ROUX-EN-Y gastric bypass (RYGB) has been linked to a higher risk of hospitalisation related to alcohol-use-disorders (AUD) compared with weight management programmes and sleeve gastrectomy in a recent study. While procedures such as RYGB promote weight loss and can reverse underlying metabolic comorbidities, they may induce differential alterations in alcohol metabolism, explained author Nadim Mahmud, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
The team conducted a retrospective cohort study to evaluate whether there is a link between bariatric surgery, AUD-related hospitalisation, and all-cause mortality, compared to weight management programmes. In total, 7,694 participants with a BMI over 30 who had a RYGB, sleeve gastrectomy, gastric banding, or referral to a weight management programme (MOVE!) were enrolled.
The median follow-up was of 59.6 months, during which RYGB was associated to a higher risk for hospitalisation related to AUDs compared to sleeve gastrectomy and MOVE!. The difference between MOVE! and sleeve gastrectomy was not significant. Furthermore, while sleeve gastrectomy and RYBG were both linked to a lower risk of mortality, compared to MOVE!, RYGB was associated to a higher risk compared to sleeve gastrectomy.
It is unclear whether the risk of alcohol-related adverse events is due to sensitivity or an increased alcohol exposure, as recent data suggests that alcohol consumption increases in patients who have undergone bariatric surgery. “Patients who undergo RYGB may be uniquely sensitive to alcohol exposure, and increased alcohol use may nullify potential gains in overall survival,” stated Mahmud. The team concluded that careful selection of patients for RYGB as well as strict counselling regarding alcohol use and long-term monitoring of complications related to AUD remains important.