Obesity, Addiction, Alcohol and Bariatric Surgery Part I
>> Saturday, August 26, 2017
We know that the factors behind each individual's struggle with obesity are unique, with a long list of physiologic, psychological, and environmental factors as potential contributors. We are also learning increasingly that there are many areas of neurophysiologic, psychological and behavioural overlap in the realms of obesity and addiction. A recent review draws on our knowledge of alcohol use after bariatric surgery to help us understand these connections.
After gastric bypass surgery:
- 9.4% of patients who have had gastric bypass surgery report a period of excessive alcohol intake at some point after surgery
- 7% of patients with no preoperative history of excessive alcohol intake develop a problem after surgery
- middle aged females seem to be at higher risk
- post bariatric surgery addiction problems seem to be fairly specific to alcohol (though addictions to other substances, or activities such as gambling are also seen - see 'addiction transference' below)
- when a person who has had gastric bypass surgery drinks alcohol, there is a faster rise, higher peak, and longer duration of blood alcohol levels
Interestingly, some people who were frequent alcohol consumers before surgery actually have a decreased enjoyment of alcohol after surgery, which may be mediated by an increase in the gut hormone GLP-1, and a decrease in the hunger hormone ghrelin.
Psychological and social factors can also have a big influence on alcohol consumption after surgery. As blogged previously, food addiction seeking a new outlet (called 'addiction transference') may be a factor for some people. A need for a coping mechanism as a person watches their body change after surgery may be involved. Some may reach for alcohol as a way to manage the complex psychological issues that can arise after surgery.
Stay tuned for the next blog post, where I'll discuss some of the parallels between obesity and addiction discussed in this review.
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