Alcoholism after gastric bypass: Is it in your mind or gut?
Scientists have competing ideas for why gastric bypass patients show higher rates of alcohol abuse post-surgery
Steph Yin • January 9, 2015
As researchers scramble to find explanations for alcoholism after gastric bypass surgery, many doctors still don’t know to warn patients about the risk. [Image credit: Flickr User Faisal Akram]
In 2009, Jackie Kim received a gastric bypass that shrunk her stomach and rerouted part of her small intestine. Within a year, she had lost 180 pounds and felt great.
Then her troubles with alcohol set in. It started with ordering wine in place of dessert at dinner. “At first I thought, ‘This is great, I don’t have to sit at the table twiddling my fork while everyone else is eating their crème brûlée,’” recalled Kim, a 44-year-old medical consultant living in St. Louis, Missouri.
But soon the occasional glass of wine turned into much more.
Kim spent the next two years fighting addiction. “Lots of scary stuff happened during those years,” she said. She regularly drank alone at home, two bottles of wine at a time. Before long, she was hiding bottles from her husband, driving while drunk, blacking out and discovering injuries she didn’t remember getting.
Her story is not uncommon. In 2012, a large study published in the Journal of the American Medical Association reported that the percentage of patients abusing alcohol increased from 7.6 percent before surgery to 9.6 percent two years after surgery — that’s potentially an additional 2,000 alcoholics each year in the United States. Since then, a growing body of evidence has corroborated these findings. The longest-running study suggests the effect persists even a decade after surgery.
Still, many patients today are unaware of the risk of alcoholism when they get a gastric bypass, and scientists themselves are not completely sure why the risk exists. One early theory was addiction transfer, which suggested that people might adopt new addictions after weight-loss surgery because they can no longer fulfill their food addictions. But more recent evidence suggests there may be an anatomical explanation: specific metabolic and hormonal changes triggered by gastric bypass that leave patients especially vulnerable to alcoholism but not other addictions. It’s also possible that both explanations are right — or neither.
“Whether it’s addiction transfer or something else going on, we really don’t know at this point,” said James Mitchell, a doctor and professor of neuroscience at the University of North Dakota. What’s certain, he said, is that the high rates of alcoholism in patients who have had a gastric bypass operation cannot be attributed to chance.
Doctors have long touted gastric bypass surgery as the gold standard for weight-loss operations. Of the 200,000 bariatric procedures performed in the United States each year, roughly 80 percent are gastric bypass surgeries. Research shows the surgery not only causes weight loss — 90 percent of gastric bypass patients keep off 50 percent of their extra weight even a decade after surgery — but also resolves related illnesses such as type 2 diabetes, heart disease and cancer, leading to a 40 percent overall reduction in mortality for gastric bypass patients.
But alcoholism could be a dark consequence of the surgery for some patients — even if no one is sure why.
The explanation of addiction transfer assumes that people who overeat are often predisposed to addiction. Researchers have reported addiction transfer in many forms — a recovering alcoholic might start chain-smoking, for instance. But the general idea is often contested, partly because it can be difficult to pinpoint the roots of addiction: some argue it is physiological, while others insist it is driven by psychology.
One physiological explanation for addiction, first described by a neuroscientist at the University of Florida named Kenneth Blum, is a blunted response to dopamine, a chemical that gets released in our brains when we perform high-reward activities such as eating, having sex, doing drugs and listening to music. Dopamine not only helps us register pleasure from these activities, it also motivates us to repeat them over and over again in search of more pleasure.
In 1990, Blum found a correlation between alcoholism and a genetic deficiency in dopamine-binding receptors in the brain, called D2 receptors. People with compromised D2 receptors seek higher thrills to satisfy their reward cravings than people with normal D2 receptors, Blum believes. He predicts that gastric bypass patients with a D2 deficiency turn to other high-reward activities, such as drinking alcohol, because they can’t binge eat with a constricted stomach.
Still, most scientists attribute addiction to a combination of genetic and environmental factors. Blaming addiction on a single gene is too simplistic, said Lance Dodes, a psychiatrist based in Boston who has written three books on the topic, including one called Breaking Addiction. Dodes believes addiction has a psychological basis. He argues that consuming a substance or behaving compulsively provides an outlet for people who feel otherwise unable to take direct action in their lives. Many of his alcoholic patients, he said, start feeling better the moment they decide to take a drink — not when the alcohol actually enters their bodies.
Addictions can be interchangeable because they are a psychological response to feeling trapped, said Dodes. “We call them separate addictions, but they’re really just one mechanism.”
But one major problem with Blum’s and Dodes’s ideas is that there’s little evidence of higher alcoholism rates after a different common bariatric surgery: gastric banding. Also known as lap banding, this surgery installs an inflatable belt around the stomach to constrict it. Unlike gastric bypass, banding does not permanently alter the stomach’s architecture.
The difference between the two surgeries suggests that alcohol abuse is related to structural changes from gastric bypass, said Alexis Conason, a New York City psychologist and researcher.
In 2012, Conason published a study in JAMA Surgery that found a significant increase in alcohol use for patients after gastric bypass, but not gastric banding. The study also found no significant increase in patients’ use of other drugs, including cigarettes, or compulsive behaviors such as gambling. “If it were addiction transfer, we’d be seeing it across the board,” Conason said.
Researchers have proposed a few physiological explanations for increased alcoholism specifically after gastric bypass. Some believe it’s due to changes in alcohol metabolism, since alcohol enters the bloodstream more quickly in a smaller stomach. A 2011 study from surgeons at Stanford University found that six months after surgery, gastric bypass patients reached higher blood alcohol levels more quickly than they did before surgery. This type of fast and high peak often characterizes addictive drugs, said North Dakota’s Mitchell. Cocaine and heroin, for example, both produce brief, intense rushes that leave users wanting more.
