Alcohol Use and the Risk of Addiction After Obesity Surgery
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https://doi.org/10.5281/zenodo.18002692Keywords:
Alcohol use disorder, obesity surgery, risk factorsAbstract
Obesity is recognized as a major public health problem due to its increasing global prevalence and its association with serious health consequences. In cases where dietary interventions, lifestyle modifications, and pharmacological treatments fail to produce adequate outcomes, bariatric surgery has emerged as an effective and sustainable treatment option. However, the effects of bariatric surgery are not limited to weight loss and metabolic improvement; they also involve significant physiological, neurohormonal, and psychosocial changes. In recent years, a growing body of research has indicated an increased risk of alcohol use disorder (AUD) following bariatric surgery. Changes in alcohol metabolism related to surgical techniques, postoperative psychosocial stressors, and alterations in eating behaviors are among the primary factors contributing to this elevated risk. The literature suggests that the risk of AUD most commonly becomes apparent within the first 1–2 years after surgery. Identifying the risks associated with alcohol use following bariatric surgery is of critical importance for both clinical practice and long-term follow-up processes. The aim of this review is to examine the risks of alcohol use after bariatric surgery, to explore the timing and prevalence of these risks, to evaluate their associations with individual and surgical factors, and to assess preventive and interventional strategies reported to be effective in the current literature. Accordingly, this review adopts a comprehensive approach to bariatric surgery–related alcohol use risks by considering surgical, demographic, and psychosocial dimensions.
References
Acevedo, M. B., Eagon, J. C., Bartholow, B. D., Klein, S., Bucholz, K. K., & Pepino, M. Y. (2018). Sleeve gastrectomy surgery: when 2 alcoholic drinks are converted to 4. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 14(3), 277–283. https://doi.org/10.1016/j.soard.2017.11.010
Acevedo, M. B., Teran-Garcia, M., Bucholz, K. K., Eagon, J. C., Bartholow, B. D., Burd, N. A., Khan, N., Rowitz, B., & Pepino, M. Y. (2020). Alcohol sensitivity in women after undergoing bariatric surgery: a cross-sectional study. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 16(4), 536–544. https://doi.org/10.1016/j.soard.2020.01.014
Allison, K. C., Wadden, T. A., Sarwer, D. B., Fabricatore, A. N., Crerand, C. E., Gibbons, L. M., Stack, R. M., Stunkard, A. J., & Williams, N. N. (2006). Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Obesity (Silver Spring, Md.), 14 Suppl 2, 77S–82S. https://doi.org/10.1038/oby.2006.286
Amerikan Metabolik ve Bariatrik Cerrahi Derneği. (2021a). Sleeve gastrektomi. https://asmbs.org/patients/bariatric-surgery-procedures/sleeve-gastrectomy
Amerikan Metabolik ve Bariatrik Cerrahi Derneği. (2021b). Adjustable gastric band. https://asmbs.org/patients/bariatric-surgery-procedures/adjustable-gastric-band
Amerikan Psikiyatri Derneği. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
Averbukh, Y., Heshka, S., El-Shoreya, H., Flancbaum, L., Geliebter, A., Kamel, S., Pi-Sunyer, F. X., & Laferrère, B. (2003). Depression score predicts weight loss following Roux-en-Y gastric bypass. Obesity surgery, 13(6), 833–836. https://doi.org/10.1381/096089203322618605
Bhatti, J. A., Nathens, A. B., Thiruchelvam, D., Grantcharov, T., Goldstein, B. I., & Redelmeier, D. A. (2016). Self-harm Emergencies After Bariatric Surgery: A Population-Based Cohort Study. JAMA surgery, 151(3), 226–232. https://doi.org/10.1001/jamasurg.2015.3414
Breslow, R. A., & Smothers, B. A. (2005). Drinking patterns and body mass index in never smokers: National Health Interview Survey, 1997-2001. American journal of epidemiology, 161(4), 368–376. https://doi.org/10.1093/aje/kwi061
Brumby, S., Kennedy, A., & Chandrasekara, A. (2013). Alcohol consumption, obesity, and psychological distress in farming communities-an Australian study. The Journal of rural health: official journal of the American Rural Health Association and the National Rural Health Care Association, 29(3), 311–319. https://doi.org/10.1111/jrh.12001
Brunault, P., Jacobi, D., Miknius, V., Bourbao-Tournois, C., Huten, N., Gaillard, P., Couet, C., Camus, V., & Ballon, N. (2012). High preoperative depression, phobic anxiety, and binge eating scores and low medium-term weight loss in sleeve gastrectomy obese patients: a preliminary cohort study. Psychosomatics, 53(4), 363–370. https://doi.org/10.1016/j.psym.2011.12.008
Bruze, G., Holmin, T. E., Peltonen, M., Ottosson, J., Sjöholm, K., Näslund, I., Neovius, M., Carlsson, L. M. S., & Svensson, P. A. (2018). Associations of Bariatric Surgery With Changes in Interpersonal Relationship Status: Results From 2 Swedish Cohort Studies. JAMA surgery, 153(7), 654–661. https://doi.org/10.1001/jamasurg.2018.0215
Buffington, C. K. (2007). Alcohol use and health risks: survey results. Bariatric Times, 4(2), 1–21.
