percent at one month post-surgery. But by three months, drinking rates had started to creep back up.

And at two years out, people were drinking significantly more often than before their procedures.

That was mainly the case for those who had gastric bypass surgery, not banding. On a scale from 0 to 10 of drinking frequency, where 0 represented never, 5 was sometimes and 10 always, gastric bypass patients reported an increase from 1.86 before surgery to 3.08 two years later.

Conason said gastric bypass, in particular, has been shown to drastically lower alcohol tolerance, to the point that some post-surgery patients have a blood alcohol content above the legal driving limit after just one drink. For some, that could make drinking more appealing, she added.

One limitation of the study is that only one-quarter of the initial participants were still in touch to report their current alcohol and drug use at the two-year mark, so the researchers don't know how everyone else fared.

James Mitchell, a psychiatrist who has studied alcohol use after weight loss surgery at the University of North Dakota School of Medicine and Health Sciences in Grand Forks, said there's also a need for research going on for longer than two years, to see if alcohol use keeps increasing.

"The health risks of obesity are such that people with severe obesity should not forgo bariatric surgery because of this," said Mitchell, who was not involved in the study.

But he added that everyone should be warned about the possibility of increased alcohol use — and people with a history of alcohol abuse should be especially careful.

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