But it’s also possible that increased alcohol dependence has nothing to do with alcohol absorption in the stomach. Recently, a team of researchers led by neuroscientists at the Pennsylvania State University College of Medicine found that rats that had been given gastric bypasses developed a higher dependence on alcohol. Here’s the twist: the effect held even when the rats were given alcohol intravenously instead of orally. The authors concluded that alcohol abuse after gastric bypass could very well occur independently of how quickly alcohol passes from the gut to the bloodstream.
Instead, anatomical changes to the stomach might impact patients’ dopamine response, the Penn State researchers suggested. Some scientists have found that gastric bypass surgery can alter the signaling of D2 receptors. The mechanism for this is unclear, although preliminary research has identified altered patterns of gene expression in areas of the brain that process dopamine. Other researchers suggest that appetite-mediating gut hormones play a role, particularly those that affect dopamine signaling, such as insulin, leptin and grehlin. Scientists have shown that leptin and grehlin levels change after gastric bypass surgery, and both hormones are known to modulate alcohol consumption.
It’s also possible the explanation is not so clear-cut. Conason admits that researchers can’t completely write off addiction transfer, and there might be other reasons why alcoholism is more prevalent than other addictions. For instance, gastric bypass patients may simply be more likely to drink alcohol than take other drugs, which are less socially acceptable.
The risk of alcohol abuse is serious, Mitchell said, but it is one of many considerations for gastric bypass candidates. Particularly for people facing life-threatening conditions such as diabetes or heart disease, the possibility of alcohol abuse might not be strong enough for patients to actually forgo the surgery.
Even so, Mitchell and most of his colleagues agree that doctors need to strongly communicate the risk of alcohol abuse to patients before surgery. In many cases, including Jackie Kim’s, doctors don’t highlight the risk at all.
After years of counseling and seeing her addiction wreak havoc on her relationships and physical health, Kim reached a breaking point. She hasn’t touched a drink in more than two years. “But it wasn’t easy,” Kim said of her hard-fought recovery. She knows that others also might not have been coached on the risks, so she mentors patients who have had the surgery and posts in bariatric support groups online.
Kim believes that being aware of the problem would have made all the difference for her. “I experienced a lot of anger with my surgeons afterwards for not doing a better job educating me,” she said. “If they had told me not to drink, I wouldn’t have started in the first place — and it wouldn’t have spiraled into what it became.”
*Correction, Jan. 10, 2015:
A previous version of this story identified Kenneth Blum by the incorrect profession. He is a neuroscientist.
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About the Author
Steph Yin
Steph Yin is a science writer & illustrator based in New York City. She hails from dreamy Providence, where she spent a lot of time “doing science” (read: baking dirt in windowless basements), making animations and chopping vegetables. Though nowadays she spends her time doing journalism, she really dreams of creating a traveling puppet show about science. Everyone is invited to help paper mâché, play music and boogie. Most recently she has been a contributor to Cafe.com. Tweet her at @Steph_Yin, learn more at inkchromatography.wordpress.com.
133 Comments
I am thrilled that this vital information is finally getting out to the mainstream public (or at least, those in the medical community). However, I’ve been blogging this very same thing for over ten years now. See by blog at itsnotaddictiontransfer or my Facepage of the same name.
Researchers and doctors such as Ostlund from Karolinska showed years ago, that the risk of not only alcoholism, but also depression, mood disorders, and suicde quadruples when the intestines are bypassed. No such increase in banded or gastrectomy.
Dr. Wendy King’s research showed that problems like alcoholism typically present around two years after surgery (not right away as one would expect for an emotional need to self soothe).
Dr. Stephen Benoit showed an increase in alcoholism in mice, and was kind enough to talk to me for quite a while. He had some interesting ideas on hormonal chnages and/or gut bacteria changes. Gut bacteria has been in the news a lot lately regarding the gut-brain connection.
I also spoke with Alexis Conason in great detail about two years ago. I understand, that as a psychologist, she has a certain level of commitment to the idea of addiction being caused by an unresolved emotional void. But, as a scientist myself, the data doesn’t seem to support it. Psychologists tend to see people who’ve had this surgery and struggle with addiction afterward, and assume because they are struggling, the struggles came first.
My thought is the struggles are secondary to the confounding biochemical changes. And everyone has “issues”, but Dr. Dodes I think is way off on his theory of addiction and I would like to see some peer reviewed data to support his idea, because I’m really not sure its there.
In fact, NIDA’s newest ‘tag line’ is they are now committed to ‘evidence based’ treatment approaches. Which implies that the past treatment approaches may not have been quite so evidence based, and was likely more what well-meaning people wanted to be true.
Thank you again, for publishing this. It’s been a long time coming.
I’m so glad I found this information as it is very pertinent to what I’m currently experiencing. It’s been 9 years since my surgery, and my doctor gave no information about alcohol issues. I agree that if I’d been told not to drink at all after the surgery, I would have avoided this. I’m convinced of that because I was advised to stop drinking sodas as they were considered a major cause in obesity, and I have not consumed any soda in 9 years.
My next question is – where to go for help? I’m not Christian, so faith-based counseling is not my answer. I don’t see myself as the typical alcoholic as I’ve never physically hurt myself or anyone else, I’ve never driven under the influence, never been to jail. But I do understand that I have a real problem drinking at home and want some direction as to where to find help. Thank you.
Hi J.G., thanks for writing. I have heard comments very similar to yours, so you are not alone. I’m not an expert on this, but one place you might want to check out is obesityhelp.com. The site has forums and groups related to this issue, such as this one: http://www.obesityhelp.com/group/crossingtotransferaddictions/. You may be able to find someone who can better answer your questions there. Best of luck.
