A Qualitative Analysis of Problematic and Non-problematic Alcohol Use After Bariatric Surgery

Abstract

Objectives Bariatric surgery is an effective weight loss tool, but an under-communicated side effect may include the increased risk for alcohol problems. Few studies have examined contributors towards alcohol problems following surgery using a qualitative approach. Therefore, the current study aimed to generate insight informed by participants with problematic alcohol use following bariatric surgery, in comparison with participants without. Methods Participants (14; females, n = 9; males, n = 5) completed semi-structured interviews using questions relating to alcohol use, relationship to food, support and surgical experiences. Thematic analysis was conducted to provide insight into the factors which influenced drinking behaviours that participants engaged in following bariatric surgery, and motivations for drinking or limiting alcohol. Results Five core themes were identified between both participants with and without problematic alcohol use: (1) drinking motivations, (2) self-image, (3) impact of restriction on eating behaviour, (4) support needs and (5) surgical preparedness. A sixth core theme (Bresilience^) was identified specifically amongst participants without problematic alcohol use. Divergent experiences, cognitions and behaviours formed sub-themes within the five core themes and highlighted the differences between participants with and without problematic alcohol use within the core themes. Conclusion This study is the first to qualitatively assess themes relating to the development of problematic alcohol use after bariatric surgery while additionally using a comparison group without problematic alcohol use. The findings highlight key features which contribute to problematic alcohol use, as well as experiences and cognitions that may be helpful in preventing this phenomenon in bariatric populations.

Patients' perceptions of the mechanisms underlying alcohol use problems after bariatric surgery: A qualitative systematic review

“…Most participants were female. One of the studies included two groups of participants: with and without problematic alcohol use [29]. For this review, the decision was made to focus only on results related to participants with PAC (which was possible since the authors distinguished clearly between themes emerging from the discourse of participants with PAC and those without).…”

“…It involved replacing food with alcohol as a coping strategy. Some participants reported that, before surgery, they had used food to suppress or reduce unpleasant emotions' intensity and, in particular, to manage the distress caused by the psychological problems described earlier (see category 1) [28][29][30][31].…”

“…"There were a lot of problems at home. And then, I suppose, in hindsight, I was comfort eating" [30] (p. 720) After bariatric surgery, several participants reported they began to use alcohol as a self-soothing or coping strategy, instead of food, to manage stress, negative emotions, boredom, psychological problems such as anxiety and depression, or to induce sleep [28][29][30][31].…”

“…The notion of a « void » created by the difficulty of resorting to food emerged from certain participants' discourse. Alcohol came to fill that void [29][30].…”

Estudio comparativo entre hombres y mujeres candidatos a cirugía bariátrica: autoestima, apego y percepción de apoyo familiar

“…Esto puede ser debido a que la privación de alimentos calóricos tras la operación reduce la activación del sistema de reforzamiento del organismo, haciendo que los pacientes necesiten sustituirlos por alcohol y otras sustancias. El uso de alcohol tras la operación también podría ser una forma de afrontamiento de la insatisfacción experimentada tras la operación o la falta de apoyo social percibido (10).…”