Weight-loss surgery can improve health issues such as diabetes, pain, and high blood pressure for those with obesity. However, a new study reveals that the procedure can increase the risk of alcohol use disorder by changing alcohol metabolism. Gastric bypass surgery, in particular, may increase the risk of excessive drinking more than other weight-loss methods.
Dr. Chika Anekwe, an obesity medicine expert at the Massachusetts General Hospital Weight Center affiliated with Harvard, states that the risk of alcohol-related issues after weight-loss surgery is recognized. Hence, they mandate patients refrain from drinking alcohol for six months to a year before surgery. She says the recent study’s results are intriguing and reasonable based on the surgical procedures’ biological distinctions.
Weight-loss surgeries considerably decrease stomach size. For instance, a sleeve gastrectomy involves the removal of around 80% of the stomach, leaving behind a tube that looks like a banana. Meanwhile, the upper abdomen is transformed into a small pouch the size of an egg for a gastric bypass. The procedure is known as bypass since a large proportion of the stomach, the small intestine’s first part, and the pylorus are bypassed.
Notably, weight-loss surgery lowers the amount of alcohol dehydrogenase enzyme available in the stomach lining, leading to a higher dose of unmetabolized alcohol when drinking. Most alcohol is absorbed into the bloodstream from the small intestine, but the pyloric valve slows the process for those who undergo sleeve gastrectomy.
However, Dr. Anekwe notes that with gastric bypass, the small intestine is rerouted and attaches to the small stomach pouch, bypassing the pyloric valve entirely, causing extra-high blood alcohol levels that may increase the risk of alcohol use disorders. AUDs can lead to alcohol-related hepatitis, alcohol gastritis, alcohol cardiomyopathy, and alcohol-induced pancreatitis.
Therefore, it is recommended that individuals that undergo weight loss surgery should avoid alcohol for up to a year, and after, they can occasionally drink. In addition, study authors warn that individuals that have undergone surgery are at risk of hospitalizations for AUDs.