Among patients who underwent bariatric surgery, there was a higher prevalence of alcohol use disorders in the second year after surgery, and specifically after Roux-en-Y gastric bypass, compared with the years immediately before and following surgery, according to a study in the June 20 issue of JAMA. This study is being published early online to coincide with its presentation at the annual meeting of the American Society for Metabolic and Bariatric Surgery.
"As the prevalence of severe obesity increases in the United States, it is becoming increasingly common for health care providers and their patients to consider bariatric surgery, which is the most effective and durable treatment for severe obesity. Although bariatric surgery may reduce long-term mortality, and it carries a low risk of short-term serious adverse outcomes, safety concerns remain. Anecdotal reports suggest that bariatric surgery may increase the risk for alcohol use disorders (AUD; i.e., alcohol abuse and dependence)," according to background information in the article.
The authors add that there is evidence that some bariatric surgical procedures (i.e., Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy) alter the pharmacokinetics of alcohol. "Given a standardized quantity of alcohol, patients reach a higher peak alcohol level after surgery compared with case-controls or their preoperative levels."
Wendy C. King, Ph.D., of the University of Pittsburgh, and colleagues conducted a study to determine whether the prevalence of AUD changed following bariatric surgery, comparing reported AUD in the year prior to surgery with the first and second years after surgery. The prospective study included 2,458 adults who underwent bariatric surgery at 10 U.S. hospitals. Of these participants, 1,945 (78.8 percent female; 87 percent white; median [midpoint] age, 47 years; median body mass index, 45.8) completed preoperative and postoperative (at 1 year and/or 2 years) assessments between 2006 and 2011. The primary outcome measure for the study was past year AUD symptoms determined with the Alcohol Use Disorders Identification Test (AUDIT) (indication of alcohol-related harm, alcohol dependence symptoms, or score 8 or greater).
The researchers found that the prevalence of AUD symptoms did not significantly differ from 1 year before to 1 year after bariatric surgery (7.6 percent vs. 7.3 percent), but was significantly higher in the second postoperative year (9.6 percent). Frequency of alcohol consumption and AUD significantly increased in the second postoperative year compared with the year prior to surgery or the first postoperative year.