Cerón-Solano, G., Zepeda, R. C., Romero Lozano, J. G., Roldán-Roldán, G., ve Morin, J. P. (2021). Bariatric surgery and alcohol and substance abuse disorder: A systematic review. Cirugía bariátrica y trastorno por abuso de alcohol y otras sustancias: una revisión sistemática. Cirugia espanola, S0009-739X(21)00109-3. https://doi.org/10.1016/j.ciresp.2021.03.006
Changchien, E. M., Woodard, G. A., Hernandez-Boussard, T., & Morton, J. M. (2012). Normal alcohol metabolism after gastric banding and sleeve gastrectomy: a case-cross-over trial. Journal of the American College of Surgeons, 215(4), 475–479. https://doi.org/10.1016/j.jamcollsurg.2012.06.008
Conason, A., Teixeira, J., Hsu, C. H., Puma, L., Knafo, D., & Geliebter, A. (2013). Substance use following bariatric weight loss surgery. JAMA surgery, 148(2), 145–150. https://doi.org/10.1001/2013.jamasurg.265
Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research. Third Edition. SAGE.
De Amorim, A. C., de Souza, A. F., Nascimento, A. L., Maio, R., & Burgos, M. G. (2015). Use of alcohol before and after bariatric surgery. Revista do Colegio Brasileiro de Cirurgioes, 42(1), 3–8. https://doi.org/10.1590/0100-69912015001002
De Zwaan, M., Enderle, J., Wagner, S., Mühlhans, B., Ditzen, B., Gefeller, O., Mitchell, J. E., & Müller, A. (2011). Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. Journal of affective disorders, 133(1-2), 61–68. https://doi.org/10.1016/j.jad.2011.03.025
Douglas, I. J., Bhaskaran, K., Batterham, R. L., & Smeeth, L. (2015). Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care. PLoS medicine, 12(12), e1001925. https://doi.org/10.1371/journal.pmed.1001925
Dünya Obezite Federasyonu. (2025a). World Obesity Atlas 2023. World Obesity. https://www.worldobesityday.org/assets/downloads/WOF-Missing-the-targets-executive-summary.pdf
Dünya Obezite Federasyonu. (2025b). World Obesity Atlas 2025. World Obesity. https://s3-eu-west-1.amazonaws.com/wof-files/World_Obesity_Atlas_2025.pdf
Dünya Sağlık Örgütü. (2021, Mart 4). WHO Director-General's opening remarks at Obesity – Setting the Global Agenda event. https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-obesity-setting-the-global-agenda-event-4-march-2021
Dünya Sağlık Örgütü. (2024, Mart 1). Obesity and overweight. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Edwards-Hampton, S. A., & Wedin, S. (2015). Preoperative psychological assessment of patients seeking weight-loss surgery: identifying challenges and solutions. Psychology research and behavior management, 8, 263–272. https://doi.org/10.2147/PRBM.S69132
Engel, S. G., Schaefer, L. M., Kerver, G. A., Leone, L. M., Smith, G., Mitchell, J. E., Gunstad, J., Crosby, R. D., & Steffen, K. (2021). The rewarding effects of alcohol after bariatric surgery: Do they change and are they associated with pharmacokinetic changes? Surgery for Obesity and Related Diseases, 17(11), 1–6. https://doi.org/10.1016/j.soard.2021.08.011
Ertelt, T. W., Mitchell, J. E., Lancaster, K., Crosby, R. D., Steffen, K. J., ve Marino, J. M. (2008). Alcohol abuse and dependence before and after bariatric surgery: a review of the literature and report of a new data set. Surgery for Obesity and Related Diseases, 4(5), 647–650. https://doi.org/10.1016/j.soard.2008.01.004
Gallo, A. S., Berducci, M. A.Changchien Nijhawan, S., Nino, D. F., Broderick, R. C., Harnsberger, C. R., Lazar, S., Echon, C., Fuchs, H. F., Alvarez, F., Sandler, B. J., Jacobsen, G., & Horgan, S. (2015). Alcohol metabolism is not affected by sleeve gastrectomy. Surgical endoscopy, 29(5), 1088–1093. https://doi.org/10.1007/s00464-014-3790-5
Hagedorn, J. C., Encarnacion, B., Brat, G. A., & Morton, J. M. (2007). Does gastric bypass alter alcohol metabolism? Surgery for Obesity and Related Diseases, 3(5), 543–548. https://doi.org/10.1016/j.soard.2007.07.003
