One study found that alcohol blood levels rose faster and stayed higher longer after a banding procedure, but another study found no changes. An ASMBS guideline on the topic, written by a team led by Parikh, concluded that more research is needed to settle the question.
There’s no evidence the banding procedure speeds up absorption, but patients tend to regain more weight after a banding than they do with the other options.
Ditch the idea of addiction transfer
If you’re considering the surgery, experts say to banish fears of “addiction transfer.”
A 2006 episode of the Oprah Winfrey show titled Suddenly Skinny, featured patients who’d started drinking after bypass surgery, and declared, “If a patient drops a lot of weight without confronting why they were overweight, they risk becoming addicted to something else. Experts call this swap of one compulsive behavior for another ‘addiction transfer.’”
Actually, the evolving science contradicts that idea.
For instance, people who were depressed before bypass surgery were not more likely to develop alcohol issues. Neither were people who had eating habits that might be deemed addictive.
“We looked at whether loss-of-control eating or binge eating was related to alcohol problems and didn’t find a connection,
How much weight you had lost was also unrelated.
“It’s not correct to say obese people are addicted to food, or that they’ll transfer one addiction for another,” Parikh said.
Also, people who quit smoking after bypass surgery were not more likely to develop alcohol issues.
King’s research didn’t look at people who drank frequenty or heavily before a bypass operation. But other research came to the conclusion that they drank less, not more, often after the surgery.
The reason may be that when the physical impact of alcohol intensifies, they adjust their consumption downward.
Yet it’s not obviously a conscious choice. The same phenomenon has been observed in alcohol-loving rats that get a bypass.
“People have different genetic tendencies,” explained Stephanie Sogg, a clinical psychologist specializing in obesity at Massachusetts General Hospital, “and bypass seems to change it.”
At Bellevue, candidates who have a current drinking problem are asked to “get it under control first,” Parikh said, and be abstinent before the surgery.
“We tell patients to abstain from drinking during the first six weeks [after surgery], and then minimize it for one to two years,” he said. “We’d be OK with one or two glasses of wine a week.”
All in all, experts agree that the risks of alcohol abuse shouldn’t be a reason to shy away from bypass or sleeve surgery.
“The only scientifically based conclusion is to be more watchful,”