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After Weight Loss Surgery, Be Extra Careful with Booze

Weight loss surgery means a lifetime of restricted diets, nutritional supplements, and — apparently — being very careful when drinking alcohol. A new study confirms what many gastric bypass patients have suspected — they will get drunk faster and take longer to get sober.

Stanford University School of Medicine bariatric surgeon John Morton, M.D., compared the reactions to alcohol of 19 gastric bypass patients to the reaction of 17 people who had not undergone the surgery. Study participants each drank 5 ounces of wine.

The average breath alcohol peak for the gastric bypass patients was 0.08 percent, the legal limit for driving in most states, while the control subjects average peak was just 0.05 percent. It took the bypass patients an average of 108 minutes to return to zero, while the control subjects took only 72 minutes.

“The bypass patients have a fundamentally altered alcohol metabolism,” Dr. Morton reported in a Stanford press release. “They reach a higher peak more quickly and take a longer time to return to zero. Also, the patients aren’t really aware of this.”

Neil Hutcher, M.D., a bariatric surgeon in Richmond, Va., has been performing gastric bypasses since 1971. He told Ivanhoe he always warns his patients of the many life-altering changes that happen after weight loss surgery.

“My informed consent is probably a 45 or more minute sit down, face to face process,” Dr. Hutcher said. A warning to patients that they can be either the designated drinker or the designated driver, not both, is part of this talk, he said.

Nonetheless, Dr. Hutcher, a past president of the American Society of Bariatric Surgeons, said he has had patients who reported some surprising results after drinking alcohol. He told the story of a patient who, after being chided for not taking vitamins, went out and bought a vitamin elixir.

“She said she felt unexpectedly giddy and high, almost like she were drinking, and she couldn’t explain it,” he said. “Unbeknownst to her, that vitamin liquid was 46 proof.”

Some experts have theorized gastric bypass patients may be at risk for addiction transfer, meaning they trade an addiction to food for other addictions after the surgery. The increased sensitivity to alcohol could make alcoholism a possibility.

According to Dr. Morton, drinking alcohol could also cause the esophageal sphincter tone to decrease and allow patients to eat more food, undoing the effect of the surgery.

SOURCE: Ivanhoe interview with Neil Hutcher, M.D.; American Society of Bariatric Surgeons 14th Annual Meeting in San Diego, June 11-16, 2007

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