Gastric Bypass Surgery and Alcohol Consumption, Critical Information to Know (May 2016)
When we have surgery how often do we think about what our future will be like? Is consideration given to all of the trips to the doctor we will experience, how much happier we will be, and whether or not our requirements for our nutritional intake will be different? When I see clients who experience various gastric procedures, many of them do not think about how their lives will be different nutritionally, socially, and physically. What many people also fail to consider is not only how their bodies’ absorption of various vitamins and minerals will be impacted, but also how alcohol consumption will need to be addressed. Since alcohol consumption is a large part of the social life of many people it is critical to think about how the body is likely to react after gastric surgery.
According to a 2015 study at Washington University School of Medicine in St. Louis, women who have gastric bypass and lose weight metabolize alcohol faster in comparison to those who do not have gastric bypass. The study showed that post-bypass women who had consumed the equivalent of two drinks in a short period of time had blood alcohol levels (BAC) close to the levels found among women who had not had the surgery but had consumed four drinks.
The way alcohol is metabolized by the body changes according to Marta Yanina Pepino, Ph.D. Dr. Pepino is an assistant professor of medicine of geriatrics and nutritional science at Washington University School of Medicine. She is also a member of the team of researchers for the 2015 study mentioned above. Although Pepino’s study focused on women, researchers suspect that men could have a similar outcome, i.e., changes in alcohol absorption likely are altered after gastric bypass surgery in men as well.
The subjects of Pepino’s study were 17 obese women who had had the Roux-en-Y gastric bypass surgery, the most common bariatric procedure. The women were required to spend two days, one week apart, at Washington University Clinical Research Center. On one visit, each of the women was randomly given either the equivalent of two alcoholic drinks or two nonalcoholic drinks to consume within a 10-minute time period. At the second appointment, each woman was given the beverage she had not received during the first visit. Blood alcohol content was measured and then a survey was used to assess their feelings of being intoxicated.
The women in the gastric bypass group had an average BMI of 30; the average BMI of the women who had not had the surgery was 44. For the latter group, blood alcohol levels peaked approximately 25 minutes after they finished the alcohol, measuring 0.60g/L. Among the women who had had the surgery, blood alcohol levels peaked about 5 minutes after consumption, reaching 1.10g/L, which is much higher than the legal driving BAC limit of 0.80g/L. After two drinks, the blood alcohol content of the surgery group exceeded the legal driving limit for 30 minutes; however, the BAC levels in the other group never reached the legal limit.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), a sub-department of the National Institutes of Health, defines binge drinking as “a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours.” It was reasonable for the researchers to conclude, therefore, that the blood alcohol content in the surgery group met NIAAA’s criteria for binge drinking. It is also important to note that women who had the gastric bypass surgery can experience the result of alcohol consumption sooner and for longer periods of time when compared to women who did not have the surgery.
This is not the first study to examine how alcohol metabolism is altered after bariatric surgery. It is important to note that the post-surgery women had only consumed the equivalent of two drinks, but they reacted as if they had consumed twice that amount.
Awareness of these results is not only important for yourself, but also for your loved ones and anyone that you know who will consider this surgery.
References:
1. Dryden, Jim, “Gastric Bypass Surgery Lowers Women’s Alcohol Tolerance”, Washington University School of Medicine, August 5, 2015. https://source.wustl.edu/2015/08/gastric-bypass-surgery-lowers-womens-alcohol-tolerance/
2.NIH-National Institute of Alcohol Abuse and alcoholism. “Drinking Levels Defined,” NIH: NIAAA, http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
3.Pepino, M.Y., and others. “Effect of Roux-en-Y Gastric Bypass Surgery: Converting 2 Alcoholic Drinks to 4,” JAMA Surgery.2015;150(11):1096-1098. doi:10.1001/jamasurg.2015.1884 http://archsurg.jamanetwork.com/article.aspx?articleid=2422337