Heinberg, L. J., Ashton, K., & Coughlin, J. (2012). Alcohol and bariatric surgery: review and suggested recommendations for assessment and management. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 8(3), 357–363. https://doi.org/10.1016/j.soard.2012.01.016
Hollon, S. D., Jarrett, R. B., Nierenberg, A. A., Thase, M. E., Trivedi, M., & Rush, A. J. (2005). Psychotherapy and medication in the treatment of adult and geriatric depression: which monotherapy or combined treatment?. The Journal of clinical psychiatry, 66(4), 455–468. https://doi.org/10.4088/jcp.v66n0408
Ibrahim, N., Alameddine, M., Brennan, J., Sessine, M., Holliday, C., & Ghaferi, A. A. (2019). New onset alcohol use disorder following bariatric surgery. Surgical endoscopy, 33(8), 2521–2530. https://doi.org/10.1007/s00464-018-6545-x
Ivezaj, V., Benoit, S. C., Davis, J. F., & Saules, K. K. (2019). Changes in alcohol use after metabolic and bariatric surgery: Predictors and mechanisms. Current Psychiatry Reports, 21(85), 1–10. https://doi.org/10.1007/s11920-019-1070-8
Kalarchian, M. A., Marcus, M. D., Levine, M. D., Courcoulas, A. P., Pilkonis, P. A., Ringham, R. M., Soulakova, J. N., Weissfeld, L. A., & Rofey, D. L. (2007). Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. The American journal of psychiatry, 164(2), 328–374. https://doi.org/10.1176/ajp.2007.164.2.328
Karlsson, J., Taft, C., Rydén, A., Sjöström, L., & Sullivan, M. (2007). Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. International journal of obesity (2005), 31(8), 1248–1261. https://doi.org/10.1038/sj.ijo.0803573
King, W. C., Chen, J. Y., Courcoulas, A. P., Dakin, G. F., Engel, S. G., Flum, D. R., Hinojosa, M. W., Kalarchian, M. A., Mattar, S. G., Mitchell, J. E., Pomp, A., Pories, W. J., Steffen, K. J., White, G. E., Wolfe, B. M., & Yanovski, S. Z. (2017). Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 13(8), 1392–1402. https://doi.org/10.1016/j.soard.2017.03.021
King, W. C., Chen, J. Y., Mitchell, J. E., Kalarchian, M. A., Steffen, K. J., Engel, S. G., Courcoulas, A. P., Pories, W. J., ve Yanovski, S. Z. (2012). Prevalence of alcohol use disorders before and after bariatric surgery. JAMA, 307(23), 2516–2525. https://doi.org/10.1001/jama.2012.6147
Klockhoff, H., Näslund, I., & Jones, A. W. (2002). Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery. British journal of clinical pharmacology, 54(6), 587–591. https://doi.org/10.1046/j.1365-2125.2002.01698.x
Kudsi, O. Y., Huskey, K., Grove, S., Blackburn, G., Jones, D. B., & Wee, C. C. (2013). Prevalence of preoperative alcohol abuse among patients seeking weight-loss surgery. Surgical endoscopy, 27(4), 1093–1097. https://doi.org/10.1007/s00464-012-2568-x
Lean, M. E. J., Vlachou, P., Govan, L., & Han, T. S. (2018). Different associations between body composition and alcohol when assessed by exposure frequency or by quantitative estimates of consumption. Journal of human nutrition and dietetics: the official journal of the British Dietetic Association, 31(6), 747–757. https://doi.org/10.1111/jhn.12583
Li, L., & Wu, L. T. (2016). Substance use after bariatric surgery: A review. Journal of psychiatric research, 76, 16–29. https://doi.org/10.1016/j.jpsychires.2016.01.009
Livingston, E. H., Huerta, S., Arthur, D., Lee, S., De Shields, S., & Heber, D. (2002). Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Annals of surgery, 236(5), 576–582. https://doi.org/10.1097/00000658-200211000-00007
Maluenda, F., Csendes, A., De Aretxabala, X., Poniachik, J., Salvo, K., Delgado, I., & Rodriguez, P. (2010). Alcohol absorption modification after a laparoscopic sleeve gastrectomy due to obesity. Obesity surgery, 20(6), 744–748. https://doi.org/10.1007/s11695-010-0136-9
