High-Risk Drinking Drops After Weight Loss Surgery

Weight loss surgery is the common term for a group of surgical procedures that change the structure of the digestive system and thereby help people affected by serious weight-related issues reduce their food intake. In a study published in January 2014 in the journal Surgery for Obesity and Related Diseases, researchers from several U.S. institutions examined the impact that undergoing a weight loss procedure can have on participation in risky drinking behaviors associated with the onset of alcohol abuse or alcoholism. These researchers found that most weight loss surgery recipients decrease their involvement in risky drinking.

The Basics

Weight loss surgery is known more formally as bariatric surgery. Bariatric procedures performed in the U.S. include adjustable gastric band surgery, vertical sleeve gastrectomy, Roux-en-Y gastric bypass surgery and biliopancreatic diversion with a duodenal switch (BPD-DS). In adjustable gastric band surgery, surgeons implant an adjustable ring that controls the width of the entrance to the stomach. During vertical sleeve gastrectomy, surgeons remove most of the tissue that makes up the stomach. A Roux-en-Y gastric bypass involves the diversion of the digestive tract around the stomach and directly into the small intestine. BPD-DS is a multi-part procedure that involves both a vertical sleeve gastrectomy and a diversion around part of the small intestine. As a rule, doctors only consider recommending bariatric surgery for people who qualify as obese or extremely obese, have already reached their maximum height and have a serious weight-related illness known to potentially benefit from a weight loss procedure.

Risky Drinking

When kept within limits, alcohol consumption does not typically lead to increased risks for diagnosable cases of alcohol abuse or alcoholism (grouped together under current guidelines as alcohol use disorder). Public health officials set both daily and weekly upper limits on relatively harmless alcohol intake. Men reach these upper limits when they consume four drinks on a single day or 14 drinks in a single week. Women reach the upper limits of relatively safe alcohol intake when they consume three drinks on a single day or seven drinks in a single week. People who exceed these daily or weekly totals qualify as participants in risky drinking or heavy drinking. About 20 percent of individuals who only participate in heavy drinking once monthly will develop alcohol use disorder at some point in time. About 33 percent of people who drink heavily once weekly will eventually be diagnosed with the disorder. In people who participate in heavy drinking two times or more per week, the alcohol use disorder rate rises to 50 percent.

The Impact of Weight Loss Surgery

In the study published in Surgery for Obesity and Related Diseases, researchers from Harvard Medical School, Harvard-affiliated Beth Israel Deaconess Medical Center, Boston Medical Center and the University of Massachusetts, Boston used an assessment of 541 recipients of weight loss surgery to explore the connection between bariatric procedures and increasing or decreasing chances of participating in risky drinking. All of the surgery recipients submitted detailed information on their drinking behaviors before undergoing their procedures. One year later, over two-thirds (69 percent) of the surgery recipients again submitted information on their drinking behaviors. In addition, 63 percent of the surgery recipients submitted information on their drinking behaviors two years after undergoing their procedures.

After analyzing all of the gathered data, the researchers found that over 50 percent of the study participants who drank heavily before undergoing weight loss surgery no longer drank heavily at the one-year follow-up or the two-year follow-up. Conversely, 7 percent of the participants reported new involvement in heavy drinking at the one-year follow-up; in addition, 6 percent of the participants reported new heavy drinking involvement at the two-year follow-up. The researchers concluded that people who undergo gastric bypass surgery have a greater chance of reducing their involvement in risky drinking than people who undergo gastric band surgery. However, they did not view the differences in the drinking-related outcomes between the two procedures as statistically meaningful.

Significance and Considerations

The authors of the study published in Surgery for Obesity and Related Diseases used a modified form of a standard test called AUDIT-C (Alcohol Use Disorders Identification Test-Consumption) to uncover the presence of risky drinking behaviors before and after the study participants underwent weight loss surgery. Despite the small number of surgery recipients who began drinking riskily after a bariatric procedure, the authors emphasize the positive effects on risky alcohol intake experienced by most of the surgery recipients.