Bariatric surgery significantly linked with increased alcohol use and abuse

Bariatric surgery significantly linked with increased levels of alcohol use and abuse is finding of a meta-analysis.Bariatric surgery is associated with improvement of obesity related co-morbidities but some studies suggest that these patients may be susceptible to alcohol abuse due to alteration in metabolism.

Dr.Praneet Wander and associates conducted the study to assess the impact of bariatric surgery on high risk alcohol use in a meta-analysis of the published data of 28 studies involving nearly 16,000 patients and found that patients showed a statistically significant 8% higher rate of new-onset alcohol abuse, and a relative 50% increased rate of significant alcohol use, compared with rates before surgery.

Following any of several methods of bariatric surgery, patients showed a statistically significant 8% higher rate of new-onset alcohol abuse, and a relative 50% increased the rate of significant alcohol use, compared with rates before surgery, Prandeet Wander, MD, said at the World Congress of Gastroenterology at ACG 2017.

The findings suggest that “after bariatric surgery, patients require close follow-up and evaluation for psychiatric illness and substance abuse,” said Dr. Wander, a gastroenterology fellow at North Shore LIJ Hospital in Manhasset, N.Y. In addition, “screening for high-risk behaviors may help with better patient selection” for bariatric surgery, she suggested.

Her meta-analysis identified prospective, retrospective, and cross-sectional studies of alcohol use that included more than 100 bariatric surgery patients and that had follow-up beyond 1 year. Patients could have undergone Roux-en-Y gastric bypass, sleeve gastrectomy, or laparoscopic adjustable gastric banding. Comparator populations had to be either the surgery patients prior to the procedure or the controls matched by age and body mass index.

Nineteen of the studies examined the prevalence of “significant alcohol abuse” following surgery in a total of 4,552 patients, with 23% of patients overall showing this behavior. Five studies, involving 2,698 patients, documented the rate of new-onset alcohol abuse after surgery, with an overall rate of 8% that was statistically significant. All five studies individually showed the increased incidence of alcohol abuse, with rates that ranged from 4% to 8%.

None of the 28 included studies had a randomized control arm, and the studies collectively ran in six countries, including the United States, and hence involved different societal norms of alcohol use. Changes in alcohol absorption and metabolism following bariatric surgery may play roles in the observed effects, as might undiagnosed depression or substance use by patients who undergo this surgery, Dr. Wander suggested.