Addiction Transfer: The emerging Gastric Bypass Effect
On the heels of a five-year boom in weight-loss surgeries, researchers are observing an unusual phenomenon: Some patients stop overeating, but they wind up acquiring new disorders such as alcoholism, gambling addiction or compulsive shopping.
Some psychologists describe it as a type of "addiction transfer," an outcome of substance abuse treatment whereby patients swap one compulsive behavior for another.
Estimates on the prevalence of new addictions after surgery vary. Philip Schauer, president of the American Society for Bariatric Surgery, estimates that about 5 percent of patients develop a new compulsive behavior after surgery.
But psychologist Melodie Moorehead, who spoke at the society's annual meeting in June, cited preliminary data suggesting that about 30 percent of patients struggle with new addictions.
One possible reason for the disparity: Alcohol problems can surface several years later, when surgeons are no longer tracking patients closely. And some patients may not see a link between their drinking and the surgery.
For a variety of reasons -- including the fact that alcohol is high in calories -- bariatric-surgery patients are often advised not to drink alcohol for the first six months to a year after surgery. Most bariatric centers screen patients for heavy alcohol use, and exclude patients who exhibit signs of alcohol dependence.
Gastric bypass surgery involves sectioning off a small portion of the stomach into a pouch that bypasses the first part of the small intestine. As a result, alcohol passes rapidly into the intestine where it is quickly absorbed into the bloodstream.
"You shorten the time to the brain so much that if you liked alcohol before, you'll love it now," says Mark Gold, professor of psychiatry and neuroscience at the University of Florida College of Medicine.
Lap-band procedures don't have the same impact. The procedure involves restricting part of the stomach with a silicon band but doesn't change the absorption process.