Why Alcoholism Occurs After Gastric Bypass Surgery

Gastric bypass surgery has helped people combat obesity, diabetes and even the risk of heart disease. While it may be helpful for many people, it can also increase the effects of alcohol use. In fact, research shows an increased risk of alcohol use disorder (AUD) in patients after just three years post-procedure.

Understanding the risk of addiction associated with gastric bypass can help you prevent or address this issue. Keep reading to learn about the connection between this weight loss surgery and alcohol addiction, the symptoms of AUD and ways to get help if you or a loved one is struggling.

What Is Gastric Bypass Surgery?

Gastric bypass is one type of surgery for weight loss. During the procedure, a medical expert alters how the stomach and small intestine work to digest food. The surgeon creates a small pocket out of the stomach, which is then connected to the patient's small intestine. Food will then enter the small pouch before moving throughout the digestive system, bypassing a large part of the stomach and the initial portion of the small intestine.

Gastric bypass surgery can aid weight loss by:

  • Limiting how much food the stomach can hold
  • Reducing the nutrients and calories the body can absorb
  • Altering gut hormones to make someone feel fuller longer

Why Is There a Connection Between Alcohol Addiction and Gastric Bypass Surgery?

Researchers aren't entirely sure why gastric bypass may lead to issues with alcohol, though there are a few possible explanations and theories:

1. Changes to Blood Alcohol Content Level

Many patients report a higher sensitivity to the effects of alcohol after gastric bypass surgery. The stomach lining contains an enzyme called alcohol dehydrogenase that metabolizes alcohol. When alcohol enters just a tiny stomach pouch after gastric bypass, it comes into contact with less alcohol dehydrogenase and moves to the small intestine quicker, leading to more alcohol entering the bloodstream. As a result, patients drinking alcohol after gastric bypass surgery:

  • Have higher blood alcohol content levels.
  • Get drunker faster.
  • Have alcohol in their system longer than those who have not had the surgery.

These effects may impact how the brain responds to alcohol and explain the increased potential for an alcohol use disorder. This is similar to why women are more sensitive to alcohol than men. Women have significantly less alcohol dehydrogenase in their stomach lining, making alcohol enter the bloodstream easier. One alcoholic drink can affect a woman more strongly than one drink for a man.

As a result, drinking alcohol after gastric bypass surgery can result in more alcohol consumption — patients might get drunker faster and take longer to sober up, making drinking seem more appealing to some.

2. Changes in Gut Hormones and Reward Circuitry

Another potential cause is that weight loss surgery affects your gut hormones, including dopamine. This and other hormones impact feelings of hunger and fullness, but they also influence the sense of reward we feel after eating and drinking. Essentially, drinking alcohol after gastric bypass might be related to a changed hormone balance, and the boosted reward sensation can lead to AUD.

Alcohol is, therefore, recognized differently in the brain following gastric bypass surgery. If the pathway to a reward sensation becomes more activated after drinking alcohol, it can lead to addiction.

3. Addiction Transfer

Another possible reason for the connection between gastric bypass surgery and AUD could be addiction transfer. Like addictive substances, food can trigger feel-good chemicals like dopamine. Patterns of overeating might transfer to substances like alcohol after gastric bypass.

While researchers cannot entirely dismiss this theory, it's more likely the chemical, physical and biological changes that occur as a result of gastric bypass are most responsible for causing AUD in post-surgery patients.

That said, the following are risk factors of addiction transfer to be aware of:

  • Personal or family history of substance use disorder
  • History of eating disorders
  • Past trauma, such as childhood abuse
  • Regular alcohol use before surgery
  • Lack of healthy coping mechanisms
  • Lack of social support
  • Feelings of isolation
  • Depression, mood or anxiety disorders

Who's Most at Risk for an AUD Following Gastric Bypass?

Some factors can affect the likelihood of alcohol addiction among gastric bypass patients, such as being male, being young and feeling left out or like you don't belong. Those who already struggled with alcohol use before surgery are also at a higher risk of AUD.

Overall, people at the most risk of alcohol addiction after gastric bypass include:

  • Men
  • Smokers
  • Young adults
  • Those missing a support system
  • People who use drugs recreationally
  • People who regularly consume alcohol

Factors that did not appear to influence the development of alcohol misuse post-surgery include binge eating tendencies before treatment.

Signs of Alcohol Use Disorder After Gastric Bypass Procedure

The signs of alcohol use disorder after gastric bypass surgery might not be noticeable at first. The following are symptoms of addiction you might notice in yourself or a loved one following the procedure:

  • Spending the majority of your time drinking or hungover
  • Unsuccessful attempts to reduce or stop drinking
  • Having cravings to drink
  • Drinking's interference with daily responsibilities
  • Engaging in reckless behavior while intoxicated
  • Quitting previously enjoyed activities in favor of drinking
  • Relationship issues
  • Drinking to the point of blackout or losing memory of events while drunk
  • Having to drink more to get the same effect
  • Drinking more or for longer periods than planned
  • Having withdrawal symptoms when attempting to stop alcohol consumption

If you or a loved one has experienced two or more of the above symptoms, an alcohol use disorder may be developing. Luckily, there are several alcohol treatment services available that can help you overcome the cycle.