Lap Band patients are not included in the study showing that there is increased alcoholism with weight loss surgery. In fact, Dr. Simpson noted that patients who had a single glass of wine with dinner had more weight loss than those who abstained. The study linking alcoholism to surgery for weight loss was for RNY gastric bypass not for Lap-Band.
The study showed that patients who underwent the RNY gastric bypass (RNY) had an increase in persons who developed alcohol utilization disorder. While the numbers were small on the face – an increase of two percent of the people developed AUD- translated over the many operations done is an increased burden to society.
Active alcoholism is a contraindication to any weight loss surgery – but for those who have had alcohol issues in the past might opt for the Lap-Band operation instead of the RNY gastric bypass.
These issue present in the second year following RNY. It is thought that since the RNY changes where the body sees alcohol (bypassing the stomach and first part of the small bowel) that its patients feel the effects of alcohol more quickly. It is as if they drink less but get more effect from the alcohol. Addiction research shows that the faster a drug hits with increased intensity the more addictive that drug tends to be. RNY changes the delivery as well as the intensity of the drug, combined with the inability to eat as much food that would buffer the action of the drug.
The study followed almost 2000 adults between 2006 and 2011. They used a measure called the Alcohol Use Disorder Identification Test, developed by the World Health Organization.
Besides RNY, other independent factors that increased alcohol use were male sex, younger age, recreational drug use, and smokers. Having the RNY was also a factor. The RNY showed a increase of more than 50% in the prevalence of alcohol use disorder versus the Lap-Band.
Dr. Terry Simpson allows patients to drink alcohol with the band. “In the early days we tell patients that drinking alcohol with the band can lead to over-eating. We caution patients to be moderate in their drinking, and to know that if they eat less, it will take less alcohol to have unwanted effects. In our experience, patients who feel their band is tight find it becomes loose with alcohol. We then studied patients who had a single glass of wine with dinner versus those who did not drink. Those who had a single glass of wine actually lost more weight than those who abstained from drinking.”
The article appeared in JAMA and can be found here.