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March 17, 2006

Alcohol and Gastric Bypass

Alcohol A recent study reported in the British Journal of Clinical Pharmacology found that the gastric bypass procedure significantly affects alcohol absorption and its inebriating influence. According to the study protocol, a group of gastric bypass patients, three years post-surgery, and their non-surgical controls consumed an alcoholic drink containing 20% v/v alcohol (95% ethanol), and blood alcohol levels were examined over a period of time. The data showed that blood alcohol levels of the gastric bypass patients were far higher and required much less time to peak than those of the non-surgical controls.

The more rapid absorption of alcohol and heightened blood alcohol levels would cause the bariatric patient to have a more pronounced feeling of inebriation during and shortly after drinking.

Alcohol2_1 Why would alcohol absorption be higher for someone who has had gastric bypass? With the gastric bypass procedure, 95% of the stomach and the upper gut (duodenum and a portion of the jejunum) are bypassed. Alcohol passes directly from the stomach pouch, usually without restriction, into the second portion of the gut, known as the jejunum. This portion of the gut has a large surface area and readily and rapidly absorbs the alcohol.

In addition to anatomical changes in the tract that influence alcohol absorption, the gastric bypass patient may also be more sensitive to the intoxicating effects of alcohol because of the reduced calorie intake that occurs after surgery. A number of studies have found that alcohol absorption is far higher if fasting or when consumed on an empty stomach than if provided with a meal or drank soon thereafter.

Drinking alcohol in the early postoperative period may have other adverse effects on health. Frequent vomiting, low calorie intake, not taking multivitamins and malabsorption may cause a number of vitamin and mineral deficits, including thiamin.

Addiction transfer is yet another precaution to be considered with regard to alcohol. The prevalence of food addiction and associated eating abnormalities, i.e. binge eating, carbohydrate cravings, are high among individuals with morbid obesity. With bariatric surgery, the addictive tendencies for food and aberrant eating behavior are considerably improved. However, individuals with addictions often transfer their addiction to yet another substance, such as alcohol. According to the findings of one study, addiction transfer may occur in up to 25% of bariatric patients.

Drinking alcohol after surgery may also reduce maximal weight loss success. Alcohol has no nutrient benefits and contains high numbers of calories that may cause weight gain or prevent weight loss. One 12-ounce can of beer, for instance, contains 150 calories; 3.5 ounces of wine contains 70 calories; 1.5 ounces of gin, rum, vodka or whiskey contains between 97 and 124 calories; and 1.5 ounces of liquor contains 160 calories.

The bariatric patient should absolutely NOT drink alcohol during the rapid weight loss period and definitely not if consuming no or low carbohydrates, not taking vitamin and mineral supplements, vomiting frequently, or not able to keep their food down. However, with time, there is no reason an individual should not be able to enjoy an occasional drink, provided they are aware that it only takes a small amount of alcohol to produce an inebriating effect. With such knowledge, appropriate precautions should be taken, such as waiting a sufficient length of time after drinking to drive or perform other skilled tasks.

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Comments

TheMorbidMe

Colleen : Exactly the same happens to me.. I can drink, get drunk, then NEVER a hangover... this is great :) But remember that Alcohol is LIQUID CALORIE !!

Fil

I am 39 years old. Had GBS April, 2000 - didn't have a drink for more than 6months later. Alcohol was never a big thing for me as I choose pot. As the weight came off & I became a hot, single female :-) I socialized wih alcohol more. As time has gone by blackouts became more frequent & hangovers became a 2 day recovery & this could be even after a few glasses of wine with dinner. I make deals with myself any time I go out of what not to do. Recently I broke a deal with myself & it cost me dearly. I blew a .20 & thank god no one was hurt. This is a serious matter and I am contacting my surgeon to put a cirriculum together to speak with people pre GBS & immediate post GBS. I think more light should be shed on the effects of alcohol to our liver, kidneys, brains, colon & the rest of our systems. Good luck to all of you & I hope to have a public speaking forum soon. Take care & stay well. Don't Drink & Drive. Period.

scared

I HAVE HAD WLS RUEN-Y 2001AND SCARED NOW THAT I'M BECOMING AN ALCOHOLIC. DIDNT DRINK BEFROE WLS ..NOW I HAVE TO TALK MYSELF OUT OF BUYING WINE ..WHICH I END UP DOING. AND AFTER I DRINK I REMEMBER NOTHING ..I'M SO SCRED , DOES ANYONE HAVE THIS GOING ON ..THANKS FOR EVEN READING THIS ...