JG check out AA. There’s plenty of Christians, Jews, Muslims, Mormons and Agnostics involved.
The only requirement to attending a meeting is a desire to stop drinking.
Many members never reached the situations you consider alcoholic. Also there are drugs available such as Vivitrol shots which drastically reduce alcohol cravings.
Good luck!
Has anyone considered the effect of sugars? After gastric bypass sugar intake is greatly reduced and the sugars in alcohol may be the individual’s response to the decrease.
I had my gastric bypass in 1999. Before surgery my surgeon did warn me that I would absorb alcohol and get drunk much faster, which I certainly found to be true. I am fortunate that I never progressed to alcoholism. I did however get much too drunk sometimes by drinking too fast. I have to always be mindful of how much and how fast I drink.
I am no expert, but obese people generally have an extremely high refined carbohydrate diet producing significant sugar handling problems. As such, it throws blood sugar in a never ending cycle of high blood sugar level followed by an Hypoglycemic reaction. The body releases large amount of insulin, which lowers blood sugar below normal level. This causes sugar craving that needs to be satisfied, starting a new sugar handling cycle. This is simple physiology. We all know that in the long run it will lead to diabetes and metabolic syndrome.
May I suggest that obese patients are already physiologically “addicted” to sugar before undergoing gastric bypass surgery. Unfortunately, the sugar craving addition persist following the surgery, and since alcohol is easy to ingest for gastric bypass individuals, it becomes an easy replacement for carbohydrate rich foods.
In my humble opinion, better patient education about the effects carbohydrate and “alcohol have on blood sugar, and the possibility of becoming an alcoholic would a long way in helping gastric bypass patient avoid a lifetime of misery.
I had my bypass 10 years ago and about four years in started drinking heavily. I isolated myself and physically was hurting myself…I ended up in the hospital several times… I am currently in AA. I believe it’s the only answer.
There could be a another explanation. Since we know these individuals are unable to control their eating behaviors, when we make them control them through a surgical intervention, they substitute one maladaptive coping strategy (food in excess) for another (Etoh in excess) as explained by the ACE study at http://www.acestudy.org. These individuals should not be treated surgically until they have been screened for and if present, had their PTSD effectively treated.
My daughter had her bypass in 2000. She didn’t really drink before the surgery. But after the first buzz from the alcohol she was lost, to 8 years of hardcore drinking.
She tried everything to try to stop, but then In 2008 I saw DR Olivier Ameisen on the news. He was talking about his book “(HEAL THYSELF)”,make sure the author is Ameisen, about his own addiction and how he discovered a treatment: a BACLOFEN regimen that he perfected for himself. Something told me “you need to read this book”. As I read the book it was like he was writing about my daughter’s experience with her addiction and trying to get the help she needed. I believe she would have died if I had not found Dr. Olivier Ameisen and his book. I found a local doctor who was willing to think outside the box and helped her with the protocol from his book. Today ,Jan. 2015, she has not drank since 2009 and becomes nauseated when she even sees a empty beer can.
I am so thankful for Olivier Ameison. He died in 2013 of a heart attack
My surgery was in 2002. No one said anything about alcoholism, maybe the didn’t know. They did suggest not drinking because it could be painful. I waited six months. The first time burned like fire, but the high was delightful so I continued. I noticed that I became intoxicated quickly but sobered up quickly so I could consume more much more than usual. I also noticed as Dr. Dodes pointed out that I began to feel good as soon as I decided to take a drink. Also, my drink of choice became a much sweeter drink which has led me to wonder how much I crave the alcohol and how much the sugar. Presently, after 13 years I have cut back but am still struggling. Advice would be appreciated.
As a psychologist who works with people who have binge eating disorders, I am always put in a position of evaluating people for surgery. It is a constant conundrum because if I tell the surgeon a person is not ready, they go to someone else. Ultimately, those (most) who do the surgery without first having psychotherapy and taking psychotropic medications self medicate after surgery with alcohol and/or other drugs. I cannot speak for a physical reason but it can surely say that mood disorder is the primary cause of their problems.
I have found a helpful FaceBook group that you can go to for information and support.
https://www.facebook.com/groups/615689415180294/
This article, and the comments made, are fascinating! Thank you so much for highlighting this issue! I had no idea.
The connections between microbiome health, nutritional deficiencies, and all sorts of psychiatric diseases is interesting and enlightening. There are a lot of answers in our guts.
I had my surgery in 2011. My story is very similar! I was a severe alcoholic for over 2 years. I am now sober for over 6 months. Thanks for writing this article! I am still in shock at how quickly and how severe my alcoholism was. It was ruining the life of my children and husband. It felt like a slow suicide to me. It was tough to get out of that dark hole. AA saved my life!
