A recent study in the Journal of the American Medical Association discovered a disturbing link between bariatric surgery and an increase in alcohol use disorders. Following 1,945 participants over a three year span, Dr. Wendy King and fellow researchers were able to find a direct link between an increase in alcohol use following gastric surgery.

The majority of patients (1,360) had the Roux-en-Y gastric bypass, a second large group (490) had a laparoscopic adjustable gastric band operation; remaining patients had various other procedures. The study researchers discovered a 2.0% increase (7.6% before surgery to 9.6% two years post surgery) in alcohol abuse. The study further found that patients undergoing Roux-in-Y surgery were twice as likely to abuse alcohol compared to other bariatric procedures. Even more mysterious was the discovery that this increase happened two years post surgery as the levels of alcohol use were relatively the same one year before and one year post surgery.

This study raises many questions, one of which is should a screening for a history of alcohol use be a factor in determining what type of surgery would most benefit the patient? According to Robin Blackstone, president of the American Society for Metabolic & Bariatric Surgery, in an interview with WebMD, due to the bypass procedure alcohol doesn’t get metabolized normally.

But, why would surgery affect the alcohol use of a person who did not have a history of alcohol abuse (60.5% reported no prior alcohol abuse problems before surgery)? Scientists know one side effect of bariatric surgery is the effect on metabolism, but it may also be affecting areas of the brain as well. A team of researchers (including James Mitchell, co-author on the JAMA study) met in July at the Radcliffe Institute for Advanced Study to discuss the issues of obesity, surgery and addiction, and to look at the possibility that the surgery affects the parts of the brain that deal with addiction.

I anxiously await the outcome of the Radcliffe meeting and further studies on this mystery. I hope there are follow up studies looking at links between surgical procedures and other addictive behaviors.

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