Increased Alcoholism Rates Seen in Gastric Bypass Patients

Something (another article with a "DUH!?" factor) that comes as zero surprise to a post operative gastric bypass patient, who reads about other gastric bypss patients, and talks to hundreds of them.  <insert heavy dramatic sigh>


European researchers have found gastric bypass patients have an increased risk for postoperative alcohol dependence. Based on a retrospective cohort of bariatric surgery patients, the investigators are calling for clinicians to examine gastric bypass patients for postoperative alcohol-related diagnoses.

“The results of this study clearly indicate the need for physicians to screen for alcohol abuse as part of the workup prior to bariatric surgery and to follow patients who undergo this operation carefully for signs of alcohol abuse,” said Craig Fisher, MD, MPH, associate professor in the Department of Surgery, Weill Cornell Medical College of Cornell University, in New York City, who was not involved in the study.

According to investigator Magdalena östlund, MD, a researcher in the Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, patients’ increased risk for acute alcohol intoxication, dependence, and weight gain after gastric bypass surgery may come from greater alcohol absorption in the small intestine and a more immediate spike in blood alcohol levels.

In light of previous research that showed substance abuse and mental illnesses were more common among obese patients, Dr. östlund’s team set out to investigate whether bariatric surgery might reduce the frequency of these illnesses. She and her colleagues examined data from 12,277 Swedish gastric bypass and restrictive surgery patients treated between 1980 and 2006 and followed for a mean of 8.9 years postoperatively. The researchers compared data between these patients and 122,770 age- and gender-matched controls who did not undergo bariatric surgery; they did not control for obesity in the matched group.

Compared with controls, bariatric surgery patients had significantly higher rates of psychosis, depression, attempted suicide and alcohol-related diagnoses, such as acute alcohol intoxication, and alcohol dependence before surgery. Preoperative rates of these illnesses were similar among patients undergoing restrictive and gastric bypass procedures; however, patients undergoing gastric bypass were 2.3 times more likely than those receiving banding procedures to get inpatient treatment for alcohol-related diagnoses postoperatively (odds ratio, 2.3 for bypass vs. banding). The only other diagnosis that changed in frequency after surgery was psychosis, which decreased in both groups.

“Patients need to be warned of the risks of alcohol consumption following gastric bypass,” Dr. östlund said at the 2011 Digestive Diseases Week (abstract 266).

Dr. Fisher said the strengths of the study’s design make the findings exceptionally reliable. “These data are unique in that they capture a population with very complete follow-up information,” said Dr. Fisher. “In the U.S., researchers often find it difficult to follow patients continuously, since they sometimes receive initial treatment at one center but go elsewhere for follow-up care. As there are a limited number of bariatric surgery centers in Sweden, the researchers were able to track all of the patients who underwent surgery.”


Drs. Fisher and Ostlund had no relevant information to disclose.

Source – General Surgery News

 

Foodgasm-new-8

Gastric bypass helps curb temptation better than banding?

A small study was done on roux en y gastric bypass patients and gastric band patients in the UK, to test the temptation of naughty foods on both types of post ops. 

Reuters

After surveying patients who had either type of surgery, and performing brain scans on several dozen of them, Dr. Tony Goldstone of Imperial College London and Hammersmith Hospital and his colleagues found that even deep down in their brains, the gastric bypass patients seemed to like high-calorie foods less.

"The results suggest that gastric-banding patients had to exert quite a lot of self-control over their eating behavior. Banding patients also had higher concern about their weight," Goldstone told Reuters Health.

In contrast, gastric bypass patients "don't feel they have to exert as much cognitive control over what they're eating," said Goldstone

Although I don't have a gastric band, I have lived seven and a half years with a gastric bypass, married to a man with a gastric bypass — who's mom and sister who have had a gastric bypass.  I would agree with this study for myself — the gastric bypass did shut down a lot of the mind-gut connection for me.  

Why?

Honestly, gastric bypass can cause such serious distress when eating so-called tempting foods, that once we DO try them again?  (And, we do!)  

We may make that cognitive connection that food = discomfort = sick = don't do that again.  Certainly it doesn't always work, and we might continue to eat foods that cause us distress because We Are Human and make mistakes and food sometimes just appeals to us too much.  Also, gastric bypass has a funny way of making some foods appeal to us, make us sick ONE TIME, and the the NEXT TIME?  We have zero reaction.  

This is a sticky situation — and it's a gastric bypass food roulette.  Many of us have a list of foods that cause a reaction every single time we try them, or just sometimes, and a list of perfectly safe foods.

Not everyone has a reaction to food — some gastric bypassers get by with no reaction to any food, ever — and love to announce this — but they're crazy and we don't talk about them.  (I'm kidding.)  

I would say that banders have it rough when it comes to food choices — they don't get the hand-slap fun that bypassers do.  This cognitive "don't eat that, it will make you sick" fun of the gastric bypass is a big part why people choose to have the roux en y to begin with.  This is a big reason why I did not have a band.  I know what I would be doing.  "Hello, ice cream.  I have missed you."  

My MRI reactions would be food-gasming over Mint Chocolate Chip again.  Which, right now?  I have COMPLETE aversion toward — because of the gastric bypass.

