Weight-loss surgery can significantly improve or reverse several serious health conditions, including pain, high blood pressure, and diabetes, in obese people. However, these operations also alter how the body processes alcohol, making people more susceptible to developing an alcohol use disorder. According to a recent study, gastric bypass surgery may make drinking significantly riskier than other weight-loss methods.
"There is a stated risk of alcohol-related issues following weight-loss surgery." Given the variations in the operations, the new findings are intriguing and make biological sense.
How does alcohol absorption change after weight-loss surgery?
Surgery to lose weight significantly shrinks the stomach.
The surgeon removes around 80% of the stomach during the most common treatment, the sleeve gastrectomy, leaving a banana-shaped tube behind.
A surgeon creates an egg-shaped pouch out of the upper stomach during a gastric bypass. The majority of the stomach, the pylorus, the valve separating the stomach from the small intestine, and the first segment of the small intestine are all bypassed during this treatment, which is why it is termed a bypass.
An enzyme that degrades alcohol is found in the stomach's lining. It is called alcohol dehydrogenase. The amount of this enzyme available to people decreases after weight-loss surgery. They will therefore receive a greater dose of unmetabolized alcohol if they drink wine, beer, or spirits. A small amount of alcohol enters the small intestine before entering the bloodstream, but the majority travels there first.
The pyloric valve still delays the flow of alcohol from the smaller stomach to the small intestine after a sleeve gastrectomy. In contrast, a gastric bypass completely avoids the pyloric valve by having the surgeon reroute the small intestine and connect it to the little stomach pouch. Drinking alcohol following a gastric bypass can therefore result in abnormally high blood alcohol levels. That causes people to feel drunk faster and may increase their chance of developing alcohol use problems.
Results of the investigation into alcohol and weight loss surgery
Nearly 7,700 patients (mainly men) who received obesity treatment between 2008 and 2021 from 127 Veterans Health Administration facilities were included in the study. The majority underwent a sleeve gastrectomy. Nearly a quarter had gastric bypass surgery. MOVE!, a programme that promotes increased physical activity and a healthy diet, was recommended to another 18% of participants.
After controlling for body mass index and alcohol consumption, researchers discovered that participants who underwent gastric bypass were 70% more likely than those who completed the MOVE! programme to be hospitalised for alcohol-related reasons and 98% more likely than those who underwent sleeve gastrectomy. There was no difference in the rate of alcohol-related hospitalisations between individuals who underwent sleeve gastrectomy and those who completed the MOVE! programme.
The negative effects of alcoholism on health
Multiple health issues can result from alcohol use disorders. Alcoholic gastroenteritis, hepatitis brought on by alcohol, pancreatitis brought on by alcohol, and alcoholic cardiomyopathy are a few that call for hospitalisation. Even though they consumed the least amount of alcohol compared to the other trial participants, people who had gastric bypass surgery had a higher probability of being hospitalised for an alcohol use problem. This implies that the findings are most likely explained by a shift in alcohol metabolism brought on by the surgery.
Advice about alcohol if you've had or are considering weight-loss surgery
Dr. Anekwe states, "We advise people to entirely abstain from alcohol following any kind of weight-loss surgery. She continues, adding that a year after surgery, an occasional drink is acceptable and that the majority of the people she meets are not bothered by this restriction.
Those who have weight-loss surgery must be careful about everything they eat to make sure they obtain enough of the essential nutrients. Alcohol lacks nutrients, much like sugary drinks, which is another reason to avoid it.
Over the past ten years, the popularity of gastric bypass has decreased relative to sleeve gastrectomy, primarily because of its increased invasiveness and marginally higher risk. Despite the fact that the new study identifies yet another drawback of gastric bypass, Dr. Anekwe maintains that it can still be a good option for those with extreme obesity, as bypass results in greater weight loss and better blood sugar control than sleeve surgery.
"There is a stated risk of alcohol-related issues following weight-loss surgery." Given the variations in the operations, the new findings are intriguing and make biological sense.
How does alcohol absorption change after weight-loss surgery?
Surgery to lose weight significantly shrinks the stomach.
The surgeon removes around 80% of the stomach during the most common treatment, the sleeve gastrectomy, leaving a banana-shaped tube behind.
A surgeon creates an egg-shaped pouch out of the upper stomach during a gastric bypass. The majority of the stomach, the pylorus, the valve separating the stomach from the small intestine, and the first segment of the small intestine are all bypassed during this treatment, which is why it is termed a bypass.
An enzyme that degrades alcohol is found in the stomach's lining. It is called alcohol dehydrogenase. The amount of this enzyme available to people decreases after weight-loss surgery. They will therefore receive a greater dose of unmetabolized alcohol if they drink wine, beer, or spirits. A small amount of alcohol enters the small intestine before entering the bloodstream, but the majority travels there first.
The pyloric valve still delays the flow of alcohol from the smaller stomach to the small intestine after a sleeve gastrectomy. In contrast, a gastric bypass completely avoids the pyloric valve by having the surgeon reroute the small intestine and connect it to the little stomach pouch. Drinking alcohol following a gastric bypass can therefore result in abnormally high blood alcohol levels. That causes people to feel drunk faster and may increase their chance of developing alcohol use problems.
Results of the investigation into alcohol and weight loss surgery
Nearly 7,700 patients (mainly men) who received obesity treatment between 2008 and 2021 from 127 Veterans Health Administration facilities were included in the study. The majority underwent a sleeve gastrectomy. Nearly a quarter had gastric bypass surgery. MOVE!, a programme that promotes increased physical activity and a healthy diet, was recommended to another 18% of participants.
After controlling for body mass index and alcohol consumption, researchers discovered that participants who underwent gastric bypass were 70% more likely than those who completed the MOVE! programme to be hospitalised for alcohol-related reasons and 98% more likely than those who underwent sleeve gastrectomy. There was no difference in the rate of alcohol-related hospitalisations between individuals who underwent sleeve gastrectomy and those who completed the MOVE! programme.
The negative effects of alcoholism on health
Multiple health issues can result from alcohol use disorders. Alcoholic gastroenteritis, hepatitis brought on by alcohol, pancreatitis brought on by alcohol, and alcoholic cardiomyopathy are a few that call for hospitalisation. Even though they consumed the least amount of alcohol compared to the other trial participants, people who had gastric bypass surgery had a higher probability of being hospitalised for an alcohol use problem. This implies that the findings are most likely explained by a shift in alcohol metabolism brought on by the surgery.
Advice about alcohol if you've had or are considering weight-loss surgery
Dr. Anekwe states, "We advise people to entirely abstain from alcohol following any kind of weight-loss surgery. She continues, adding that a year after surgery, an occasional drink is acceptable and that the majority of the people she meets are not bothered by this restriction.
Those who have weight-loss surgery must be careful about everything they eat to make sure they obtain enough of the essential nutrients. Alcohol lacks nutrients, much like sugary drinks, which is another reason to avoid it.
Over the past ten years, the popularity of gastric bypass has decreased relative to sleeve gastrectomy, primarily because of its increased invasiveness and marginally higher risk. Despite the fact that the new study identifies yet another drawback of gastric bypass, Dr. Anekwe maintains that it can still be a good option for those with extreme obesity, as bypass results in greater weight loss and better blood sugar control than sleeve surgery.
