title: High-risk alcohol use after weight loss surgery.
abstract: BACKGROUND
  Bariatric or weight loss surgery (WLS) may alter alcohol metabolism resulting in a higher prevalence of problem drinking postoperatively. Few studies distinguish those who report improvements in drinking from those who report worsening behavior after surgery. The objective of this study was to characterize high-risk alcohol use before and after WLS and according to surgery type.
  
  
  METHODS
  We interviewed patients before and annually after WLS. High-risk alcohol use as assessed via a modified version of the Alcohol Use Disorders Identification Test-Consumption.
  
  
  RESULTS
  Of 541 participants who underwent WLS, 375 (69% retention) completed the 1-year interview and 328 (63% retention) completed the 2-year interview. At 1 year, 13% reported high-risk drinking compared to 17% at baseline, P = .10; at year 2, 13% reported high-risk drinking compared to 15% at baseline, P = .39; 7% and 6% of patients, respectively, reported new high-risk drinking at 1- and 2-year follow-up. At both follow-up time points, more than half of those who reported high-risk drinking at baseline no longer did so. A larger proportion of gastric bypass patients (71%) reported amelioration in high-risk drinking than gastric banding (48%) at year 1, but this difference did not reach statistical significance (P = .07); the difference largely dissipated by year 2 (50% versus 57%) .
  
  
  CONCLUSIONS
  Although 7% of patients report new high-risk alcohol use 1 year after WLS, more than half who reported high-risk alcohol use before surgery discontinued high-risk drinking.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts. Electronic address: cwee@bidmc.harvard.edu.
authors.forename: Christina C
authors.initials: CC
authors.lastname: Wee
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Karen W
authors.initials: KW
authors.lastname: Huskey
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Davis
authors.affiliation: Center for Survey Research, University of Massachusetts, Boston, Massachusetts.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Colten
authors.affiliation: Center for Survey Research, University of Massachusetts, Boston, Massachusetts.
authors.forename: Dragana
authors.initials: D
authors.lastname: Bolcic-Jankovic
authors.affiliation: Evans Department of Medicine, Boston Medical Center, Boston, Massachusetts.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Apovian
authors.affiliation: Division of Minimally Invasive Surgery, Department of Surgery, Harvard Medical School, Boston, Massachusetts.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jones
authors.affiliation: Division of Minimally Invasive Surgery, Department of Surgery, Harvard Medical School, Boston, Massachusetts; Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: George L
authors.initials: GL
authors.lastname: Blackburn
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D050110:Bariatric Surgery / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D016017:Odds Ratio; D011184:Postoperative Period; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015431:Weight Loss
keywords: Alcohol; Bariatric surgery; Gastric banding; Roux-Y gastric bypass