Changes in Alcohol Use after Metabolic and Bariatric Surgery: Predictors and Mechanisms

Valentina Ivezaj, Stephen C Benoit, Jon Davis, Scott Engel, Celia Lloret-Linares, James E Mitchell, M Yanina Pepino, Ann M Rogers, Kristine Steffen, Stephanie Sogg, Valentina Ivezaj, Stephen C Benoit, Jon Davis, Scott Engel, Celia Lloret-Linares, James E Mitchell, M Yanina Pepino, Ann M Rogers, Kristine Steffen, Stephanie Sogg

Abstract

Purpose of review: This review synthesized the literature on predictors and mechanisms of post-bariatric alcohol problems, in order to guide future research on prevention and treatment targets.

Recent findings: Consistent evidence suggests an elevated risk of developing problems with alcohol following bariatric surgery. While there is a paucity of empirical data on predictors of problematic alcohol use after bariatric surgery, being male, a younger age, smoking, regular alcohol consumption, pre-surgical alcohol use disorder, and a lower sense of belonging have predicted alcohol misuse post-operatively. This review synthesizes potential mechanisms including specific bariatric surgical procedures, peptides and reinforcement/reward pathways, pharmacokinetics, and genetic influences. Finally, potential misperceptions regarding mechanisms are explored. Certain bariatric procedures elevate the risk of alcohol misuse post-operatively. Future research should serve to elucidate the complexities of reward signaling, genetically mediated mechanisms, and pharmacokinetics in relation to alcohol use across gender and developmental period by surgery type.

Keywords: Alcohol; Alcohol use disorder; Bariatric surgery; Obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy.

Figures

Figure 1.
Figure 1.
Preliminary model of potential mechanisms underlying AUD risk after MBS

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