title: A prior history of substance abuse in veterans undergoing bariatric surgery.
abstract: BACKGROUND
  The rates of obesity and substance abuse are high among US veterans.
  
  
  OBJECTIVE
  To examine weight loss and substance abuse rates following bariatric surgery in veterans with a history of substance abuse (SA).
  
  
  METHODS
  A prospective database of consecutive bariatric operations was reviewed. Data for SA patients were compared to patients without a substance abuse history (NA). Behavioral medicine staff followed patients throughout the pre- and postoperative courses.
  
  
  RESULTS
  Of 205 bariatric surgery patients, there were 74 (36.1%) SA patients. The mean preoperative body mass index (BMI) was 46.2 ± 8.1 kg/m², and percent excess weight loss at 12 months was 71.8%, 58.0%, and 33.5% for Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic gastric banding, respectively, not significantly different than the NA group (P = 0.15, 0.75, 0.96). Postoperative substance abuse in SA and NA patients was 8.1% and 1.5%, respectively (P = 0.234).
  
  
  CONCLUSIONS
  A prior history of substance abuse is common in veterans undergoing bariatric surgery; weight loss results are comparable to the general veteran bariatric cohort. Rates of substance abuse are low postoperatively, but higher in patients without a prior history of substance abuse. Close multidisciplinary followup throughout the postoperative course is likely to be integral to the patient's success.
authors.affiliation: Department of Surgery, Stanford School of Medicine, Stanford, CA 94304, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Tedesco
authors.forename: William Q
authors.initials: WQ
authors.lastname: Hua
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Lohnberg
authors.forename: Nina
authors.initials: N
authors.lastname: Bellatorre
authors.forename: Dan
authors.initials: D
authors.lastname: Eisenberg
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013997:Time Factors; D016896:Treatment Outcome; D014728:Veterans / Q000706:statistics & numerical data*; D015431:Weight Loss