Changes in Alcohol Use after Metabolic and Bariatric Surgery: Predictors and Mechanisms

Curr Psychiatry Rep. 2019 Aug 13;21(9):85. doi: 10.1007/s11920-019-1070-8.


Purpose of review: This review synthesized the literature on predictors and mechanisms of post-bariatric alcohol problems, in order to guide future research on prevention and treatment targets.

Recent findings: Consistent evidence suggests an elevated risk of developing problems with alcohol following bariatric surgery. While there is a paucity of empirical data on predictors of problematic alcohol use after bariatric surgery, being male, a younger age, smoking, regular alcohol consumption, pre-surgical alcohol use disorder, and a lower sense of belonging have predicted alcohol misuse post-operatively. This review synthesizes potential mechanisms including specific bariatric surgical procedures, peptides and reinforcement/reward pathways, pharmacokinetics, and genetic influences. Finally, potential misperceptions regarding mechanisms are explored. Certain bariatric procedures elevate the risk of alcohol misuse post-operatively. Future research should serve to elucidate the complexities of reward signaling, genetically mediated mechanisms, and pharmacokinetics in relation to alcohol use across gender and developmental period by surgery type.

Keywords: Alcohol; Alcohol use disorder; Bariatric surgery; Obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alcohol Drinking / epidemiology*
  • Alcoholism / complications
  • Alcoholism / epidemiology*
  • Bariatric Surgery / psychology*
  • Gastric Bypass / psychology
  • Humans
  • Obesity, Morbid / complications
  • Obesity, Morbid / psychology*
  • Obesity, Morbid / surgery*
  • Risk Factors