Predictors of Alcohol Use after Bariatric Surgery
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Predictors of Alcohol Use after Bariatric Surgery Lisa R. Miller‑Matero1,2 · Aaron Hamann1,3 · Leah LaLonde1 · Kellie M. Martens1,3 · John Son4 · Shannon Clark‑Sienkiewicz1 · Monika Sata1 · Joseph P. Coleman1,2 · Leah M. Hecht1,2 · Jordan M. Braciszewski1,2 · Arthur M. Carlin3,4 Accepted: 1 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Patients undergoing bariatric surgery are at risk for devloping an alcohol use disorder (AUD). The purpose of this study was to investigate pre-surgical psychosocial risk factors for post-surgical alcohol consumption and hazardous drinking. Participants (N = 567) who underwent bariatric surgery between 2014 and 2017 reported their post-surgical alcohol use. Information was collected from the pre-surgical evaluation including history of alcohol use, psychiatric symptoms, and maladaptive eating behaviors (i.e., binge eating, purging, and emotional eating). Younger age and pre-surgical alcohol use predicted post-surgical alcohol use and hazardous drinking. In addition, higher levels of depressive symptoms and maladaptive eating patterns predicted post-surgical binge drinking. Clinicians conducting pre-surgical psychosocial evaluations should be aware of the multiple risk factors related to post-surgical problematic alcohol use. Future research should evaluate whether preventive interventions for high-risk patients decrease risk for post-surgical alcohol misuse. Keywords Bariatric surgery · Alcohol use · Psychiatric symptoms · Maladaptive eating
Introduction Bariatric surgery is the most effective treatment for weight loss and medical co-morbidity remission among those with severe obesity (Clark et al., 2005; Gloy et al., 2013; Maciejewski et al., 2016). Patients who undergo bariatric surgery are recommended to adhere to lifestyle changes to reduce surgical risk and maintain weight loss, including abstinence from alcohol (Sogg, Lauretti, & West-Smith, 2016). This recommendation is based on research demonstrating that patients who undergo bariatric surgery may be at higher risk for developing alcohol use disorder (AUD). Despite the recommendation to abstain from alcohol, 60 to 83% * Lisa R. Miller‑Matero [email protected] 1
Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI 48202, USA
2
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
3
Department of Surgery, Henry Ford Health System, Detroit, MI, USA
4
Wayne State University School of Medicine, Henry Ford Health System, Detroit, MI, USA
of patients still consume alcohol after undergoing bariatric surgery (Buffington, 2007; Miller-Matero et al., 2019), leaving many patients at risk of developing an AUD. The prevalence of AUD of approximately 7% at 1-year post-bariatric surgery is similar to the rate in the general population (King et al., 2012; Substance Abuse Mental Health Services Administration, 2017), yet the rate of those meeting criteria increases over time with over 16% meeting criteria for AU
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