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Tuesday, October 16, 2012

"Addiction Replacement" Following Bariatric Surgery

Diagram of a Roux-en-Y gastric bypass.
Diagram of a Roux-en-Y gastric bypass. (Photo credit: Wikipedia)
If you work in the field of addiction treatment, then you know that often when patients start the recovery process they search, consciously or unconsciously, for something to replace their drug/substance of choice. Before they know it they are "addicted" to another substance, activity or behavior. This addiction replacement can be something as simple as suddenly enjoying strong coffee, perhaps many cups per day. Or they may, if their budget allows, become "shopaholics." It could be they replace their substance addiction with exercise...working out every day, running, jogging, swimming. In searching for recovery and accepting the possibility of recovery, it is important that patients become aware of the possibility of addiction replacement.

Obesity and alcoholism...

We have written before about the health dangers of alcoholism and resultant obesity; for example, studies have established the connection between alcoholism, obesity and sudden death from cardiac arrest. You often hear people talk about "comfort foods"; that is, many people use foods to deal with their emotions. A problem arises when we search for a solution to one health problem without really trying to deal with the cause of our underlying emotional problems.

We all diet one time or another in our life. We join Weight Watchers to lose a few pounds or a lot of pounds. We might try a New Year's resolution to start eating right, getting better sleep, exercising a bit more regularly. We might try an eating program like Nutrisystem. But the person who suffers from morbid obesity who has tried many different diets during their life may eventually consider some type of bariatric surgery.

Addiction a risk after weight loss surgery

Recently a study was conducted by Alexis Conason, PsyD, and her colleagues of the New York Obesity Research Center looking at a specific operation, laparoscopic Roux-en-Y gastric bypass surgery and a link of alcohol abuse following the surgery.  Here is how the study was conducted:
  • The study included 132 women and 23 men 
  • Each of these people had either Roux-en-Y gastric bypass surgery or gastric band surgery
  • Study participants were given a questionnaire that looked at use of alcohol or drugs before the surgery and then at intervals of one, three, six, 12 and 24 months following the surgery.  
  • Participants reported significant increases in the frequency of substance use (a composite of drug use, alcohol use, and cigarette smoking, hereafter referred to as composite substance use) 24 months after surgery.
Conason was quoted by WebMD:
"When we looked at patients individually, we didn't see a huge difference, but when you looked at the whole group, we saw a significant increased risk for drug and alcohol use at the two-year point after the surgery. Our findings are important because it raises some concerns about who is at risk."
It should be pointed out that patients who seek to have a bariatric surgery are required to meet with mental health professionals. They are routinely advised to avoid alcohol because alcohol can damage the gastrointestinal lining. They are also told they must be tobacco free three months prior to the surgical proceeding. 

Reviewing the entire study...

You can read the study abstract published online in the Archives of Surgery.

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