Gastric bypass weight-loss surgery increases risk of alcoholism, study says

Gastric bypass surgery for weight loss doubles the risk of developing alcoholism compared with Lap-Band surgery, Swedish researchers reported Monday. Researchers already knew that bypass surgery allows the body to absorb alcohol quicker, but the new findings, reported at the Digestive Diseases Week meeting in Chicago, are the first to suggest an increased risk of problems associated with the effect.

Dr. Magdalena Plecka Ostlund of the Karolinska Institutet in Stockholm and her colleagues examined medical records for 12,277 patients who underwent bariatric surgery in Sweden between 1980 and 2006. The patients had a mean age of just under 40 and three-quarters of them were female. The team compared them with 122,770 carefully matched healthy controls in the general population. Prior to their surgery, the obese patients were significantly more likely than those in the general population to be treated for psychosis, depression, attempted suicide and alcoholism. After the surgery, the risks of the various disorders remained higher than normal, with the exception of psychosis, Ostlund said.

After the surgery, however, the risk of developing alcoholism among the patients who underwent Roux-en-Y surgery, commonly known as gastric bypass, was 2.3 times higher than in the group who underwent Lap-Band surgery. The Roux-en-Y procedure creates a smaller stomach pouch and bypasses part of the intestines. The Lap-Band procedure, in contrast, involves placing an inflatable silicone band around the stomach to restrict food intake, but food continues to pass through the entire stomach.

An earlier version of this post said the Lap-Band procedure involves placing an inflatable silicon band around the stomach to restrict food intake. As this corrected version notes, the band is made of silicone.

Dr. John Morton, a bariatric surgeon at the Stanford School of Medicine, noted that alcohol is normally at least partially metabolized in the stomach by enzymes there. When a patient has a gastric bypass, this digestion does not occur and the alcohol reaches the intestines largely intact. The finger-like structures called villi on the interior surface of the intestines absorb alcohol extremely well, so that the drug reaches high concentrations in the blood more quickly. “A single glass of red wine can make a bypass patient legally intoxicated regardless of weight loss,” Morton said.


Researchers are not sure, however, how that increased absorption may increase the risk of alcoholism. Nonetheless, patients undergoing the surgery should be counseled to limit their consumption of alcohol. “They shouldn’t drink as much and they shouldn’t drink and drive afterwards,” Morton said.