U.S. Department of Health and Human Services

Weight-loss Surgery Increases Risk for Alcohol Use Disorders Over Time

A recent study showed that adults who had Roux-en-Y gastric bypass (RYGB) bariatric surgery to lose weight had a significantly higher risk of alcohol use disorders (AUD) 2 years after surgery compared with before surgery. Researchers investigated alcohol consumption and AUD symptoms in 1,945 participants from the Longitudinal Assessment of Bariatric Surgery (LABS), a prospective study of patients undergoing weight-loss surgery at one of 10 different hospitals across the United States. Within 30 days before surgery and again 1 and 2 years after surgery, study participants completed the Alcohol Use Disorders Identification Test (AUDIT), a validated and reliable alcohol use screening method, to identify symptoms of AUD. Study participants were categorized as having AUD if they were positive for at least one symptom of alcohol dependence or alcohol-related harm, or if their total AUDIT score was at least 8 (out of 40). Among participants who had the RYGB procedure, 7.0 percent reported symptoms of AUD prior to surgery. There was no significant increase in AUD 1 year after surgery. However, by the second postoperative year, 10.7 percent of patients reported symptoms of AUD, a relative increase of more than 50 percent compared to pre-surgical rates. Patients who underwent another common type of weight-loss surgery, laparoscopic adjustable gastric banding (LAGB), did not report an increase in symptoms of AUD. About 70 percent of the study participants had RYGB surgery, another 25 percent had LAGB surgery, and about 5 percent of the patients had other, less common weight loss surgeries. AUD prior to surgery was one of the strongest predictors of postoperative AUD, although more than half of the study participants with AUD after surgery did not report having the condition during the year before surgery. In addition, patients with less social support or who reported preoperative recreational drug use or smoking were more likely to report symptoms of AUD after surgery. Men and younger adults were also more likely to develop AUD. Depressive symptoms, mental health treatment, and binge eating prior to surgery were not independently related to an increased likelihood of AUD after surgery. The study results suggest that clinicians should be aware of the importance of monitoring for signs and symptoms of AUD and consider counseling after bariatric surgery, particularly in patients who undergo gastric bypass.
King WC, Chen J-Y, Mitchell JE, et al. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA 307: 2516-2525, 2012