Fil

Hi Scared,
Blackouts seem to be be a side effect of drinking after this surgery! It is a serious thing here & should be looked into because it is not just the memory that we lose. If it is affecting the brain in this manor I can only imagine how the rest of the insides are being affected. I'll come on here weekly so if you need to talk just post & I will answer you. I don;t have answers myself but we may be in a similiar dilemma! Good luck & love yourself!

Lori

Ever since my surgery, I have lost the weight, become an alcoholic, and attended detox and rehab . What is wrong with this picture ? I have also gained all of my weight back. Help !!!!!

Debra

I'm so glad to know I'm not alone with this post surgery alcohol addiction. I lose most of memory of what I did, said and ate. I too don't experience hangovers. Instead of eating all night I now drink. I am the life of all parties, but I never remember the fun. Had this been brought to my attention prior to surgery, I would have stayed away from drinking. I am contacting my surgeon so he can inform future patients of this risk. Thanks everyone!

Gary

My 18 yo son said something about alcohol and gbs. I am 8 weeks out and have noticed the difference both in how much you drink and how fast it hits you. In my case, however, it seems to take long to feel the buzz.

Stay tuned

Jim

I had WLS in March 05. Could not believe the attention I got from women, left my wife (was already having problems pre-op). I started drinking slowly, it took an hour for me to drink one glass of wine. A couple months later, I was drinking two bottles a night, blacking out, hung over every day, sexually promiscuous, etc. Went to a psychiatrist and am getting help with the underlying reasons. On a lot of med that I dont think help much, but he says I am making progress. It is quite a journey and I hope to live through it....though I would have been dead from being overweight as well. Any ideas to help?

Fil

Hi, I hope everyone's holidays are going nicely & I wish the best for everyone in the New Year!
I come on here about once a week to read & reread some postings to know that I am not alone in this so thanks to everyone who posts here. GARY-I am amazed that you have had a drink 8 weeks after surgey - please be careful - it is very a serious thing we deal with! It doesn't turn into alcoholism for everyone but addiction transfer is something that all GBS patients should be aware of. After my DWI in October I was forced into a program by the courts & must remail clean & sober -it is 85 days today & I feel a tremndous difference in my body my mind however is another story! JIM you are not alone-the attention I get from men is exciting & I went through the same things you are going through. You will live through it - believe in yourself & know that the exterior may be hot & sexy - the interior will always be the same! God bless you & if you want to post I will definitely anser-it helps me as well! Take care everyone! :-)

Jim

Fil, thanks for the response and vote of confidence. You are right..I will live through it. Compared to this time last year, I am much more in control and more knowledgeable about my inside self. I was drinking a lot because of fear of being alone after my divorce as well as boredom. Still have the boredom, but am becoming very comfortable being alone. I think praying and going to church more often has helped. Good luck to you.

Fil

Hi Jim, You are welcome-it is amazing how we all have the same issues! It is everyone regardless of our exterior. The hardest for me was all the attention I get as a single female & not to toot my own horn - I was always cute but at 310 pounds not too many people notice. When I lost all the weight it was like I was a kid in a candy store & couldn't get enough so add the drinking to all of that - my social life was out of control, I thought it was great but after doing this for a few YEARS-I am tired & want just one man in my life. So now I stopped looking, started working on myself more & good things wil happen. Stay well & I hope to hear back from you. I am in NY where are you?

