Alcohol consumption and alcohol problems after bariatric surgery in the swedish obese subjects study

Authors

  • Per-Arne Svensson,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Åsa Anveden,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Stefano Romeo,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Markku Peltonen,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
    2. Department of Chronic Disease Prevention, National Institute for Health and Welfare, FI-00271 Helsinki, Finland
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  • Sofie Ahlin,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Maria Antonella Burza,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Björn Carlsson,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Peter Jacobson,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Anna-Karin Lindroos,

    1. Food Data Division, National Food Agency, SE-75126 Uppsala, Sweden
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  • Hans Lönroth,

    1. Department of surgery, Institute of Clinical Sciences, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Cristina Maglio,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Ingmar Näslund,

    1. Department of Surgery, University Hospital, SE-70185 Örebro, Sweden
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  • Kajsa Sjöholm,

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Hans Wedel,

    1. Nordic School of Public Health, SE-40242 Gothenburg, Sweden
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  • Bo Söderpalm,

    1. Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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  • Lars Sjöström,

    Corresponding author
    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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    • Lars Sjöström and Lena M. S. Carlsson contributed equally to this work.

  • Lena M.S. Carlsson

    1. Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden
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    • Lars Sjöström and Lena M. S. Carlsson contributed equally to this work.


  • Funding agencies: The study was supported by grants from the Swedish Research Council (K2012-55X-22082-01, K2010-55X-11285-13, K2008-65X-20753-01), Swedish Foundation for Strategic Research, Swedish Federal Government under the LUA/ALF agreement, The Sahlgrenska Academy, the VINNOVA-VINNMER program. The study also received unconditional support from Hoffmann La Roche, Cederoths, AstraZeneca, Sanofi-Aventis, Johnson&Johnson.

  • Disclosure: All authors have completed the ICMJE Form for disclosure of potential conflicts of interest. SOS has previously been supported by grants from Hoffmann-La Roche, AstraZeneca, Cederroths, Sanofi-Aventis and Johnson&Johnson. Dr Sjöström has obtained lecture and consulting fees from AstraZeneca, Biovitrum, BMS, GlaxoSmithKline, Johnson&Johnson, Lenimen, Merck, Novo Nordisk, Hoffmann-La Roche, Sanofi-Aventis, and Servier, and holds stocks in Lenimen and is chairman of its board. Dr B Carlsson is employed by AstraZeneca and holds stocks in the same company. Dr Näslund has obtained lecture fees from Johnson&Johnson. Dr Jacobsson has obtained research grants from Hoffmann-La Roche. Dr L Carlsson has served as a consultant for AstraZeneca and holds stocks in Sahltech. Dr Sjöholm holds stock in Pfizer. Dr Söderpalm has obtained research grants from Organon and Schering-Plough (now MSD) and Pfizer, and lecture and consulting fees from Organon, Merck, Janssen and Actavis. Dr Söderpalm is also an inventor of a patent own by MSD regarding glycine uptake inhibitors for treatment for alcohol abuse disorders. All other authors declared no competing interests.

Abstract

Objective

Increased sensitivity to alcohol after gastric bypass has been described. The aim of this study was to investigate whether bariatric surgery is associated with alcohol problems.

Design and Methods

The prospective, controlled Swedish Obese Subjects (SOS) study enrolled 2,010 obese patients who underwent bariatric surgery (68% vertical banded gastroplasty (VBG), 19% banding, and 13% gastric bypass) and 2,037 matched controls. Patients were recruited between 1987 and 2001. Data on alcohol abuse diagnoses, self-reported alcohol consumption, and alcohol problems were obtained from the National Patient Register and questionnaires. Follow-up time was 8-22 years.

Results

During follow-up, 93.1% of the surgery patients and 96.0% of the controls reported alcohol consumption classified as low risk by the World Health Organization (WHO). However, compared to controls, the gastric bypass group had increased risk of alcohol abuse diagnoses (adjusted hazard ratio [adjHR] = 4.97), alcohol consumption at least at the WHO medium risk level (adjHR = 2.69), and alcohol problems (adjHR = 5.91). VBG increased the risk of these conditions with adjHRs of 2.23, 1.52, and 2.30, respectively, while banding was not different from controls.

Conclusions

Alcohol consumption, alcohol problems, and alcohol abuse are increased after gastric bypass and VBG.

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