Alcohol use disorder risk higher for teens who undergo metabolic, bariatric surgery
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Nearly half of adolescent patients who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy had increased alcohol use and were at risk for alcohol-related harm and problems within 8 years of surgery, according to study results.
“We undertook this investigation for two reasons: First, literature suggests that adults who undergo Roux-en-Y gastric bypass and vertical sleeve gastrectomy are at increased risk for alcohol use disorders,” Gretchen E. White, PhD, assistant professor of medicine, epidemiology and clinical and translational science at the University of Pittsburgh School of Medicine, told Healio. “Second, alcohol is the most widely abused substance for American youth and alcohol use is often initiated during adolescence.”
She continued, “Because of this, we felt that it was critically important to understand alcohol use and alcohol-related problems longer term following Roux-en-Y gastric bypass and vertical sleeve gastrectomy in adolescence.”
In a prospective cohort study published in Annals of Surgery, White and colleagues analyzed 217 patients (median age, 17 years; median BMI, 51 kg/m2; 76% women) who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy from 2007 to 2011. Participants completed alcohol-use questionnaires preoperatively and every year postoperatively for up to 8 years.
Researchers analyzed time to elevated Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score, alcohol-related harm and alcohol-related problems to determine cumulative incidence estimates. They collected data within 30 days preoperatively, 6 months postoperatively and annually thereafter, with data obtained from 88% of the population at 6 months and 80% of the population at 8 years.
Study results showed an increase in frequency and average number of drinks per day at 6 months (2% consumed alcohol 2-4 times/month and 2% consumed 3 drinks/day) and 8 years (24% and 35%) postoperatively. The prevalence of elevated AUDIT-C score also increased from 6 months to 8 years (3% [95% CI, 1-6] vs. 25% [95% CI, 19-31]), as did symptoms of alcohol-related harm (2% [95% CI, 0-3] vs. 16% [95% CI, 10-22]) and alcohol-related problems (2% [95% CI, 0-3] vs. 19% [95% CI, 13-25]).
“Nearly half of this cohort had postoperative onset of a positive screening test for alcohol use disorder (45%), alcohol-related harm (43%) or alcohol-related problems (47%) within 8 years following surgery,” White said. “The most important take-away from this research regarding patient care is that providers prioritize postoperative routine screening for alcohol use, particularly in order to identify safety concerns and provide referral for treatment.”
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