High Risk Alcohol Use Can Improve After Weight Loss Surgery

Will having weight loss surgery affect your alcohol consumption? For years we’ve heard different answers to this question, ranging from ‘not at all’ to worrisome information about increased alcohol use after surgery. A new study from Beth Israel Deaconess Medical Center found that as much as half of high-risk drinkers are less likely to report high-risk drinking behavior after weight loss surgery . Roughly one in six patients in the study reported high-risk drinking before weight loss surgery, but at one year after surgery, that group was looked at again. Two-thirds of gastric bypass patients and nearly half of Lap-Band patients reported that they’d stopped high-risk drinking. Further, at two years after surgery, half of gastric bypass and more than half of Lap-Band patients reported this improvement.

In contrast to these findings, earlier studies have pointed to the potential for increased risk of alcohol misuse after weight loss surgery, with most theories indicating a lower alcohol tolerance and a longer time to return to a sober state after surgery. The study authors hypothesize that previous studies may have missed this positive effect because post-surgery alcohol use wasn’t compared against baseline drinking behavior.

The study did, however, find that some patients increased alcohol usage after surgery; seven percent of patients who did not report high-risk drinking at baseline, reported new high-risk drinking at years one and two after surgery. These findings were similar between band and bypass patients.

More research is necessary to understand why weight loss surgery seems to help some patients improve alcohol misuse, while it increases misuse in others. It’s important to better understand which patients are at highest risk for developing alcohol misuse so that they can be properly counseled and monitored throughout the surgery process.

“I am happy to see this article,” said Dr. Adam B. Smith, bariatric surgeon at Fort Worth Lap-Band.  “It seems we as physicians are sometimes too eager to jump to assumptions regarding the behavior of our patients and frequently the assumption is to blame the patient. In my experience, the weight loss surgery patient is at no different risk for bad decision-making than a similar non-surgical patient. In fact, with an aggressive support program we have the opportunity to identify and intervene before the problem becomes severe.”

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