Memarian, E., Sundquist, K., Calling, S. et al. Socioeconomic factors, body mass index and bariatric surgery: a Swedish nationwide cohort study. BMC Public Health 19, 258 (2019). https://doi.org/10.1186/s12889-019-6585-8
Mitchell, J. E., Selzer, F., Kalarchian, M. A., Devlin, M. J., Strain, G. W., Elder, K. A., Marcus, M. D., Wonderlich, S., Christian, N. J., & Yanovski, S. Z. (2012). Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 8(5), 533–541. https://doi.org/10.1016/j.soard.2012.07.001
Mitchell, J. E., Steffen, K., Engel, S., King, W. C., Chen, J. Y., Winters, K., Sogg, S., Sondag, C., Kalarchian, M., ve Elder, K. (2015). Addictive disorders after Roux-en-Y gastric bypass. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 11(4), 897–905. https://doi.org/10.1016/j.soard.2014.10.026
O'Donovan, G., Stamatakis, E., & Hamer, M. (2018). Associations between alcohol and obesity in more than 100 000 adults in England and Scotland. The British journal of nutrition, 119(2), 222–227. https://doi.org/10.1017/S000711451700352X
Park, K. Y., Park, H. K., & Hwang, H. S. (2017). Relationship between abdominal obesity and alcohol drinking pattern in normal-weight, middle-aged adults: the Korea National Health and Nutrition Examination Survey 2008-2013. Public health nutrition, 20(12), 2192–2200. https://doi.org/10.1017/S1368980017001045
Pepino, M. Y., Okunade, A. L., Eagon, J. C., Bartholow, B. D., Bucholz, K., & Klein, S. (2015). Effect of Roux-en-Y Gastric Bypass Surgery: Converting 2 Alcoholic Drinks to 4. JAMA surgery, 150(11), 1096–1098. https://doi.org/10.1001/jamasurg.2015.1884
Peterhänsel, C., Petroff, D., Klinitzke, G., Kersting, A., & Wagner, B. (2013). Risk of completed suicide after bariatric surgery: a systematic review. Obesity reviews : an official journal of the International Association for the Study of Obesity, 14(5), 369–382. https://doi.org/10.1111/obr.12014
Saules, K. K., Wiedemann, A., Ivezaj, V., Hopper, J. A., Foster-Hartsfield, J., & Schwarz, D. (2010). Bariatric surgery history among substance abuse treatment patients: prevalence and associated features. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 6(6), 615–621. https://doi.org/10.1016/j.soard.2009.12.008
Schumudde, S. (2019). Veränderungen des Alkohol- und Nikotinkonsums nach bariatrischer Operation [Doktora tezi, Philipps-Universität Marburg]. https://archiv.ub.uni-marburg.de/diss/z2019/0332/pdf/das.pdf
Sheets, C. S., Peat, C. M., Berg, K. C., White, E. K., Bocchieri-Ricciardi, L., Chen, E. Y., & Mitchell, J. E. (2015). Post-operative psychosocial predictors of outcome in bariatric surgery. Obesity surgery, 25(2), 330–345. https://doi.org/10.1007/s11695-014-1490-9
Smith, C. E., Hawkins, M. A. W., Williams-Kerver, G. A., & Duncan, J. (2020). Depression subtypes, binge eating, and weight loss in bariatric surgery candidates. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 16(5), 690–697. https://doi.org/10.1016/j.soard.2019.12.017
Sockalingam, S., Wnuk, S., Kantarovich, K., Meaney, C., Okrainec, A., Hawa, R., & Cassin, S. (2015). Employment outcomes one year after bariatric surgery: the role of patient and psychosocial factors. Obesity surgery, 25(3), 514–522. https://doi.org/10.1007/s11695-014-1443-3
Spadola, C. E., Wagner, E. F., Dillon, F. R., Trepka, M. J., De La Cruz-Munoz, N., ve Messiah, S. E. (2015). Alcohol and Drug Use Among Postoperative Bariatric Patients: A Systematic Review of the Emerging Research and Its Implications. Alcoholism, clinical and experimental research, 39(9), 1582–1601. https://doi.org/10.1111/acer.12805
