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Gastric bypass and alcohol: mix with caution

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Alcohol can be a minefield for anyone trying to lose weight. But for bariatric surgery patients, drinking can become increasingly problematic, a new study has found.

Changes in the way the body absorbs and metabolizes alcohol after WebMD’s Roux en Y description” href=”https://www.webmd.com/diet/weight-loss-surgery/gastric-bypass” target=”_self”>gastric bypass mean these patients need less alcohol to register intoxication on a breathalyzer, says a study published recently in the Journal of the American College of Surgeons. After drinking a single 5-ounce glass of red wine before their surgery, the study’s 19 subjects had an average NIH breath alcohol content page” href=”https://www.nlm.nih.gov/medlineplus/ency/article/003632.htm” target=”_blank”>breath alcohol content of .024% -- well below the level at which most states consider a driver intoxicated.

Three months after surgery, the same glass of red wine resulted in an average breath alcohol content of .059%, and six months post-surgery, the group averaged .088%, which surpasses the .08% widely recognized as the legal threshold for intoxication.

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It also took longer for patients to return to complete sobriety in the wake of that drink: Pre-operation, it took subjects 49 minutes to return to complete sobriety after a glass of wine; three months after the operation, it took 61 minutes for that to happen, and six months after surgery, it took 88 minutes.

The study -- the first to compare the same group of subjects pre- and post-surgery -- found a potentially insidious change, as well, in how patients experienced alcohol consumption. Before surgery, 58% reported a feeling of euphoria after a glass of wine -- a number that shot up to 88% at three months post-surgery, and then dropped to 50% at six months on. Sensations of dizziness and warmth -- rare before surgery -- were commonly reported six months after. At that point, one in four subjects also reported experiencing double-vision after drinking a glass of wine--a sensation none reported before.

The researchers, from Stanford University School of Medicine, expressed concern that bariatric surgery patients’ different experience of alcohol consumption might result in confusing signals. “Patients feel different effects of alcohol intoxication postoperatively, and this can lead to over-indulgence to achieve the same symptoms of intoxication that they experienced before surgery,” the study’s authors wrote.

There are lots of reason to forgo alcohol in the wake of a gastric bypass the authors warned: Bariatric patients that have unresolved binge-eating issues, in particular, are at risk of “transferring” their food addiction to other substances, including alcohol. And even those without such issues raise their risk of weight regain after surgery, and of deficiencies in thiamine (vitamin B-1).

After obesity surgery, patients should never drink and drive, wrote the authors. They should also limit their alcohol consumption to a maximum of 1 unit of alcohol (a 5-ounce glass of wine, 12-ounce beer, or 2-ounce serving of distilled alcohol) in any two-hour period.

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