A Prospective Cohort of Alcohol Use and Alcohol-related Problems Before and After Metabolic and Bariatric Surgery in Adolescents

Abstract

Objective: To describe alcohol use, alcohol-related harm, and alcohol-related problems preoperatively and up to 8 years following metabolic and bariatric surgery (MBS) in adolescents. Background: Risk for alcohol use and alcohol use disorders (AUD) increases post-Roux-en-Y gastric bypass and vertical sleeve gastrectomy in adults. However, data are lacking in adolescents who undergo MBS. Methods: This study includes 217 adolescents (aged 13–19 y) enrolled in a 5-center prospective cohort study who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy (2007–2011) and reported alcohol use preoperatively and annually postoperatively for up to 8 years. Time to elevated Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score, alcohol-related harm, and alcohol-related problems were analyzed with Kaplan-Meier estimates of cumulative incidence. Results: Preoperatively, the median age was 17 years; the median body mass index was 51 kg/m2. Alcohol use frequency and average quantity of drinks per drinking day increased postoperatively (2% consumed alcohol 2–4 times/month 6 months versus 24% 8 years postoperatively, P<0.001; 2% consumed≥3 drinks per drinking day 6 months versus 35% 8 years postoperatively, P<0.001). Cumulative incidence of postoperative onset elevated AUDIT-C score, alcohol-related harm, and alcohol-related problems at year 8 were 45% (95% CI:37–53), 43% (95% CI:36–51), and 47% (95% CI:40–55), respectively. Conclusions: Nearly half of those who underwent MBS as adolescents screened positively for AUD, symptoms of alcohol-related harm, or alcohol-related problems 8 years post-MBS, highlighting the risk for alcohol use and AUD after MBS in adolescents. AUD evaluation and treatment should be integrated into routine long-term care for adolescents undergoing MBS.

Alcohol associated liver disease and bariatric surgery: Current perspectives and future directions

“…Estimates suggest that between 2%-33% of adult bariatric surgery patients develop AUD, with the peak incidence occurring in the second post-operative year[ 3 , 4 , 7 , 8 ]. This risk may be higher in adolescent bariatric surgery recipients with a recent multi-center study reporting an AUD prevalence of approximately 45% eight years post-surgery[ 9 ].…”

The impact of alcohol on patients after bariatric surgery

“…• No significant difference seen in the incidence rate of alcohol-associated diagnoses between the RYGB and SG groups 2020 Maciejewski et al [15] Retrospective White et al [17] Prospective cohort RYGB (155) SG (62)…”

“…Over the past decade, SG has now replaced RYGB as the predominantly conducted bariatric procedure in the United States. While initial data on AUD after SG were mixed due to inadequate representation in studied populations, newer studies show a similarly increased risk of unhealthy alcohol use among American veterans, American teens, and adults in Norway who have undergone either RYGB or SG 14,15,17 . Head-to-head comparisons between SG and AGB or vertical banded gastroplasty are limited due to the relative obsolescence of the latter.…”

Association Between Alcohol Expectancy and Drinking Behaviors in Summer Vacation and Last Year Among College Students

“…Studies have shown that alcohol exposure in young adults increased the risk of gambling, 3 smoking, 4 drug use, 5 and violence. 6 At the same time, it can also increase the risk of cardiovascular diseases, 7 digestive diseases, 8 cancers, 9 and other diseases 10 in later life. The potential risk of alcohol use and dependence peaks in young adulthood.…”