Something most people who are considering weight loss surgery probably don’t consider is what role a history of or a predisposition to addiction might play in the decision.
Researchers at the University of Pittsburgh Graduate School of Public Health set out to examine the long-term changes in patients who had undergone bariatric surgery. They found a link between having the procedure and alcohol problems in particular. Although there are many types of weight loss surgery, this study focused on Roux-en-Y gastric bypass (RYGB), a type of weight loss surgery that changes the structure of the small intestine and makes the stomach smaller, about the size of an egg.
The study revealed that 20.8 percent of RYGB patients went on to develop alcohol use disorder symptoms within five years of having the procedure. Although they were unable to determine an exact reason for this, one possibility is that RYGB increases tolerance by altering the hormones that deal with reward circuits in the brain. One theory has to do with the effects of bariatric surgery on dopamine, a chemical that gets released in our brains when we perform high-reward activities such as eating, having sex, and doing drugs. Dopamine not only helps us register pleasure from these activities, it also motivates us to repeat them in search of more pleasure. The presumption is that anatomical changes in the stomach might impact patients’ dopamine response.
There is also a phenomenon called transfer addiction, where one addiction (in this case, food) ends only for a different one to begin. Studies show transfer addiction in up to 30 percent of patients who have had bariatric surgery. In some cases, it is literally impossible, because of physical changes to the stomach, for their previous eating habits to continue. For these patients, food is no longer a source of comfort, distraction, or reward, and they are forced to look elsewhere to satisfy these feelings.
Some of the risk factors that show an individual may be at risk for transfer addiction include:
- A history of eating disorders, food addiction, or compulsive eating
- A family history of substance abuse
- Regular consumption of alcohol before bariatric surgery
- A history of chronic pain/overuse of narcotics for pain management
- A history of trauma, especially childhood sexual abuse
- A history of depression and other mood or anxiety disorders
- A lack of adequate support or feeling isolated
- An avoidance of emotions and experiences
- A history of engaging in self-sabotaging tendencies
For someone who is dealing with an addiction (not including food) or has some of these risk factors before surgery, it is important to seek treatment for the substance use disorder first. It is also recommended that they be sober for a year or more before they consider having the weight loss procedure. These individuals can sometimes be hard to spot because they can jump from addiction to addiction without lingering long enough on anyone to become noticeable.
If you believe that you or a loved one are suffering from a substance abuse problem, call Asana Recovery at (949) 438-4504 to learn about our medical detox and residential and outpatient therapy programs.
