Bariatric Surgery and Alcohol

As increasing numbers of men and women seek surgery in order to reduce their excess weight, addiction counsellors are starting to see an increase in these clients coming for help with their alcohol intake.

Food addiction in itself is a complex problem to treat.  A behaviour that starts out as a source of comfort, and quickly develops into long-term addiction doesn’t disappear with the excess weight; the behaviours remain the same but food is no longer the option it was at times of distress or celebration.  After bariatric surgery the individual’s ability to satisfy cravings is greatly reduced, thereby causing people to look for something else to make them feel better. 

Studies have shown that up to a quarter of people who undergo a form of weight loss surgery go on to develop alcohol addiction once the level of food they can ingest becomes drastically limited.

Case Study:

‘Karen’ started to eat for comfort when she was a child, she would retreat to her bedroom with biscuits, sweets or fizzy drinks when things at home were frightening.  This method of seeking comfort continued through adulthood and at the age of 35, after trying every diet available, she saved enough money to have bypass surgery.  The surgery worked, Karen rapidly reduced her weight and one evening she had a glass of wine to relax, she was aware of the cautionary warnings from the surgeons about being careful with alcohol but she was amazed at how quickly she felt the effects of alcohol.  She soon discovered that just a little alcohol would make her feel ‘better’, would help her sleep and numb the negative thoughts and feelings she had previously managed through comfort eating.  Therefore, alcohol became her next form of comfort – addiction professionals describe this process as cross addiction – when a person moves from one addictive substance to another in order to achieve the same effect.

In addition to biological changes in the gastro-intestinal track, gastric bypass surgery limits the amount of calories an individual is able to eat. As food in the stomach helps limit the rate of absorption of alcohol, the reduced diet of weight loss surgery patients causes quicker, and more intense, intoxication. This phenomenon is also seen in people who drink alcohol on an empty stomach.

Weight loss surgery patients who drink alcohol are also at increased risk of malnutrition. Given that only a limited amount of calories can be ingested and absorbed by the body, the empty, non-nutritious calories found in alcoholic beverages take up the space that would otherwise be used by proteins and healthy carbohydrates. Patients who drink heavily often experience vitamin and mineral deficiencies.

So what do people who have moved from food to alcohol do in order to prevent the physiological and emotional problems that an increased intake of alcohol causes?

In an ideal world everyone considering such a drastic form of weight loss would be required to undergo counselling to help them look at the relationship they have developed with food, what its role has become in their lives and how it makes them feel.  The fact is it’s not about the food, it’s why you eat it.  

Unfortunately it’s not an ideal world and many people undergo this surgery without any preparatory counselling to look at the underlying reasons for their poor relationship with food, or a clear understanding of their body’s functioning and nutritional requirements.  

Fortunately, suitably qualified counsellors are able to offer such clients counselling to help them to understand what alcohol has become to them, and to help them to discover why they feel they need this source of comfort.  We help clients to identify their feelings and emotions and deal with them rather than trying to bury them with food or drink.

If you have undergone weight loss surgery and find that your cravings and emotions are drawing you to other substances or behaviours, you need to talk to a specialist who can help you to understand what is going on.