Not all obese people are food addicts. I never was a food addict; I had a pre-disposition to being obese. I’m an educated person and lost weight successfully many times for many years. At one point I kept off over 100 pounds for 18 years. When I got out of the military and I cut back on working out (which was 3 times A DAY everyday for eight years) the weight crept back on. I finally gave in and had bariatric surgery in March 2003. It took a year but I lost 85lbs to my goal weight of 135. I loved wine but not regularly. A bottle would go bad before I could finish it. Then when I moved to NY, to a more isolated lifestyle (opposite that of California) I was drinking more and more. I successfully went back to being a ‘social drinker’ on weekends. But by 2009 that escalated to 1/2 bottle, to 1 bottle, now to 2. I’ve gained most of my weight back due to the empty calories but I blame it on my thyroid – but I know that’s just a lie. I tried AA but I’ve never been able to connect with the folks in that group – any AA group I’ve tried. I haven’t had the troubles and struggles in life that many of them have had. I don’t do drugs, I’m a high functioning alcoholic, and never miss work. I know I have a problem but I also know I can stop with the right help. I don’t want to use my health insurance as I don’t want treatment to become part of my permanent file God forbid. I just wish there was a local group that was available everyday that I could reach out to or even someone just to talk to. Now I’m an obese alcoholic and I don’t blame the doctors. I blame myself. I take full responsibility for how this happened but I can’t go into my 50’s and have this be a part of mylife for another decade – jeeze, I can’t imagine living that long = my organs can’t handle it. I’m a binge drinker – I drink 1 to 2 bottles 5-6 days a week at the same time everyday. Not at work, not when I drive, not in front of people and only at home alone. I’m a closest case for sure. I think if I could talk to someone that’s been in my shoes or is going through the same thing, one day at a time the alcohol will become a thing of the past. This is no life. I’m a beautiful person and I don’t want this life anymore. I struggle with it everyday and I’m alone in my secret. No one knows about this other life I lead. I thought about hypnosis. Not sure. Thanks for the article. I speculated for years it was definately something to do with the absorption of the alcohol. It hits you hard and you feel very very different than with alcohol before. I can’t have an intimate life because of this. Anyway, thanks for reading and listening.
This information has been very helpful. Prior to surgery I was a social drinker …maybe a martini or two once a week. I had gastric bypass in 2010. In 2013 I would have a glass of wine at night. Early 2014 to 2 glasses at night then late 2014 drinking 3-4 glasses a day. Now 2015 I go through a bottle every other day. Sometimes a bottle a day. I am educated, employed full time, married and not into the support group scene (always thought I was stronger.) I never understood craving alcohol but its what I do now. I have a private email blingitmonme at yahoo if anyone would like to talk. Glad I am not alone. This is the first time I have acknowledged this.
My surgery was in 2004. About two year later is when drinking became the “solution”. I have been struggling mightily the last few years and do not have a treatment that works for me…yet. I’ve tried AA, inpatient, outpatient, therapy and lots of reading. It’s pretty disheartening. I love the research that is coming out in more recent years. Understanding it my not help me treat it, but I couldn’t imagine it hurts and I appreciate not feeling so alone.
What can be done to help with this problem, It makes you feel so alone and embassressed .you feel so puzzeled why are you self harming yourself. How can i stop this please help
Thank you for providing this information. It’s very helpful.
Please take a look at SMART Recovery – it is an evidence-based recovery method that does not involve 12-steps or a belief in a Higher Power. I had my gastric bypass in 2003, had never been a drinking prior to that and by 2006, I was drinking every day to numb myself from unhappiness with my life in general. I tried AA but found the spiritual aspect of it and the powerlessness aspect of it very, very unhealthy.
I am a Psychologist, a Post-Gastric-Bypass patient, and a recovering alcoholic. I had my surgery in 2001. Due to my family history of alcoholism, I was always careful with alcohol prior to my surgery and even for a few years following my surgery. After years of trying to manage my drinking which I knew was starting to be a mild problem , I began binge drinking. By 2007 I was a full-blown alcoholic. By 2008, I had two DUI’s within 6 months. I totaled a car, almost killed people in my accident I had in full blackout, and was completely out of control. I had falls, injuries from my falls, and I was in 4 detox centers, one rehab, and A.A. I almost lost my jobs, and I was extremely fortunate that I was able to get it together to obtain my doctorate. At my worst, I was drinking two bottles of wine nightly and blacked out constantly. This all happened in about two years. I, like others who have posted, felt similarly. I would get a great buzz and felt like I would sober up quickly. I would then keep drinking until blackout which would happen so rapidly. I finally have over 2 years of continuous sobriety and now treat others in a rehab where I am employed. I see post-gastric bypass patients so often in recovery and the psychiatric hospitals I have worked at. Their stories are all very similar; 90% of them never had a drinking problem prior to their surgery. They also do not substitute other addictions for food but find themselves baffled by their alcohol addiction stating that the onset was post-gastric bypass. It usually takes them fast and hard and they cannot understand how they end up in rehab. While my experience has cost me almost everything (e.g my career, ungodly amounts of legal fees and other financial problems, family problems I am still repairing, etc), I only wish one thing from all the surgeons who do this surgery…that they tell anyone who is considering this surgery to never drink alcohol again because their risk for alcoholism goes up exponentially. I had a wonderful psychiatrist say to me something beautiful as I was sobbing in rehab. He said, “it isn’t your fault. You don’t have a stomach anymore so alcohol floods your system and your organs. You just can’t drink”. What I wouldn’t give to go back and have had that warning so I could make an informed decision. I was told I would just get buzzed easily and I should just avoid the calories of alcohol. I wasn’t told of the risks. I didn’t develop alcoholism until I was 38. I have the genetic predisposition for alcoholism, the social element from growing up in an alcoholic home, and yet I didn’t have a problem until post-gastric bypass. If you are considering this surgery, please, never drink alcohol again. It is too risky. You don’t have to have the predisposition, but you will get the physiological inability to properly metabolize alcohol if you have this surgery.
I had gastric bypass in 2002, with not only great doctors, but great support groups. We were told to eliminate alcohol, carbonation, sugar (given many people experience “dumping”), and don’t drink while you are eating. Two of my passions in life are food and wine, and that has not changed with gastric bypass. After the weight loss and subsequent plastic surgeries, I started dating for the first time in over 15 years, and alcohol and food were part of that activity for me. I did not really see a large change in affect of the alcohol on me, as I was always a social drinker, only on rare occasion to excess. Part of the fun for me is the food with wine, so I brought that habit back with me, in moderation after about 6-9 months.
