The final issue that I talk to prospective Gastric Bypass patients about is the development of Alcoholism after surgery.  For a long time, most of us described the increased rate of alcoholism after Gastric Bypass surgery as the result of a “transfer addiction.”  The belief was that because the surgery minimized a person’s ability to indulge their food addiction, they sought out other substances, like alcohol.  However, as our understanding of these surgeries evolved, we began to recognize that the transfer addiction model did not fully explain the increased rate of alcoholism.  First, we determined that we were not seeing increased rates of addiction to other drugs, only alcohol.  Also, post operative patients were reporting that their body’s response to alcohol changed after surgery.  While we were seeing this after both Sleeve Gastrectomy and Gastric Bypass, it appeared more pronounced after Gastric Bypass surgery.

Patients after both procedure reported that they became more intoxicated after drinking less alcohol than they did before surgery.  They also reported that the intoxication lasted longer.  When we examined alcohol levels in postoperative patients, we found that their absorption pattern differed from those who have not had surgery.  We found that alcohol levels increased faster, went higher and stayed high for longer, supporting the patient’s’ reports.  

These results were profound in some patients, while others experienced less sensitivity.  In many female patients, we found that a single alcoholic beverage caused them to develop blood alcohol levels over the legal limit for driving.  Male patients required slightly more, exceeding the driving limit after one and half to two beverages.

It’s very difficult to determine the exact rate of the development of new alcohol problems after surgery, however, our best estimate is that between 3%-5% of all Gastric Bypass patients will develop a new alcohol use problem after surgery.  This is a very important statistic for anyone considering Gastric Bypass surgery to take seriously.  The change in your alcohol absorption pattern will change your relationship with alcohol.  Many patients report that they no longer enjoy alcohol at all and have found that their consumption decreases.  However, for some, this new absorption pattern triggers pleasure centers in the brain that weren’t stimulated by alcohol before surgery.  These patients now have the potential to develop an alcohol problem if they continue to drink.  If you notice that you enjoy alcohol much more after surgery than you did before, it is absolutely critical that you stop drinking before the problem starts.  You are choosing to undergo Bariatric Surgery in order to make your life better.  After a decade of performing these surgeries, I have a handful of patients who now struggle with alcoholism.  I can assure you that, although the surgery has made these patients thinner, their life is not better.

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