Alcohol and Other Addictive Disorders Following Bariatric Surgery: Prevalence, Risk Factors and Possible Etiologies

Oct 10, 2015European eating disorders review : the journal of the Eating Disorders Association

Alcohol and Other Addictions After Weight Loss Surgery: How Common They Are, Risk Factors, and Possible Causes

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Abstract

A significant minority of patients may develop new-onset alcohol use disorders (AUDs) following bariatric surgery.

Bariatric surgery is the most effective intervention for sustained weight loss in obese individuals.
Improvements in obesity-related health issues are common, but some patients experience less optimal results.
Roux-en-Y gastric bypass (RYGB) is associated with an increased risk of developing AUDs, unlike laparoscopic adjustable gastric banding.
The concept of 'addiction transfer' suggests patients may replace food addiction with alcohol addiction after surgery.
Animal studies indicate a neurobiological basis for heightened alcohol reward following RYGB.
Pharmacokinetic studies reveal significantly increased peak alcohol concentrations after RYGB.

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Bariatric surgery is currently the most effective intervention for significant and sustained weight loss in obese individuals. While patients often realize numerous improvements in obesity-related comorbidities and health-related quality of life, a small minority of patients have less optimal outcomes following bariatric surgery. The literature on the emergence of alcohol use disorders (AUDs) following bariatric surgery has grown in the past several years and collectively provides convincing evidence that a significant minority of patients develop new-onset AUDs following bariatric surgery. Rouxen-Y gastric bypass (RYGB) has generally been associated with the risk of developing an AUD, while laparoscopic adjustable gastric banding generally has not, in several large studies. One theory that has been discussed at some length is the idea of 'addiction transfer' wherein patients substitute one 'addiction' (food) for a new 'addiction' (alcohol) following surgery. Animal work suggests a neurobiological basis for increased alcohol reward following RYGB. In addition, several pharmacokinetic studies have shown rapid and dramatically increased peak alcohol concentrations following RYGB. The prevalence of alcohol and other addictive disorders and potential etiological contributors to post-operative AUDs will be explored.

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Alcohol and Other Addictive Disorders Following Bariatric Surgery: Prevalence, Risk Factors and Possible Etiologies

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