Here is the odd part I notice – That first 1/2 wine glass gives me a quick rush or buzz, usually with a flush/mild hot flash, but it’s effect dissipates very quickly also. It seems very consistent with the fact that I have always metabolized medications quickly – novocaine at the dentist – they always have to give me more during the procedure, benadryl or other antihistamines – don’t make me sleepy, ritalin – needed bigger doses and long acting varieties for focus. It would take a bottle of wine in an hour to get me drunk, and since I don’t drink for intoxication, I hardly ever get to that point. I do occasionally have as much as a bottle of wine in a long evening (4+ hours). Could there be a “metabolism” difference that remains before and after gastric bypass?
Alcohol’s empty calories have contributed to gaining some of the weight back, but 13 years out, drinking wine regularly has not taken a toll beyond that. Or maybe I have my head in the sand?
My 39 y.o. son had gastric bypass surgery in 2013 and within 6 months began drinking relatively heavily. He ultimately lost his mid-6-figure income job (twice), wrecked two cars and was on the verge of losing his family. I discovered a Program called Start Fresh Recovery and his life has changed totally for the better.
Google two things; The Sinclair Method and Naltrexone, an opiod antagonist that removes the cravings for alcohol. Happy to answer any other questions you might have about this.
I got the surgery 7yrs ago and i am now a alcoholic! I never liked hard liquor and would only drink beer. But after the surgery,all i wanted was vodka and i used to HATE vodka! I was never told about the risk of drinking. As a matter in fact,my doctor just told me to wait 1mth before consuming alcohol. Yea i lost 125lbs.but now all i want to do is drink. All my family and friends couldn’t believe it cause i would b the DD! LOL,not anymore!!
Before I had gastric bypass 10 years ago I was not a drinker. Occasional drink at events but never at home.
About 2 years out I began having reactive hypoglycemia. This still plagues me but I’m able to keep it at bay by eating small meals throughout the day that consist of high protein foods. If I miss one of these snacks and have a full meal that has any carbs at all in it my sugar bottoms out between 35-40. I started having a few drinks about three years out. It wasn’t a craving, just a social thing. I would be fine and then in a nano second I was full blown drunk. The first time I blacked out I thought someone had put something in my drink. I never associated it with alcohol. I would only drink on the weekends but it quickly became binge drinking. I don’t crave it at all but once I have one glass of wine I know I can’t go past two even if I’m fine. It’s like someone flipped a switch! Once I reach that point I become an emotional idiot! I’ve tried talking to friends but they just don’t understand. AA doesn’t relate and I need to talk to people who understand the gastric bypass aspects of it. I go weeks without drinking anything! Then go out and hit that switch mode and just lose it!
Any advice would be appreciated! I’m going to look into some of the things mentioned here.
Thank you!
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Same story here. I had my RNY in 2001. prior to that I had been a social drinker, I could take it or leave it. About 2 years after my surgery I started drinking 1 or 2 drinks a night, then 3 or 4, then full blown alcoholism within 6 months. Blacking out, driving drunk, waking up in my own urine. I am a professional, intelligent, educated woman. I had a hard time admitting I was an alcoholic. I went to rehab and AA, but still couldn’t admit it, and spent the next 8 years binge drinking, isolating and living a secretive, miserable life. I finally admitted I was an alcoholic and started going to AA, even though I didn’t like it. I kept trying different groups and finally found a women’s group that I really like. 4 other women in my group have also had gastric bypass. Many of them, like me, haven’t lost jobs, gotten DUI’s, or ruined marriages. We just couldn’t stop drinking on our own, and it was only a matter of time. Now I am a staunch supporter of AA, and honestly believe it has saved my life. I’m also learning to manage my relationship with food. I don’t know why this happens, in my opinion it doesn’t matter how or why, it did happen, and I’m glad I was able to face up to it and get sober. It was a very difficult journey.
As a certified addiction counselor, 13 year RNY post-op, and 25 years in recovery I say this… The predisposition is real – the addiction pre-op is with sugar ( carbs break down to sugar). Individuals need to address the underlying issues that food was numbing … If not addressed, then other substances, such as alcohol will become an option to numb what they do not want to feel or deal with. I specialize in food addiction and find it necessary to educate bariatric patients! Thank you for such an insightful article!
I’m in the midst of this insanity now. Been through the courts, losing my marriage, feel ill all the time when I’m sober but hate the drinking and it’s effects.
It may be too late for me but is there anyone in MI who can help? I’m desperate and having thoughts of suicide. I don’t know how to handle this and I don’t think AA will help. The SMART recovery system looks interesting but the nearest meeting is over an hour away.
I’m afraid that I’m going to be the one that falls through the cracks.
My story is really about my husband. He had RN
Y in 2001 and was not warned about the damage or danger of alcohol. Within 2 years of the surgery he began drinking. I really believe it snuck up on him, a beer or two here and there and then it was vodka. At this point we had been married 14 years and when we began the marriage I asked that no alcohol would be in the house because of our young children. So this sudden behavior change was shocking. Within 5 years he was drinking heavily and the first DUI came. He started AA but, that didn’t seem to help him. By this time he was a full blown alcoholic and would sneak any form of alcohol he could. I sadly recall a morning I decided to look through his truck (so I could rid his life of liquor) and removed 7-8 bottles of bourbon. Once he realized his precious cargo was missing, it was full blown war. I thought I was helping him by getting rid of any evidence so he wouldn’t get an open container ticket. This is such a debilitating disease, it actually affects the significant other, I became the enabler!! This story goes downhill from this point. 2 more arrests, job losses, family completely disgusted and giving up on him. 10 1/2 years after the surgery his body started shutting down. He went to his Dr.’s office who sent him to the hospital for testing. He was diagnosed with cirrhosis of the liver with a life expectancy of 6-9 months. Sadly I say he passed away 6 months to the date of that diagnosis.
If you or a loved one would like to visit I am here for you. God Bless.