Jim

Fil, I was 347 lbs pre-op and the ex liked me that way. She got all the attention. When I lost the weight, she couldn't deal with it. I used to go out to bars and could not believe how many available, pretty women there are out there. I am trying to be better and feel I am better off being celibate and sober than the bar scene. I am in St. Louis. I spent a lot of time on the East coast...lived in Brooklyn for 6 mos. Where are you in NY?

Fil

Hi Jim,
I am originally from Brooklyn & live on Long Island for most of my years though! Yeah some people like to shine wile the ones they love stand in the background-it sounds like she has some issues to dela with too! I wish I could give you a personal email or contact but don't feel too comfortable posting it on here as everyone will then have it! What do you think? Maybe this site can get it to you or vice versa! Stay in touch! Have a great day!

Vana

This is amazing! i honestly felt like i was the only one. i also thought i just started drinking because they say some depression is normal after the surgery. i am only 6 months post op, but i want to drink all the time! i was never like this before. i have to struggle to not drink. i have two friends who have had the surgery and they are BOTH addicted to alcohol now too. its just good to know that i am not alone.

Pamla

It is a good thing to know you are not the only one. Four friends of mine and myself had this surgery almost 4yrs ago. I am the only one that had to struggle with the drinking. My life has been a very interesting ride since this surgery, specially after I did lose all the weight and more that I wanted. As much and my friends and I had researched this procedure before hand we have all felt at least at one moment or another or more..that we felt we were not very prepared at all on how our lives have changed or is still changing since the surgery. Its been a very bumpy road to this point in our lives but it seems that all our roads our much smoother now. We have helped each other tremendously. If you are not in a support group or in a very supportive family I strongly suggest that you get into one. You have no idea how much it helps. If I didn't have them I think I would have still had a problem. I have experienced at lot in this journey and I would do this surgery again if I had to. It has made me a much stronger person in every way. So.. for those that need a ear.. I'm here for anyone who needs or wants it. No one completely understands any of this unless you have gone through it. my email is [email protected]

Kris

My name is Kris and I am a food addict and alcoholic. I have become quite familiar with that saying because I attend 12-step meetings approximately 4 times a week. I had roux-en-y gastric bypass on Dec. 26, 2000. I had no physical complications post surgery, but the emotional/psychological implications have taken a toll. I lost 1/2 of my body weight within a relatively short amount of time. Before I knew it, I was spending money wildly and went bankrupt. Next came the relief of alcohol. I was not an alcoholic prior to gastric bypass, but addiction transfer and depression set in. Eventhough I was persistent at following my blood labs and consistent with taking suppplements, I experienced all over body PAIN. Excruciating aches. I have gone through rehab and have periodically relapsed with alcohol within the past 1.5 years. I have also put most of the weight back on since trying to control other impulsiveness problems. During my rehab, I started seeing a doctor who wanted to help with the alcohol cravings and put me on a drug called ReVia, which is an opiod-blocking drug. Amazingly, I no longer have any body pain and the depression has lifted. My personal belief is that since the Vagus nerve is cut during the surgery, there are long term psychological effects/deficiencies. Has anyone else experienced any of this?

mary

My husband had a gastric bypass about 4 years ago. Prior to it he drank alcohol and never appeared to be intoxicated. Now he can not stop drinkiong. Thus an alcholic... Recently he got stopped DUI and alcohol level was .28. No one told him prior to the procedure this could happen

Lisa

Wow, I was doing so well on my post op. I had lost all but twenty pounds that I wanted to. June 06 I started to drink, now I can not stop, it is insatiable and scarey. I am a middle age professional woman and I am saddened that I am now becoming an alcoholic. I drink more now than I ever did, sometimes 18 beers in a four hour peridod. I black out, I hurt myself and I do not remember convesations. My diabetis is trying to come back, blood pressure is now up and I have to go to work feeling bad, but after all is said and done, I go back. I was once a day, then several a week then about everyother day.
I am on Cambral now, it is to assist with the addition. I am addicted. I have been looking for a good AA on line group with interaction.

I pray I beat this. Thanks for listening...

