I am not a big drinker, but would an occasional alcoholic drink be a problem for a weight loss surgery patient?
Can You Still Drink Alcohol After Bariatric Surgery?
Question Below Submitted By:
Alcohol After Weight Loss Surgery
Alcohol After Weight Loss Surgery
Thanks for your question.
The short answer is that it's best to keep alcohol out of your diet entirely if you've had weight loss surgery.
1. With part of your stomach removed or bypassed you are unable to metabolize the alcohol as well. Most alcohol absorption happens in the small intestine. If the stomach can't break as much down, more alcohol will be absorbed by your system.
2. All people - weight loss surgery patient or not - get intoxicated more quickly on an empty stomach because the alcohol passes more quickly into the small intestines (is not slowed down by food). With a smaller or bypassed stomach less food is there to slow down the alcohol.
As a result, you'll get intoxicated faster (for the reasons mentioned above), making you more likely to do something you'll regret like eating things you shouldn't, driving drunk, etc.
3. Procedures that bypass the connection between your stomach and small intestine no longer have that barrier to slow down the passing of fluids. As a result, the alcohol passes even more quickly into your small intestines.
4. The sugar and carbs in alcohol are horrible for keeping your bariatric diet on track.
5. Weight loss surgery patients have a greater risk of alcohol-related health problems such as acid reflux, gastric and esophageal cancer, liver damage and heart problems.
I hope that helps.
DISCLAIMER: The above should never replace the advice of your doctor.
SURGEON RESPONSE TO: "Gastric bypass alcohol"
Dear Sarah Archer,
You are absolutely correct in considering the potential for your husband's alcohol use/abuse relapse after undergoing Weight Loss Surgery (WLS). Alcohol use/abuse remains a significant problem for a minority of patients following WLS, not all of whom had a known alcohol use problem before the WLS. As you outline, whether or not "addiction transfer" to alcohol abuse post WLS is a proven entity, a person who is an alcoholic in remission is forever at risk for relapse.
Having considered that risk, however, WLS offers tremendous benefits to the morbidly obese patient who otherwise (without undergoing WLS) is unlikely to lose the excess weight and resolve the multitude of associated obesity related medical morbidities deleterious to their health and longevity. Consequently, your husband's interest in pursuing WLS is also very appropriate provided he fully appreciates the risks involved.
All patients undergoing an evaluation for WLS should be assessed by a psychiatry/psychology professional as a part of that pre WLS evaluation. Among other reasons, this assessment is to look for substance abuse behaviors that may adversely impact the results of the anticipated WLS as well as to provide some information/tools for the prospective WLS patient to use after their WLS to avoid subsequent substance abuse behaviors. In your husband's case, with your husband's permission, I suggest that you thoroughly discuss your concerns with the professional providing the psychiatric/psychologic assessment for your husband.
Of the four standard WLS options, there is only limited data to indicate the optimal WLS procedure in your husband's situation. The Sleeve Gastrectomy (SG) is currently the most commonly performed WLS in the United States in no small part due to its simplicity and effectiveness. The Roux-en-Y Gastric Bypass (RYGB) has a longer 'track record' than the SG as its been practiced for many decades but, in my opinion, would NOT be a better choice than the SG for your husband. Despite your husband's friends' WLS experiences, the overall risks and complications experienced by patients undergoing the SG is LESS than those who choose the RYGB with similar intermediate term weight loss results. Furthermore, as the ingested nutrients after the SG aren't bypassing the proximal small intestine as they would be in a patient who has undergone a RYGB, the metabolism of those nutrients (including alcohol should there be a relapse) is normal; after the RYGB any alcohol consumed will potentially have a more powerful and/or toxic effect due to the bypass anatomy.
Consequently, my advice would be for your husband to undergo the necessary pre WLS assessments and, if determined to be a suitable candidate for WLS, should proceed with the SG with your support.
John M. Rabkin, M.D.
DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.
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