Abstract
ObjectivesBariatric 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.MethodsParticipants (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.ResultsFive 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 (“resilience”) 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.ConclusionThis 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.
Highlights
Bariatric surgery is offered as an effective intervention to reduce severe obesity wherein patients are expected to lose an average of 60% of their excess weight, varying by procedure [1, 2]
The present study aimed to interview both participants who do and do not have problematic alcohol use or misuse post-surgery to understand which factors influence the development of post-surgical alcohol misuse
Overall, drinking to cope was a core motivation driving problematic alcohol use post-surgery, which had either been a habit continued from pre-surgery or had newly onset following surgery
Summary
Bariatric surgery is offered as an effective intervention to reduce severe obesity wherein patients are expected to lose an average of 60% of their excess weight, varying by procedure [1, 2]. Recent studies have raised concerns than an under-communicated side effect of bariatric surgery may include increased risk for alcohol misuse, especially following Roux-en-Y gastric bypass (RYGB) [4,5,6]. This is possibly attributable to physiological changes in alcohol absorption, which produce increased sensitivity to the effects of alcohol [7]. Physiological changes are unlikely to increase alcohol use in isolation, as they are experienced by most
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