Anecdotal reports suggest bariatric surgery may increase the risk of alcohol use disorders (AUD), but prospective data are lacking.
Determine the prevalence of pre- and postoperative AUD, and independent predictors of postoperative AUD.
Design, Setting, Participants
Longitudinal Assessment of Bariatric Surgery-2 is a prospective cohort study of adults who underwent bariatric surgery at 10 U.S. hospitals. Of 2458 participants, 1945 (78.8% female, 87.0% white, median age=47 years, median body mass index=45.8 kg/m2) completed pre- and postoperative (1 and/or 2 years) assessments between 2006–2011.
Main Outcome measure
Past year AUD symptoms determined with the Alcohol Use Disorders Identification Test (indication of ‘alcohol-related harm,’ ‘alcohol dependence symptoms,’ or score ≥8).
The prevalence of AUD did not significantly differ from pre- to 1 year postoperative (7.6% vs. 7.3%; p=.98), but was significantly higher at 2 years (9.6%; p<.01). Male sex (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5–3.0; p<.0001), younger age (OR, 1.3; CI, 1.03–1.7 per 10 years younger with pre-op AUD; p=.03; OR, 2.0; CI, 1.7–2.3 per 10 years younger without pre-op AUD; p<.0001), smoking (OR, 2.6; CI, 1.2–5.6; p=.02), regular alcohol consumption (OR, 6.4; CI, 4.2–9.7; p<.0001), AUD (e.g., OR, 11.1; CI, 7.7–16.1 at age 45; p<.0001), recreational drug use (OR, 2.4; CI, 1.4–4.1; p<.01) and lower ‘belonging’ interpersonal support (OR, 1.1; CI, 1.04–1.2; p<.01) preoperatively, and undergoing a Roux-en-Y gastric bypass (OR, 2.1; CI, 1.4–3.1; p<.001; reference=adjustable gastric band) were independently related to an increased odds of AUD postoperatively.
In this cohort, the prevalence of AUD was greater in the second postoperative year than preoperatively or in the first postoperative year, and was associated with preoperative AUD and regular alcohol consumption, and undergoing Roux-en-Y gastric bypass.