Similar story here. I was always a social drinker…. sometimes going over the top but not on any consistent basis. I was warned that alcohol would have a greater effect on me after my surgery but I didn’t realize HOW great of an effect. I had my surgery in 2004 and became an alcoholic very soon afterward. Rehab in 2008 and I have not had a drink since. I don’t believe that it was an addiction transfer. I believe it was a chemical reaction somehow.
Drs need to emphasize the real possibility of becoming an alcoholic because of gastric bypass surgery so that people can make a decision based on the overwhelming statistical data.
I know five people who have had this surgery, three became alcoholics. The forth person did not drink before surgery, but is now drinking and will probably also become an alcoholic. The fifth lady almost died due to complications from the surgery, but she is thin now. One had a stroke from malnutrition, which still causes her problems now. Out of the five ladies I know that had the surgery, only two were successful in losing all the weight they needed to, the other three still struggle because they are drinking and do not adhere to the post surgery restrictions. Eating is considered an addiction, and I believe that the issue in the person’s heart needs to be resolved before the weight issue can be resolved successfully. It seems alcohol is replacing their food issue. Before getting this surgery, please ask yourself, why do I eat? And, do your research. What are the post surgery restrictions?
I had the vertical sleeve gastrectomy in 2010. Prior to that, I was on pain medications for back issues and used them normally. Shortly after my surgery, they began to produce a high that they never had before and I became severely addicted, ended up in pain clinics, getting kicked out is them for overuse and by 2013, the amounts were so dangerous. I went to AA in early 2013 and have been clean and sober ever since. I noticed too that I would get drunk quickly on alcohol and would be sober quickly too, and the cycle would continue all night sometimes. I didn’t have the RNY, but the VSG and I don’t even produce ghrelin. The effects appear to be the same as with the RNY.
Not sure of the whole story behind my niece. She is 32 married with one child. She had the gastric bypass surgery a little over a year ago. She is in ICU from alcohol abuse. Seeing her detox is terrible.
I feel the pain of so many of your comments. I had Gastric bypass surgery in 2002. I lost 135 lbs in one year and got very thin. I’ve only ever had to have one iron infusion and only occasionally have to take B12 because my levels are normal. Here’s the kicker though:
I was always a social drinker but didn’t have cravings for alcohol. After surgery, I didn’t drink for about two years. I became pregnant with my first child one year after surgery. The drinking stopped once I was pregnant with my second child and I didn’t drink anything alcoholic for two years. Then we moved to a new neighborhood, met some new friends who had kids of similar ages, and guess what…they LOVED to party. So, my drinking escalated. Always beer or wine. For the last 5 years, I’ve been drinking anywhere from one bottle to two bottles of red wine per night, and sometimes beer during the day on the weekend if we are boating. I have maintained my job and marriage. Never drank wine around my kids – only after they were in bed.
For the first four years, I didn’t have any symptoms afterwards other than a typical hangover. Now, I’m having symptoms that are scaring me to the point that I don’t want to drink again. Specifically (sorry if too much info), when my blood alcohol level gets to zero, I begin having diarrhea. And usually the stool is a clay color or other odd color. Second, I have crushing anxiety. Third, heart palpitations. Fourth, I have high blood pressure for the first time in my life.
When I have a drink, these symptoms go away. And that just terrifies me, because it makes me want to drink again despite the fact that I want to quit. Someone else above my comment mentioned how awful they feel when they don’t drink. That’s true for me, too. The only thing I know to do is just stop completely and suffer through the side effects until they go away.
I did go see my doctor and he gave me Ambien to help me sleep. Obviously, it can’t be taken with alcohol and I won’t. That’s why I haven’t taken any yet.
I have blood work results coming back on Thursday this coming week, so at that point, I’ll know the damage I’ve done over the years, and I hope that further strengthens my resolve to abstain for good. It’s really really hard to imagine life without alcohol, but I want to live to see my grandchildren (if my kids have kids) grow up.
I hope my story has helped someone here or someone looking for anyone out there with similar issues. If you want to talk, comment and I’ll send you my email address.
I would to talk to u…i have a similar story.
I would like to chat same type of issues
Same situation, I’m in shock over these stories. I would like for my email to be shared with Annette and Beth if possible. I started with trying wine and immediately felt that feel good sensation that prior to surgery would have taken 3 glasses. Then I started drinking a couple of glasses of wine a night, then a bottle a night. There were very few nights that I wasn’t drinking wine. It would take all of my willpower not to get a glass as soon as I got home from work. Now I feel like I can’t stop. I am 2 years post RYN. I have a familial predisposition for addiction (family members with alcoholism, drug addition….) I’m really scared. I rarely drank before the operation. There’s more…… if I can make any connections, I would appreciate it more than I can say. thanks.
Hi, my name is Georgia. It feels so good to have other people discusing the things that I complain about all the time. We should create a Facebook chat page to vent. Lol…This is my story to date!
I had my RNY in Jan “06”. I was never a drinker before that. I was around drinking through my entire life, because of that I hated drinking. I almost died from my surgery losing all my blood and needing a full transfusion, due to too much Ibuprofen in my system, so I bleed out. I was in a car accident that hurt my liver two weeks before. The seatbelt hurt my liver on impact. My ultrasound revealed a fatty live. My doctor closed the door to her office and had me sit down to tell me, if I didn’t lose weight, I had 5 years the most to live. I had my gastric bypass two weeks later.
Months later I needed an Iron transfusion. My memory started to fade slowly. There was a dimness from lack of b12 and nutrition. Loose stools, sugar crashes and dumping became unmanageable. Maintaining my diet in a way that didn’t make me sick was exhausting.
