Obesity Surgery

, Volume 28, Issue 5, pp 1248–1254 | Cite as

Problematic Alcohol Use and Associated Characteristics Following Bariatric Surgery

  • Kathryn E. Smith
  • Scott G. Engel
  • Kristine J. Steffen
  • Luis Garcia
  • Karen Grothe
  • Afton Koball
  • James E. Mitchell
Original Contributions



Evidence suggests that a significant minority of individuals who undergo Roux-en-Y gastric bypass (RYGB) experience problematic alcohol and substance use following surgery. However, little research has examined characteristics, drinking patterns, and possible risk factors within this population. To provide descriptive information of a sample of adults with self-identified alcohol use problems following bariatric surgery, this study examined (1) alcohol and substance use symptoms using standardized assessments, (2) current and past psychiatric comorbidity, (3) subjective changes in alcohol sensitivity following surgery, and (4) specific patterns of alcohol use prior to and following bariatric surgery.

Materials and Methods

Adult participants (N = 26) completed a series of structured diagnostic interviews and self-report assessments (e.g., Alcohol Use Disorders Identification Test [AUDIT], Michigan Alcohol Screening Test [MAST], Drug Abuse Screening Test [DAST]) by telephone 1 to 4 years following a RYGB or sleeve gastrectomy.


All participants met objective criteria for current problematic alcohol use based on AUDIT and MAST cutoff scores, reported increased subjective sensitivity to alcohol following surgery, and evidenced significant current and past psychiatric comorbidities, most notably previous major depression (45.5%). Approximately one third of participants evidenced new-onset Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) alcohol use or dependence following surgery. Preoperative drinking frequencies and quantities were similar to those reported during the period of the heaviest postoperative alcohol use.


Findings have implications for pre- and postoperative prevention and intervention efforts. Additional research is needed to further elucidate risk factors for problematic alcohol use following bariatric surgery.


Postoperative alcohol problems Alcohol use Substance use Comorbidity Psychopathology 


Compliance with Ethical Standards

Conflicts of Interest

Authors K.E.S., S.G.E., K.J.S., L.G., K.G., A.K., and J.E.M. have no conflicts of interest to disclose. The research was supported by NIMH T32MH082761 (Author K.E.S.). K.J.S. was also supported by the following grants: NIH (1R01DK112585, 3R01DK112585-01S1, 1R01AA022336, 3R01AA022336-01A1S1), Shire Pharmaceuticals, and Sanford Profile.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Neuropsychiatric Research InstituteFargoUSA
  2. 2.Department of Psychiatry and Behavioral ScienceUniversity of North Dakota School of Medicine and Health SciencesFargoUSA
  3. 3.Department of Pharmaceutical Sciences, College of Pharmacy, Nursing, and AlliancesNorth Dakota State UniversityFargoUSA
  4. 4.Department of SurgeryUniversity of North Dakota School of Medicine and Health SciencesGrand ForksUSA
  5. 5.Sanford HealthFargoUSA
  6. 6.Department of Psychiatry and PsychologyMayo ClinicRochesterUSA
  7. 7.Department of Behavioral MedicineGundersen Health SystemLa CrosseUSA

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