Weight Loss Surgery and Alcohol: Tread Carefully

Weight loss surgery is designed to limit how much a person can eat to reduce their daily caloric intake, but it can also limit how much alcohol a person can drink before becoming intoxicated. For this reason, post-operative weight loss surgery patients are wise to limit how much they drink when the occasion arises.

For gastric bypass patients, the effects of alcohol are especially rapid. The new stomach design reduces the body's production of alcohol dehydrogenase, an enzyme that metabolizes alcohol. In addition, with the bypass, alcohol is transferred to the blood stream much more quickly. This means that one drink can be enough to legally intoxicate some gastric bypass surgery patients who used to have a higher tolerance.

Lap-Band patients do not experience effects as dramatically, since the Lap-Band procedure does not impact their body's production of the enzyme. For the most part, gastric banding patients process alcoholic beverages in same way they did before surgery, says Minnesota Lap-Band surgeon Dr. William Lee.

He notes, however, that alcoholic beverages are still a source of "empty" calories, regardless of the type of weight loss surgery procedure someone has had. Wine, beer and liquor offer no real nutritional value, and they also break down vitamins. Since they are liquid, they pass into the bodily easily, no matter how the stomach has been restructured. So for people who are trying to keep track of calories and make progress with shedding pounds, regular alcohol consumption can be a real hindrance.

Equally important is the issue of "addiction transfer," which occurs frequently among weight loss surgery patients. People who once used food as a way to manage uncomfortable emotions suddenly find themselves unable to pursue their food addiction after bariatric surgery, and they find another addiction to replace it, such as alcohol, drugs, smoking, shopping or sex.

An estimated 70 percent of weight loss surgery candidates are addicted to food, says Katie Jay, director of the National Association of Weight Loss Surgery, and 7 percent of them develop new addictions after their operation. This low percentage, of course, represents the people who admit they have a problem.

"What happens is, some people call it 'a hole in their soul,' but there's something there," Jay said during an interview at the 2009 American Society for Metabolic and Bariatric Surgery Conference. "We use food to manage our mood and all kinds of things. After surgery, you lose that coping skill, and some people need something to replace that."

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