Lisa

Belinda

I am almost 3 years out. I never drank before my surgery and rarely do even now. But when I do drink I drink too much. Last night I drank two bottles of wine. The first one was to get drunk, and by the time I got to the second one, I was doing it to die. I was completely out of control. Once I start I can't stop and when I can't stop I just want to die.

Michael

It is so amazing to me to read all theses stories about alcohol addiction. I had my surgery in January of '99. I never drank before my surgery but started drinking socially about 2 years ago. I now drink almost daily. I too can't seem to stop once I start and I don't remember much of what I have said while I was drinking. I know I need to get some help but am really embarrased by the whole situation. My wife has told me if I don't stop drinking we are through.

Burt

My surgery was just approved by insurance.Surgery should be in about a month. My wife and I typically have a few drinks most evenings before dinner. Have done this for years. Neither of us drinks during the day and we never get drunk. I know that drinking is out for some time after surgery per my surgeon and I see from the blog that there is a more rapid effect with less quantity of alcohol consumed. How significant is the effect of alcohol on weight loss especially since it looks like one would drink much less calorie wise to get the same relaxation effect. If I were to have a mild cocktail or glass of wine each evening before eating , does it have a large effect on weight loss? I plan to be very strict on diet, vitamins etc.

Burt

I was not drinking and was on a strict diet, vitamins, exercise and walking. I took a drink and was loaded, then more, and more. It has wrecked my health which I had gained back from a stroke and diabetis, now, I do not know what I am doing. I pray and keep spiritual, but this is an unhappy journey I am on right now. Just be careful. One drink can become many more. I have seen Medical doctors and professionals fall. It is overpowering because of the method alcohol starts to metabolize within the body.

Lisa

Rachel

How strange. I had never really heard of this alcoholism after gast bypass. I am 23 years old, and had it 4 years ago. I always blamed my cravings to get drunk on my age group....but i guess not. I always thought, whatever, i'm 21, 22, 23....everyone my age is drinking and partying...but when i do drink...i can never stop! I don't know why...even when i've realized i shouldn't have had the last 2 drinks...ha! But now i have a little more self-control and usually drink 2 or 3 glassed of wine once a week....unless there's a party....then i'll drink a lot more, but that's maybe once every 3 months.

Mike

Hey everyone! i have enjoyed reading many of your entries about Alcohol and the effects after surgery. I am 22 years old and just had the surger done 10 days ago. I feel great and have already lost 31 pounds with this time period. i was soo happy i wanted to go out and have 1 glass of wine. i didnt think it would hurt being that i felt good. needless to say i didnt end up drinking because good friends of mine told me they didnt think it was a good idea. i still have cravings of having just a glass of wine. before surgery i was on my way to becoming a social alcoholic. i drank beer, liquor and all the sweet frutie mix drinks. i know that i cant continue that same behavior after surger but i would like to limit myself to a glass of wine or two every now in there when out at social gatherings. when is the soonest i can take a sip of wine without hurting myself??? p.s. i think this is a wonderful site to share different ideas about things regarding gastric bypass and hope we all are able to continue to share ideas on her more often. doo keep in touch.

Mike

Hey everyone! i have enjoyed reading many of your entries about Alcohol and the effects after surgery. I am 22 years old and just had the surger done 10 days ago. I feel great and have already lost 31 pounds with this time period. i was soo happy i wanted to go out and have 1 glass of wine. i didnt think it would hurt being that i felt good. needless to say i didnt end up drinking because good friends of mine told me they didnt think it was a good idea. i still have cravings of having just a glass of wine. before surgery i was on my way to becoming a social alcoholic. i drank beer, liquor and all the sweet frutie mix drinks. i know that i cant continue that same behavior after surger but i would like to limit myself to a glass of wine or two every now in there when out at social gatherings. when is the soonest i can take a sip of wine without hurting myself??? p.s. i think this is a wonderful site to share different ideas about things regarding gastric bypass and hope we all are able to continue to share ideas on her more often. doo keep in touch.

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