Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery
Open accessAbstract
CONTEXT: Anecdotal reports suggest bariatric surgery may increase the risk of alcohol use disorder (AUD), but prospective data are lacking. OBJECTIVE: To determine the prevalence of preoperative and postoperative AUD, and independent predictors of postoperative AUD. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study (Longitudinal Assessment of Bariatric Surgery-2) of adults who underwent bariatric surgery at 10 US hospitals. Of 2458 participants, 1945 (78.8% female; 87.0% white; median age, 47 years; median body mass index, 45.8) completed preoperative and postoperative (at 1 year and/or 2 years) assessments between 2006 and 2011. MAIN OUTCOME MEASURE: Past year AUD symptoms determined with the Alcohol Use Disorders Identification Test (indication of alcohol-related harm, alcohol dependence symptoms, or score ≥8). RESULTS: The prevalence of AUD symptoms did not significantly differ from 1 year before to 1 year after bariatric surgery (7.6% vs 7.3%; P = .98), but was significantly higher in the second postoperative year (9.6%; P = .01). The following preoperative variables were independently related to an increased odds of AUD after bariatric surgery: male sex (adjusted odds ratio [AOR], 2.14 [95% CI, 1.51-3.01]; P < .001), younger age (age per 10 years younger with preoperative AUD: AOR, 1.31 [95% CI, 1.03-1.68], P = .03; age per 10 years younger without preoperative AUD: AOR, 1.95 [95% CI, 1.65-2.30], P < .001), smoking (AOR, 2.58 [95% CI, 1.19-5.58]; P = .02), regular alcohol consumption (≥ 2 drinks/week: AOR, 6.37 [95% CI, 4.17-9.72]; P < .001), AUD (eg, at age 45, AOR, 11.14 [95% CI, 7.71-16.10]; P < .001), recreational drug use (AOR, 2.38 [95% CI, 1.37-4.14]; P = .01), lower sense of belonging (12-item Interpersonal Support Evaluation List score per 1 point lower: AOR, 1.09 [95% CI, 1.04-1.15]; P = .01), and undergoing a Roux-en-Y gastric bypass procedure (AOR, 2.07 [95% CI, 1.40-3.08]; P < .001; reference category: laparoscopic adjustable gastric band procedure). CONCLUSION: In this cohort, the prevalence of AUD was greater in the second postoperative year than the year prior to surgery or in the first postoperative year and was associated with male sex and younger age, numerous preoperative variables (smoking, regular alcohol consumption, AUD, recreational drug use, and lower interpersonal support) and undergoing a Roux-en-Y gastric bypass procedure.
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Changes in neuroendocrine hormones triggered by food restriction are dynamically associated with brain DA signalling, and addictive personality is related to maladaptive eating behaviours following bariatric surgery.
“This is consistent with preclinical (40) and clinical (41) studies showing dynamic associations between the changes in neuroendocrine hormones (e.g. insulin, leptin, ghrelin) triggered by food restriction and brain DA signalling and those of recent reports of a relationship between addictive personality and maladaptive eating behaviours following bariatric surgery (42,43).”
From Obesity and addiction: Neurobiological overlaps (2013) · cites this paper as [43]
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BackgroundA review of the psychosocial aspects of clinically severe obesity and bariatric surgery.
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- Authors
- King, W. C., Chen, J.-Y., Mitchell, J. E., Kalarchian, M. A., Steffen, K. J., Engel, S. G., Courcoulas, A. P., Pories, W. J., & Yanovski, S. Z.
- Affiliations
- University of Pittsburgh (US)
- Neuropsychiatric Research Institute (US)
- University of Pittsburgh Medical Center (US)
- East Carolina University (US)
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2012-06-20
- Volume
- 307
- Issue
- 23
- Pages
- 2516-25
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC3682834
- OpenAlex
- W1993605848
- Cited by
- 509
- References
- 50
- Citations by year
- 2026: 23 · 2025: 32 · 2024: 32 · 2023: 35 · 2022: 31 · 2021: 44 · 2020: 32 · 2019: 40 · 2018: 34 · 2017: 32 · 2016: 33 · 2015: 47 · 2014: 44 · 2013: 37 · 2012: 12
- FWCI
- 45.36
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK066471, U01DK066557, U01DK066526, U01DK066568, U01DK066555, U01DK066667, U01DK066585)
- National Center for Research Resources (UL1RR024153, M01RR000037, UL1RR024996)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- alcoholism, bariatric surgery, alcohol-related harm, smoking, obesity, sex differences
- MeSH terms
- Adult, Aged, Female, Humans, Male, Middle Aged, Obesity, Postoperative Period, Prospective Studies, Risk Factors, Sex Factors, United States, Cohort Studies, Prevalence, Odds Ratio, Alcohol-Related Disorders, Bariatric Surgery, Young Adult, Preoperative Period
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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