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Why alcohol can become a problem after weight loss surgery

Tuesday, 07 May 2019

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Weight loss surgery rates have more than doubled in Australia in the last decade, but a down-side to bariatric surgery may be the increased risk of developing an alcohol problem.

Previous research has found bariatric surgery, particularly Roux-en-Y gastric bypass surgery, increases the risk of developing alcohol use disorder, with up to one fifth of participants reporting symptoms within five years of surgery.

A new study by Dr Charlotte Hardman at the University of Liverpool and Associate Professor Joanne Dickson from Edith Cowan University (ECU) has provided insight into the psychological factors that influenced drinking behaviours following bariatric surgery, and the motivations for drinking or limiting alcohol generally.

The research was informed by interviews with participants with problematic alcohol use following bariatric surgery, as well as participants who did not abuse alcohol.

ECU Associate Professor Joanne Dickson, from the School of Arts and Humanities, said bariatric surgery represents an effective tool for weight reduction, however the intervention is biologically based and if potential psychological contributors to excessive weight are left unaddressed, they could give rise to further complications.

“Individuals who are pre-disposed to engage in eating to cope prior to bariatric surgery could be more likely to use alcohol as a replacement coping mechanism if other self-regulatory measures are not learned or employed,” Professor Dickson said.

The study found several key themes implicated in the development of alcohol problems after bariatric surgery.

“Participants with problematic alcohol use endorsed drinking to cope and disinhibited drinking motivations, a more negatively perceived self-image, adverse impacts of surgical restriction, receiving less emotional support or having unmet needs and feeling underprepared for surgery in terms of expectations regarding alcohol use,” Professor Dickson said.

“Conversely, narratives from participants without alcohol problems were marked by social motivation or maintaining control over drinking, a more positive self-image, manageable surgical restriction, having sufficient emotional support, feeling more prepared for surgery and more resilience contributing to the capacity to endure difficulties following surgery,” she said.

The study ‘A qualitative analysis of problematic and non-problematic alcohol use after bariatric surgery’ is published in Obesity Surgery. Authors are Danielle L Reaves, Joanne M Dickson, Jason C G Halford, Paul Christiansen and Charlotte A Hardman.

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