Alcohol consumption and alcohol problems after bariatric surgery in the swedish obese subjects study
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.
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.
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.
Alcohol consumption, alcohol problems, and alcohol abuse are increased after gastric bypass and VBG.