AT RISK The study showed that 20.8% of Roux-en-Y gastric bypass patients developed symptoms of alcohol use disorder within 5 years of the procedure. Only 11.3% of gastric banding patients developed such symptoms.

Roux-en-Y gastric bypass may be a popular weight-loss option for obese patients, but a new study suggests patients who undergo this procedure may be prone to an ominous side effect: alcohol abuse. One in 5 patients who undergo Roux-en-Y gastric bypass is likely to struggle with alcohol-abuse problems, some of which don't develop till years later.

Lead author Wendy C. King, PhD, and her team of researchers from the University of Pittsburgh (Pa.) Graduate School of Public Health discovered that 20.8% of Roux-en-Y gastric bypass (RYGB) patients developed symptoms of alcohol use disorder within 5 years of the procedure. In contrast, only 11.3% of patients who underwent gastric banding reported problems with alcohol use, according to a report in Surgery for Obesity and Related diseases.

Starting in 2006, Dr. King and her colleagues tracked more than 2,000 patients participating in the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2), an observational study of patients undergoing weight-loss surgery at 10 hospitals across the United States. RYGB, a surgical procedure that significantly reduces the size of the stomach and changes connections with the small intestine, was the most popular procedure, with 1,481 participants having received it. Most of the remaining participants had laparoscopic adjustable gastric banding, a less invasive procedure — a less popular one, too, because patients tend to lose less weight — in which the surgeon inserts an adjustable band around the patient's stomach to limit the amount of food the stomach can hold.

Both groups of patients increased their alcohol consumption over the 7 years of the study, but there was an increase in the prevalence of alcohol use disorder symptoms in RYGB patients. Among patients without alcohol problems in the year prior to surgery, RYGB patients had more than double the risk of developing alcohol problems over 7 years compared with those who had gastric banding.

These findings suggest that bariatric surgery patients should receive long-term clinical follow-up to monitor for and treat alcohol abuse and dependence. Although nearly 21% of patients report having alcohol problems after the surgery, only 3.5% of RYGB patients reported getting treatment. In other words, treatment programs are being underutilized despite their ready availability.

Bill Donahue