Alcohol sensitivity in women after undergoing bariatric surgery: a cross-sectional study

María Belén Acevedo, Margarita Teran-garcia, Kathleen K. Bucholz, J. Christopher Eagon, Bruce D. Bartholow, Nicholas A. Burd, Naiman Khan, Blair Rowitz, Marta Yanina Pepino

Research output: Contribution to journalArticle

Abstract

Background Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol’s sedative effects. Objectives To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population. Setting University medical centers in Missouri and Illinois. Methods Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing post surgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking. Results In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery ( P < .001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (−2.3 ± .3 versus −1.2 ± .2; P < .05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50% above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects. Conclusions Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.
Original languageEnglish (US)
JournalSurgery for Obesity and Related Diseases
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • bariatric surgery
  • metabolic surgery
  • alcohol
  • subjective response
  • pharmacokinetics
  • sleeve gastrectomy
  • Roux-en-Y gastric bypass
  • laparoscopic adjustable gastric banding surgery
  • ethanol

Cite this

Alcohol sensitivity in women after undergoing bariatric surgery: a cross-sectional study. / Acevedo, María Belén; Teran-garcia, Margarita; Bucholz, Kathleen K.; Eagon, J. Christopher; Bartholow, Bruce D.; Burd, Nicholas A.; Khan, Naiman; Rowitz, Blair; Pepino, Marta Yanina.

In: Surgery for Obesity and Related Diseases, 01.01.2020.

Research output: Contribution to journalArticle

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abstract = "Background Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol’s sedative effects. Objectives To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population. Setting University medical centers in Missouri and Illinois. Methods Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing post surgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking. Results In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery ( P < .001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (−2.3 ± .3 versus −1.2 ± .2; P < .05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50{\%} above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects. Conclusions Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.",
keywords = "bariatric surgery, metabolic surgery, alcohol, subjective response, pharmacokinetics, sleeve gastrectomy, Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding surgery, ethanol",
author = "Acevedo, {Mar{\'i}a Bel{\'e}n} and Margarita Teran-garcia and Bucholz, {Kathleen K.} and Eagon, {J. Christopher} and Bartholow, {Bruce D.} and Burd, {Nicholas A.} and Naiman Khan and Blair Rowitz and Pepino, {Marta Yanina}",
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T1 - Alcohol sensitivity in women after undergoing bariatric surgery: a cross-sectional study

AU - Acevedo, María Belén

AU - Teran-garcia, Margarita

AU - Bucholz, Kathleen K.

AU - Eagon, J. Christopher

AU - Bartholow, Bruce D.

AU - Burd, Nicholas A.

AU - Khan, Naiman

AU - Rowitz, Blair

AU - Pepino, Marta Yanina

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol’s sedative effects. Objectives To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population. Setting University medical centers in Missouri and Illinois. Methods Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing post surgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking. Results In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery ( P < .001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (−2.3 ± .3 versus −1.2 ± .2; P < .05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50% above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects. Conclusions Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.

AB - Background Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most common bariatric surgeries performed worldwide, increase the risk to develop an alcohol use disorder. This might be due, in part, to surgery-related changes in alcohol pharmacokinetics. Another risk factor, unexplored within this population, is having a reduced subjective response to alcohol’s sedative effects. Objectives To assess whether the alcohol sensitivity questionnaire (ASQ), a simple self-report measure, could pinpoint reduced alcohol sensitivity in the bariatric population. Setting University medical centers in Missouri and Illinois. Methods Women who had RYGB (n = 16), SG (n = 28), or laparoscopic adjustable gastric banding surgery (n = 11) within the last 5 years completed the ASQ for both pre- and postsurgical timeframes, and 45 of them participated in oral alcohol challenge testing post surgery. Blood alcohol concentration (BAC) and subjective stimulation and sedation were measured before and for 3.5 hours after drinking. Results In line with faster and higher peak BACs after RYGB and SG than laparoscopic adjustable gastric banding surgery ( P < .001), postsurgery ASQ scores were more reduced from presurgery scores after RYGB/SG than after laparoscopic adjustable gastric banding surgery (−2.3 ± .3 versus −1.2 ± .2; P < .05). However, despite the dramatic changes in BAC observed when ingesting alcohol after RYGB/SG surgeries, which resulted in peak BAC that were approximately 50% above the legal driving limit, a third of these women felt almost no alcohol-related sedative effects. Conclusions Although RYGB/SG dramatically increased sensitivity to alcohol in all participants, meaningful interindividual differences remained. The ASQ might help identify patients at increased risk to develop an alcohol use disorder after surgery.

KW - bariatric surgery

KW - metabolic surgery

KW - alcohol

KW - subjective response

KW - pharmacokinetics

KW - sleeve gastrectomy

KW - Roux-en-Y gastric bypass

KW - laparoscopic adjustable gastric banding surgery

KW - ethanol

U2 - 10.1016/j.soard.2020.01.014

DO - 10.1016/j.soard.2020.01.014

M3 - Article

JO - Surgery for Obesity and Related Diseases

JF - Surgery for Obesity and Related Diseases

SN - 1550-7289

ER -