Foodgasm-new-8

Follow Up After Bariatric Surgery May Save Your Life – Suicide

If you, or someone you know, is in suicidal crisis or emotional distress please call

1-800-273-TALK (8255)

Follow Up After Bariatric Surgery May Save Your Lifefrom Mary Jo Rapini

Suicide is one of those things you can never change your mind about. It is final, and it hurts everyone who ever loved or cared for the person who commits it. A recent study reports an increase in suicides two to three years after surgery.
Considering that about 225,000 Americans are now having bariatric surgery each year, according to the American Society for Metabolic and Bariatric Surgery, this is a problem we cannot ignore.
The latest study, which tracked deaths among Pennsylvania residents who underwent bariatric surgery, examined a longer period than previous research — up to 10 years following the procedure. Among 16,683 who had bariatric surgery between 1995 and 2004, 31 committed suicide by the end of 2006, the researchers found. The data translate into a suicide rate of nearly 14 per 10,000 men per year, and five per 10,000 women each year. Those numbers are substantially higher than the suicide rates among Pennsylvanians in the same 35-to-64 age range, during the same period. Among all men in the state, the suicide rate in 2005 was 2.5 per 10,000, while the rate among women was 0.6 per 10,000. Overall, 30 percent of suicides in the surgery group occurred within two years of the procedure, and 70 percent occurred within three years.
Study author, Dr. Hilary A. Tindle of the University of Pittsburgh, reports that the reasons for the higher suicide rates are unclear. She was not able to examine the details surrounding the individual suicides. She does state that this study does not imply bariatric surgery itself leads to suicide, but it may be the emotional conditions the patients suffered prior to bariatric surgery or they may have developed after the surgery which leads to suicide.
Read the whole article at Obesity Help

Study – Gastric Bypass Increases Risk for New-Onset Alcohol Abuse

And, from the "No, really?" files 

A study of 340 patients who underwent Roux-en-Y gastric bypass surgery in Boston found that the surgery increases the risk of new-onset alcohol abuse, Medscape Medical News reported.

Stephanie Sogg, PhD, a clinical staff psychologist at the Massachusetts General Hospital Weight Center in Boston, said she looked into the link after hearing anecdotal evidence about middle-age patients becoming dependent on alcohol.

Ms. Sogg and other research conducted phone interviews with participants to ask about their alcohol intake before and after surgery. More than two-thirds said alcohol affected them more after surgery. Seven percent reported developing a drinking problem after surgery.

Medscape

Screen shot 2011-08-13 at 9.01.18 AM

Intervention – Brittney – Gastric Bypass – Alcoholism

Screen shot 2011-08-13 at 9.01.18 AM
Brittney is a post op.  Brittney has a problem.  

Welcome to the thousands of post ops with the same problem.  

Here is where I interject my link:  HAVE YOU READ WEIGHTY SECRETS?  

People ARE addicts.  People ARE Alcoholics.  It IS real.  There are entirely too much denial in our community about the reality of post weight loss surgery addiction.  I see it EVERY FUCKING DAY.  "Is it wrong that I watch Intervention while I drink a bottle of wine?"

Yes.  Very.  WHAT THE FUCK?

Brittney saw her food addiction transformed into a raging alcohol addiction after gastric bypass surgery. Now she stands to lose her family as they grow weary of her alcohol-fueled antics.

Watch preview here.

Watch it on A + E Monday Night 

Screen shot 2011-08-13 at 9.04.08 AM

Over-eating-7

Binge Eating Officially Defined As A Mental Disorder

Over-eating-7 Binge Eating Officially Defined As A Mental Disorder.  It's about TIME – NO?

Really?  It wasn't already?  Binge eating disorder, as defined by Mayo Clinic is a serious eating disorder in which you frequently consume unusually large amounts of food. Almost everyone overeats on occasion, such as having seconds or thirds of a holiday meal. But for some people, overeating crosses the line to binge-eating disorder and it becomes a regular occurrence, shrouded in secrecy.  When you have binge-eating disorder, you may be deeply embarrassed about gorging and vow to stop. But you feel such a compulsion that you can't resist the urges and continue binge eating.  Although binge-eating disorder is the most common of all eating disorders, it's still not considered a distinct psychiatric condition. But if you have binge-eating disorder symptoms, treatment can help you.

NPR

Binge eating is defined as eating large amounts of food when you're not hungry and then feeling disgusted and depressed afterward. But most people do this from time to time. It's the frequency of a person's binge eating — and the depth of the anguish he or she feels — that raises flags.

Previously the DSM had listed binge eating in the manual's appendix, as a tentative category. Research that has come out since the last major revisions to the DSM 15 years ago justifies the classification of binge eating as a disorder in its own right, says Dr. B. Timothy Walsh, a psychiatry professor at Columbia University Medical Center and chairman of the eating disorders work group for this version of the DSM.

Some doctors treated binge eating with therapy or with medication even before it was recognized as a disorder. In some cases, a binge eater's treatment included a weight-loss regime that basically ignored the psychological aspect of the disorder.

"We're not talking intermittent overeating — that is normal — but this is recurrent, persistent, frequently occurring, accompanied by lots of distress, guilt and unhappiness," Walsh says. "We do have data that this affects a small percentage — 2 to 5 percent — of Americans throughout their lifetime."

Researchers and doctors still don't really know what causes these issues, he says, and various factors appear to contribute.

"There's no consensus as to what is the best treatment," Walsh says. "Several types of medications appear helpful, as do several types of psychological treatment."

Binge eating is associated with middle-aged men and women, and it is not always linked with obesity. That's why treatments that address weight loss alone aren't necessarily helpful, Walsh says. He is hopeful that the categorization of binge eating as a disorder will stimulate further research. In particular, he says, he'd like to see some study of how mental health treatments for binge eating affect a patient's outcome.