My husband decided we should go do something fun together the following summer of “07” while I was on summer break in college. So he looked up local vineyards in Connecticut and then we started going on weekend trips for wine tasting. There was a contest for a trip involved if we went to all of the CT wine vineyards having our book stamped at each. We didn’t win but we did go to all of the vineyards. They were beautiful. We collected all the etched wine glasses and purchased a bottle of our favorite wine at the end of each tasting which we would drink together that evening when we got home. We saved all the empty bottles in the basement in a wine rick to remember our wonderful summer together with my nice new healthy fit body. We had a lot of beautiful pictures of us together in my new size ten clothes. Those were the happy days!
When school started again, I would drink wine at night, thinking I liked it. Soon after, beer and depression followed. I started drinking more and more. My two youngest children were teenagers then. I didn’t want them to see me drinking, so I started spending weekend at my mom’s house, telling everyone that she needed my help, but really we drank a lot. My mom is an alcoholic, so it made it easy for me to go there and drink, we were now buddies, when before I didn’t like spending time with her because of her obsessive drinking. I tried to hide it and denied it even to myself, but the truth was, I was becoming an alcoholic. I remember passing out on my mom’s lawn one night after retching and waking up freezing and wet in the dark am. For some reason I thought I still had my drinking under control. I told myself I could stop. I felt I was still functioning with an A average in school and I even finished up my associate’s degree that fall.
The following July I was at my mom’s house again on a Friday planning to spend the weekend to hide my drinking from my kids. I got a phone call, I was already passed out but my mom woke me up. My 15 year old son was coming home from our local church carnival when he was hit by a car. He died 3 days later in the hospital from a traumatic brain injury.
I went to legal study’s classes for the next year so I could, with the help from our state representative, write a bill to change a law under a side walk bill in Connecticut. The Bill now makes a safe passage for intersections that was not there before. We found out that the intersection was messed up soon after my son passed, others had died before we found out but nothing had been done because the government protects the states through sovereignty. I was so angry I thought if I fixed it would make me feel better. Also, along with my town, the schools and my friends we got 4000 signatures to have the inappropriate intersection fixed. I thought this too would make me feel better, but it didn’t bring my son back, so I feel deeper into the bottle and depression. I didn’t care anymore! I was chronically suicidal, in an out of the psychiatric hospital.
Finally, after 4 years I decided, my sons passing didn’t kill me, but now I am a pathetic drunk, I need help, so I went into rehab in Florida for 6 weeks to try and help myself. Once I completed this, the rehab dropped me off at the airport, I was drunk before I got on the plain. A few months later PTSD therapy followed. I have slowed my drinking down so I’m not passed out and blacking out all the time, but it’s not over. That was a year and a half ago.
I go for B12 shots every 3 weeks just to function now, when I try to completely stop drinking my sugar falls over and over until I am too tired to get out of bed, my memory is diminishing from lack of vitamins and now I’m back in therapy. I just got blood work back, my liver is paying the price. I have to stop drinking or I will die. For the first time in six years since my son died, I want to live and achieve things in my life again, but I can’t function. I have been sober for 2 weeks and I feel hopeless. I wish I never had this gastric bypass. I can’t function and I’m sick all the time, tired or depressed. I’m glad I checked this page out though it gives me hope. When I see my doctor tomorrow I’m going to ask him about the Sinclair method of Naltrexone. Maybe if I go off alcohol slowly, I won’t feel so sick.
I wanted to mention a couple of meds I’m on to help from earlier posts. The person with the very low sugar problem. I have it too, it’s from the dumping my gastrologist gives me Montelukast SOD to help. It doesn’t make it stop, but it does take away the dumping sickness and helps regulate my sugar levels some. Also, the woman with the muddy stools, ask your doctor about cholestyramine powder, it helps us digest food better. Mine was so bad I was pooping out whole food. Did you ever pull lettuce pieces out of your butt? This will help! I know, TMI…lol
Thanks to everyone for telling their story, I feel a little bit more normal now.
well, South Korea is a place where u can find a lot of professional clinics. alcohol is not a solution, even though u are depressed. at all!
10 years, 4 months… GONE. I am currently in active addiction. 2 years post RNY and I have relapsed with epic proportions. I am hiding bottles everywhere… in the spare wheel house of my car; I have “lost” bottles of booze because I have blacked out and whilst on drunk auto-pilot I have forgotten where I have hidden these glass bottles of happiness. I equate this relapse as a rapid and galloping slide towards utter destruction. I am an alcoholic; I had been sober for 10 years and 4 months and then I started with a “little” Angostura Bitters in my cold drink… that turned out to be 2-3 bottles a day. I have a history of alcohol abuse. I have bi-polar mood disorder and have a history of chronic insomnia. This binge has eased the symptoms of all of the bi-polar effects. I have not properly dealt with my familial issues, nor my extremely addictive personality. Here I am appealing to you to give me a lifeline. I have done the 12 steps, I have been to rehab centres and psychiatric instituitons… I just do not have the energy to do what it takes right now. I guess I am just posting this so that “other” people are aware that I am a fallen “hero”. It takes courage and conviction to admit you are an alcoholic.
I am admitting here, because I do not feel I will be judged and reviled.
I had surgery in 2002, prior to that I had only drank one time to excess om my 21st bday and maybe had a beer or a few wine coolers after that. I waitied the 6 months to try any alcohol and it has been downhill ever since. Thats 13 years of battling with drinking to excess. That is sad. I get hwat others are saying about a switch turning on. That first sip hits me and I am lite up like a tree. Everything looks brighter feels better until I drink to a point of blackout and feel like crap the next day. My emotions go crazy and I become someone I dont recognize. I was not a binge eater before surgery nor a sugar addict. I would do anything to go back to that first drink after surgery and never take it. I believe I became an alcoholic at that moment. Thank you for sharing the article.
What’s up, just wanted to say, I loved this blog post. It was funny. Keep on posting!
