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Problematic Alcohol Use and Associated Characteristics Following Bariatric Surgery

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Abstract

Purpose

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.

Results

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.

Conclusions

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.

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Authors and Affiliations

  1. Neuropsychiatric Research Institute, 120 South 8th St, Fargo, ND, 58103, USA

    Kathryn E. Smith, Scott G. Engel, Kristine J. Steffen, Luis Garcia & James E. Mitchell

  2. Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA

    Kathryn E. Smith, Scott G. Engel & James E. Mitchell

  3. Department of Pharmaceutical Sciences, College of Pharmacy, Nursing, and Alliances, North Dakota State University, Fargo, ND, USA

    Kristine J. Steffen

  4. Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA

    Luis Garcia

  5. Sanford Health, Fargo, ND, USA

    Luis Garcia

  6. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA

    Karen Grothe

  7. Department of Behavioral Medicine, Gundersen Health System, La Crosse, WI, USA

    Afton Koball

Authors
  1. Kathryn E. Smith
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  2. Scott G. Engel
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  3. Kristine J. Steffen
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  4. Luis Garcia
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  5. Karen Grothe
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  6. Afton Koball
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  7. James E. Mitchell
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Corresponding author

Correspondence to Kathryn E. Smith.

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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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Smith, K.E., Engel, S.G., Steffen, K.J. et al. Problematic Alcohol Use and Associated Characteristics Following Bariatric Surgery. OBES SURG 28, 1248–1254 (2018). https://doi.org/10.1007/s11695-017-3008-8

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  • DOI: https://doi.org/10.1007/s11695-017-3008-8

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