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Weight loss surgery may be linked to substance use

Monday October 15, 2012
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Patients who undergo bariatric weight loss surgery may be at increased risk for drug use, alcohol use and cigarette smoking following surgery, according to a study.

Especially notable was the association between patients undergoing lapaoscopic Roux-en-Y gastric bypass surgery and alcohol use following surgery, researchers reported.

"Studies have shown that drugs, alcohol and food trigger similar responses in the brain and that bariatric surgery candidates whose condition has been diagnosed as binge-eating disorder display addictive personalities similar to individuals addicted to substances," researchers wrote in background information for the study, which appeared Oct. 15 on the website of the Archives of Surgery.

"Therefore, alcohol and drugs (including nicotine) are likely to substitute for overeating following WLS [weight-loss surgery]."

Alexis Conason, PsyD, of the New York Obesity Nutrition Research Center, and colleagues, assessed questionnaire responses from 155 patients (132 women) who underwent weight loss surgery and were recruited from an information session at a bariatric surgery center.

In the study, 100 patients underwent laparoscopic Roux-en-Y gastric bypass surgery and 55 underwent laparoscopic adjustable gastric band surgery. Each patient completed questionnaires to assess eating behaviors and substance use prior to the operation and at one, three, six, 12 and 24 months after surgery.

Overall, the authors found that patients reported an immediate decrease in frequency of substance use following WLS, but these improvements were not maintained by the three-month follow-up, and there was a significant increase in the frequency of substance use from the time of surgery to the 24-month follow-up.

Specifically, the authors found that patients reported a significant increase in the frequency of substance use (a composite of drug use, alcohol use and cigarette smoking) from the time of surgery to 24 months after surgery and significant increases from one, three, and six months to 24 months after surgery.

Additionally, patients who underwent laparoscopic Roux-en-Y gastric bypass surgery reported a significant increase in the frequency of alcohol use from the time before surgery to 24 months after surgery.

"Based on the present study, undergoing RYGB surgery appears to increase the risk for alcohol use following WLS," the authors wrote. "Risks and benefits should be weighted when recommending LRYGB surgery to patients who may be at increased risk of developing problems with alcohol after WLS, such as those with a personal or family history of alcohol abuse or dependence."

The study abstract is available at http://archsurg.jamanetwork.com/article.aspx?articleid=1379763.


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