Researchers believe gastric bypass surgery also changes how the body digests and metabolizes alcohol; some people who've had the surgery say they feel alcohol's effects much more quickly after drinking less, compared to before the procedure. For the study, published online June 18 in the Journal of the American Medical Association, researchers asked about 1,950 men and women who had various kinds of obesity surgery at 10 centers nationwide about their drinking habits one year before their operations, versus one and two years afterward. More than two-thirds of patients had gastric bypass surgery and were most at risk, the study showed. By contrast, about 5 percent of patients who had stomach-banding obesity surgery drank excessively two years later, similar to the pre-surgery numbers. The Centers for Disease Control and Prevention says excessive drinking is associated with chronic diseases such as cirrhosis of the liver, pancreatitis, cancers of the liver, mouth, throat and esophagus - in addition to psychological disorders, and an elevated risk for accidental injuries and violence.
Patients should be screened for alcohol problems before and after surgery and told about the risks, said study author Dr. Blackstone said obese people are often socially isolated because of their weight, and that drinking often increases when patients have slimmed down and pursue a more active social life.
Patients seeking obesity surgery often undergo psychological evaluations to make sure they are stable enough to handle the operation and life changes afterward. Last year, a Swedish studythat monitored 12,000 patients who underwent gastric bypass over a 25-year period found gastric bypass patients were twice as likely to enter an alcohol treatment program compared with people who underwent other types of weight-loss surgeries such as gastric banding. Fancy living somewhere with low taxes, affordable real estate and a reasonable cost of living?
Most didn't drink excessively before or after surgery, and increases in drinking didn't occur until two years post-surgery.
Two years after the surgery, almost 11 percent, or 103 of 996 bypass patients, had drinking problems, a 50 percent increase from before surgery. Stomach banding is a reversible procedure in which an adjustable band is placed around the stomach to decrease the amount of food it can hold. Gastric bypass, also called stomach-stapling, is the most common and generally results in more weight loss than other methods. Wendy King, an assistant professor at the University of Pittsburgh's graduate school of public health.
Robin Blackstone, president of the American Society for Metabolic and Bariatric Surgery, said the results echo findings smaller studies and clearly show an alcohol-related risk from gastric bypass surgery.
She said many doctors routinely warn patients that they may be more sensitive to alcohol, and the study reinforces that advice.
Guidelines recommend against the surgery for people with substance abuse problems including excessive drinking, said psychologist Leslie Heinberg, director of behavioral services for Cleveland Clinic's bariatric and metabolic institute. Two years after surgery, these problems were more common in gastric bypass patients, and in men, young adults and smokers after either type of surgery. The study authors say their results suggest that an additional 2,000 people each year will develop drinking problems because of obesity surgery. The benefits of gastric bypass surgery include sometimes reducing diabetes and heart disease risks.
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