Weight-Loss Surgery Can Trigger Problem Drinking

After weight-loss surgery, women who drink two alcoholic drinks can feel like they downed four. And it happens quickly. Here's what you should know.

If you’re living with obesity, you have probably thought about weight-loss surgery. Among the risks you need to consider are alcohol use disorder.

You’re not alone. Obesity is common in the United States. Two in five U.S. adults deal with it, including severe cases that might qualify for weight-loss surgery. About 9 percent of the U.S population has a severe problem, according to government surveys. 

Those extra pounds raise your risk of heart disease, stroke, type 2 diabetes, and certain types of cancer. That’s why a doctor might suggest you have surgery.

There are several types of weight-loss surgery. The procedure called sleeve gastrectomy is the most common in the United States. Another type, gastric bypass, also called RYGB, was once considered the gold standard, but the sleeve procedure has become more common.  

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Weight-loss surgery and problem drinking

If you considered gastric bypass, your doctors should have asked if you’ve ever had problems with alcohol consumption, as the surgery can increase your risk of drinking too much, too quickly.

For a time, doctors thought that the sleeve procedure didn’t affect drinking. Newer evidence, however, shows that patients who have had the sleeve procedure tend to moderate their drinking in the first three years, but they start drinking more within four to six years.    

Weight-loss surgery affects how your body processes alcohol. For example, one study from the Washington University School of Medicine in St. Louis found that women who’ve had gastric bypass surgery can get drunk — within only five minutes — after just one or two drinks. 

Although the blood levels in women who hadn’t had the surgery didn’t peak until almost 30 minutes after a drink, blood alcohol levels of women in the surgical group averaged 1.10, significantly above the legal driving limit of 0.80 — in five minutes.  It stayed there for around a half hour.  

If you have had gastric bypass surgery, watch for any changes in how and when you drink. As with the sleeve procedure, the changes can emerge years later. In fact, some research indicates that one in five people who’ve had bypass surgery met the definition for alcohol use disorder within five years of their surgery, even though they hadn’t had a problem during the year before their procedure.

That is especially important because doctors advise weight-loss patients to stay away from liquid calories. And because you typically eat very little after surgery, the alcohol calories will represent a much larger percentage of your intake.

The best practice is not drinking

Ideally, weight-loss patients wouldn’t drink alcohol at all.  That’s good advice for anyone. According to the World Health Organization (WHO), no amount of drinking is truly safe.

Light and moderate alcohol consumption causes half of all alcohol-attributable cancers in the WHO European Region. Those drinking patterns are responsible for most alcohol-attributable breast cancers in women, for example.

Which weight-loss surgery should you have?

Talk to your doctor about alcohol when considering which procedure to choose. Gastric bypass patients may be more likely to maintain weight loss and tame type 2 diabetes.

Despite the possible complications and side effects of either option, don’t dismiss them if you are extremely overweight. Either procedure could extend your life.

In one large study, half of the patients who had weight-loss surgery gained more than nine years of life expectancy if they had type 2 diabetes, and five years if they didn’t.  The results were similar for both sleeve and gastric bypass, although the researchers noted that “differences could emerge with larger studies or longer follow-up.”

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