Strømmen, M., Bakken, I. J., Klöckner, C., Sandvik, J., Kulseng, B., ve Holen, A. (2020). Diagnoses related to abuse of alcohol and addictive substances after gastric bypass and sleeve gastrectomy: a nation-wide registry study from Norway. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 16(4), 464–470. https://doi.org/10.1016/j.soard.2019.12.011
Suzuki, J., Haimovici, F., ve Chang, G. (2012). Alcohol use disorders after bariatric surgery. Obesity surgery, 22(2), 201–207. https://doi.org/10.1007/s11695-010-0346-1
Svensson, P. A., Anveden, Å., Romeo, S., Peltonen, M., Ahlin, S., Burza, M. A., Carlsson, B., Jacobson, P., Lindroos, A. K., Lönroth, H., Maglio, C., Näslund, I., Sjöholm, K., Wedel, H., Söderpalm, B., Sjöström, L., & Carlsson, L. M. (2013). Alcohol consumption and alcohol problems after bariatric surgery in the Swedish obese subjects study. Obesity (Silver Spring, Md.), 21(12), 2444–2451. https://doi.org/10.1002/oby.20397
Şen, O., Ünübol, H., Gökhan Türkçapar, A., ve Yerdel, M. A. (2021). Risk of Alcohol Use Disorder After Sleeve Gastrectomy. Journal of laparoendoscopic & advanced surgical techniques. Part A, 31(1), 24–28. https://doi.org/10.1089/lap.2020.0306
T.C. Sağlık Bakanlığı. (2025). Obezite. https://www.saglik.gov.tr/TR,11692/obezite.html
Tindle, H. A., Omalu, B., Courcoulas, A., Marcus, M., Hammers, J., & Kuller, L. H. (2010). Risk of suicide after long-term follow-up from bariatric surgery. The American journal of medicine, 123(11), 1036–1042. https://doi.org/10.1016/j.amjmed.2010.06.016
Türkiye Endokrinoloji ve Metabolizma Derneği. (2024). Obezite tanı ve tedavi kılavuzu. https://file.temd.org.tr/Uploads/publications/guides/documents/obezitetanitedavikilavuzu-2024.pdf
Vangoitsenhoven, R., Frederiks, P., Gijbels, B., Lannoo, M., Van der Borght, W., Van den Eynde, A., Mertens, A., Mathieu, C., & Van der Schueren, B. (2016). Long-term effects of gastric bypass surgery on psychosocial well-being and eating behavior: not all that glitters is gold. Acta clinica Belgica, 71(6), 395–402. https://doi.org/10.1080/17843286.2016.1174393
Wee, C. C., Mukamal, K. J., Huskey, K. W., Davis, R. B., Colten, M. E., Bolcic-Jankovic, D., Apovian, C. M., Jones, D. B., ve Blackburn, G. L. (2014). High-risk alcohol use after weight loss surgery. Surgery for obesity and related diseases: Official journal of the American Society for Bariatric Surgery, 10(3), 508–513. https://doi.org/10.1016/j.soard.2013.12.014
White, G. E., Boles, R. E., Courcoulas, A. P., Yanovski, S. Z., Zeller, M. H., Jenkins, T. M., & Inge, T. H. (2023). A Prospective Cohort of Alcohol Use and Alcohol-related Problems Before and After Metabolic and Bariatric Surgery in Adolescents. Annals of surgery, 278(3), e519–e525. https://doi.org/10.1097/SLA.0000000000005759
Wong, E., Fleishman, A., Brem, A., Jones, D. B., & Wee, C. C. (2022). High-Risk Alcohol Use and Disordered Eating Behavior Before and 1 Year After Sleeve Gastrectomy. Obesity surgery, 32(3), 593–598. https://doi.org/10.1007/s11695-021-05847-3
Woodard, G. A., Downey, J., Hernandez-Boussard, T., & Morton, J. M. (2011). Impaired alcohol metabolism after gastric bypass surgery: a case-crossover trial. Journal of the American College of Surgeons, 212(2), 209–214. https://doi.org/10.1016/j.jamcollsurg.2010.09.020
Zeller, M. H., Washington, G. A., Mitchell, J. E., Sarwer, D. B., Reiter-Purtill, J., Jenkins, T. M., Courcoulas, A. P., Peugh, J. L., Michalsky, M. P., Inge, T. H., & Teen-LABS Consortium and in collaboration with the TeenView Study Group (2017). Alcohol use risk in adolescents 2 years after bariatric surgery. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 13(1), 85–94. https://doi.org/10.1016/j.soard.2016.05.019
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