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After Gastric Bypass: Drunk Faster?

Study Shows Patients Who Have Weight Loss Surgery May Need to Drink Carefully

Interpretations of the Study

Based on the study findings, gastric bypass patients "are not metabolizing alcohol the same way and not feeling the same way [as the nonsurgery participants]," Morton tells WebMD.

The finding, he says, may explain why some experts have observed, and feared -- that those who undergo bypass surgery might experience "addiction transfer," in which they trade the addiction of binge eating, an issue for many gastric bypass surgery patients, for an alcohol addiction.

"This might account for some people becoming addicted to alcohol [after bypass surgery]," Morton tells WebMD. "They may have to drink more to get the same effect."

Physiologically, he says, there are explanations, too. The levels of a key enzyme for metabolizing alcohol, called alcohol dehydrogenase, decline because of the much smaller stomach size after gastric bypass surgery. Gastric bypass and other weight loss surgeries reduce the stomach's capacity to a few ounces. "This is probably why the alcohol peaks higher and stays higher," Morton says.

Why the patients aren't feeling more symptoms is not known, he adds.

"Alcohol is not calorie-free, of course," Morton reminds his patients. "A glass of wine has 125 calories. The other thing that happens when you drink alcohol is it relaxes you both outside and inside -- your esophagus and stomach also relax, and that allows you to eat more."

"I tell my patients to be careful with alcohol, and if they drink to do so at home or to have a designated driver," Morton says.

Second Opinion

"This study supports our observations," says Philip Schauer, MD, president of the American Society for Bariatric Surgery and director of the Bariatric and Metabolic Institute at Cleveland Clinic. "Because we are reducing stomach capacity, food and liquor move rapidly into the intestines for absorption."

This study does not prove that alcohol problems are more likely among bariatric patients, says Neil Hutcher, MD, immediate past president of the society and director of bariatric surgery at Bonsecour St. Mary’s Hospital in Richmond, Va. "This study does not in any way address whether increased blood levels of alcohol or the magnitude of them has anything to do with alcohol addiction or the transference of food dependence to alcohol dependence,” he says.

More than 177,000 people in the U.S. had gastric bypass or other forms of bariatric or weight loss surgery in 2006, according to estimates from the Society. In consultations with his patients about what to expect after surgery, Schauer says, "I usually tell them, 'One beer will feel like two.'"

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