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Alcohol use disorders prevalent following bariatric surgery
Alcohol use disorders increased in prevalence 2 years following bariatric surgery compared with 1 year prior to and 1 year after the procedure in a recent study.
In a prospective cohort study, researchers evaluated 1,945 patients who received bariatric surgery at 10 hospitals throughout the United States between February 2006 and February 2009. Of these participants, 1,763 also received 1-year postoperative assessments and 1,582 2-year postoperative assessments between 2006 and 2011. The study was designed to assess the presence of alcohol use disorders (AUD) before and after surgery and to establish potential predictors for postoperative AUD. AUD symptoms were measured according to the Alcohol Use Disorders Identification Test (AUDIT).
Symptoms of AUD were not significantly different from 1 year prior (7.6% of patients) to 1 year after (7.3%) bariatric surgery (P=.98), but increased significantly by the second postoperative year (9.6%, P=.01 compared with preoperative and 1-year postoperative assessment). AUDIT scores also were significantly higher at the 2-year assessment, with 5.5% scoring 8 or more compared with 2.6% at preoperative and 3.1% at 1-year postoperative assessments (P<.001 for both).
The majority of patients (62.3%) who reported AUD symptoms at preoperative assessment continued to have or had recurrent AUD symptoms at the 2-year assessment (95% CI, 53.0%-71.5%), compared with 7.9% of patients with postoperative AUD who did not report symptoms at preoperative assessment (95% CI, 6.4%-9.4%).
Investigators associated an increased risk for AUD after surgery with male sex (adjusted OR=2.14; 95% CI, 1.51-3.01), smoking (AOR=2.58; 95% CI, 1.19-5.58), regular alcohol consumption of two drinks or more per week (AOR=6.37; 95% CI, 4.17-9.72), recreational drug use (AOR=2.38; 95% CI, 1.37-4.14) and undergoing Roux-en-Y gastric bypass (RYGB) as opposed to a laparoscopic adjustable gastric band procedure (AOR=2.07; 95% CI, 1.40-3.08), among others.
“This study has important implications for the care of patients who undergo bariatric surgery,” the researchers wrote. “Regardless of alcohol history, patients should be educated about the potential effects of bariatric surgery, in particular RYGB, to increase the risk of AUD. … Further research should examine the long-term effect of bariatric surgery on AUD, and the relationship of AUD to postoperative weight control.”