Tessa, you need to love you. I am sure you are wonderful and strong just for posting. If you need someone to call that has been through the same I will help you. we all need a helping hand. 475…238…8999… call me now!!! I will help you and you can help me as well
I had gastric bypass in 2008. Before surgery, I drank at most a wine cooler a year or a single glass of low alcohol dessert wine a year. After surgery, I started going out a lot and the alcohol helped me talk to people. I would usually get tipsy when going out, but never too much to not be able to drive home safely. I only went out and drank on weekends. This went on for a few years, then I started having a glass of wine each night at home. The alcohol intake has slowly increased over the years. I stay away from hard liquor because it has lead me to binge drink and black out and drive drunk with no memory of it. So, for years I have been drinking a bottle of wine each night. With each passing year, the alcohol content of each wine increases – it used to be 13.5%, then 13.9%, then 14.5% and now 15%. I drink a glass within an hour and then chug the rest to pass out. I am addicted to this behavior. I can go without drinking and do not have any withdrawal symptoms, so I do not consider myself a full blown alcoholic yet, I am just addicted to chugging a bottle of wine every night to pass out. I cannot buy more than one bottle at a time for fear of over drinking and driving drunk. I know this behavior is NOT sustainable. I think for me it is addiction transference. My main love is still food and I wish I could binge eat all day BUT I do not ever want to be fat again, so I would rather be a skinny alcoholic. But it is no life because I have ZERO energy to do ANYTHING. Caffeine does not even affect me anymore. Morbid obese people with horrid eating habits can still function better than I can.
My entire family has had addiction in it: my mom was a chain smoker and died of lung cancer, my grandfather was an alcoholic and died of liver failure, my aunt was a drug addict who died of overdose, my uncle is a food addict. I think being raised in a dysfunctional family is what results in having an addiction. There is a book about Adult Children of Alcoholics that goes into great detail about how an adult will turn out if they were a child raised in a dysfunctional family. I HIGHLY recommend reading that book and taking the test online to see if you can relate. Not only can you be addicted to a substance or act (sex, gambling) but you can also be addicted to a person. My sister does not drink or do any drugs but she is with an alcoholic who treats her like the dirt under the doormat. She is co-dependent on him. HE is her addiction. She has tried several times to leave him over the years but she always goes back. When you are raised in a dysfunctional family, you do not develop healthy self esteem. Why else would we do these bad addictions that we know are harming and killing us? Because we have no true self love on the inside. We were never shown healthy unconditional love as children and as a result, do not love ourselves as adults, thus we can do these harmful behaviors to ourselves (which includes binge eating or any other eating disorder).
I find it interesting that none of the scientists researching this problem seem to have asked the people who have had stomach surgery why they feel they need to drink more alcohol after surgery.
I had a gastric sleeve eight years ago. What I noticed straight away was ‘something’ missing when I ate food. It was hard to put my finger on, but there was definitely some different. I would get hungry and look forward to eating, but there did not seem to be any message from my stomach to my brain to say that the meal was nice or satisfying. This was good at first as I didn’t have any urge to overeat. I even developed my own theory as to why it felt different after surgery, putting it down to the removal of the part of my stomach that produced the hunger hormone grehlin, (I now more firmly believe that I was correct in thinking this).
This would all have been good except that I gradually started eating more and drinking more. I always was a good cook, but gradually I spent more time cooking beautiful meals and accompanying those meals with a glass or two or three while cooking and while eating my meal. Now eight years later, I know I have a problem with my alcohol intake. Reading this article lets me know that perhaps I am not alone with this.
I will be trying my best to stop drinking with food or at any other time as I know it is not good for me. I hope I can do it alone, but do wish that there was some help and a lot more research around this.
Wow. 3 weeks post sleeve. Haven’t drank since 20s now at 52 I have been drinking wine in evenings about 1-2 glasses. I don’t have support re the surgery not from hubby and it angers me. Im a food addict. Not many folks get that. I’ve been using wine in evenings to mellow out. To keep calm. But reading these comments makes me feel I’m headed for destruction
I’ve been eating less looking forward to the wine at night. Not sure how to get a grip. Any help would be appreciated.
G’day my name is Andy and I am intending to have the Gastric Sleeve operation next year. The Doctor I consulted suggested I get the gastric bypass as I have a strong sugar craving/addiction.
I am also a recovering alcoholic in Alcoholics Anonymous and sober One Day At A Time for nearly 13 and a half years.
When the doctor said to me about Gastric Bypass patients having a possible problem with alcoholism post surgery, I said to myself ” No Way “.
I read in a blog posted also about Gastric Bypass patients possibly suffering from increased risk of depression, mood disorders and suicide.
Do any of you know or were any of you recovering alcoholics before Gastric Bypass surgery? If so, how has your post surgery life been? Psychologically?
Thank you for your time.
Yours sincerely
Andy
Andrew Macklan
The problem is very real. I run a transfer addiction group on FB with over 600 members, and it is always growing. The transfer addiction group on obesityhelp.com has over 1000 members. I had my surgery in 2007, developed alcoholism by late 2008, finally got sober in 2010, and by the grace of God and by working a 12-step program now have over 5 years sober.
My 44 year old sister had gastric bypass surgery 5 years ago. She did drink some before her surgery, although it was after that she began drinking heavily. In mid January, she was admitted to the hospital with severe jaundice, ascites, and confusion. Her terminal liver damage occurred after her surgery. She died last week from severe alcoholic cirrhosis of the liver, kidney failure and encephalopathy. It seems to me, after reading all of the above messages and watching my sister die because a surgical choice designed to make her healthy ended up bringing upon her demise, that there needs to be some serious screening or education or something to make patients understand that alcohol illnesses are just as serious a risk as any other medical risk.