Drinking Alcohol After Bariatric Surgery
Every year, hundreds of thousands of Americans undergo some form of weight loss surgery. While the procedure itself is very effective in helping the patient lose weight, ultimately it is the patient’s dedication to a new and improved lifestyle – including diet and exercise – that determines their level of success, both as it relates to weight loss and disease improvement and resolution.
While many patients enjoyed drinking before surgery, they come to find out that alcohol after a weight loss surgery procedure is not recommended both for weight gain and even in some cases, safety. Let’s dive in:
Nutritional & Dietary Considerations
- Regardless of the procedure you undergo, restricting calories is paramount after surgery. This is both to lose weight and to improve or eliminate the diseases associated with morbid obesity, known as comorbidities. Alcohol is very high in sugar and calories. Even low-calorie drinks and mixes, that advertise themselves as diet-friendly, are problematic.
- Getting adequate vitamins and nutrients after bariatric surgery is critical to the patient’s health and ongoing weight loss. However, studies have shown that alcohol can interfere with nutrition by causing problems both when absorbing and using key vitamins and nutrients. Oftentimes nutrients are not fully broken down because alcohol inhibits the secretion of important enzymes from the pancreas. Bariatric patients are already at risk of nutritional deficiencies and these risks are increased by alcohol use, especially heavy or binge drinking.
- Alcohol is a diuretic and while some patients may believe they’re consuming liquids, and they are, they are also expelling more liquid than they normally would. The net result is a deficiency in a key component of the aftercare process – hydration.
Blood Sugar Considerations
- After bariatric surgery, patients will experience rapid weight loss. One of the most restricted compounds are carbohydrates, most specifically sugars. During this time, patients are therefore susceptible to low blood sugar levels. Consuming alcohol can create a glycogen deficiency which in turn causes blood sugar levels to fall even further. Many of us have experienced temporary, mild low blood sugar symptoms in the form of lightheadedness, but bariatric patients may experience more severe symptoms including loss of consciousness resulting in serious injury.
Impairment and Overeating
Some weight loss surgeries, such as the gastric bypass, reduce the stomach to roughly the size of a ping-pong ball and as such, patients need to be careful to monitor not only their food intake, but alcohol consumption as well. The concerns are two-fold:
- First, because of the phenomenon known as rapid gastric emptying, gastric bypass patients may experience heightened sensitivity to alcohol. The reduction or elimination of a stomach enzyme that metabolizes alcohol means the alcohol passes into the sensitive lighting of the small intestine relatively undigested. This enhances inebriation and increases blood alcohol levels. This is especially true during the first six months to one year after surgery. As patients become more accustomed to life after bariatric surgery, they may be able to enjoy a very occasional drink, with the knowledge that a smaller concentration of alcohol will create more significant impairment. Patients should wait ample time before driving and performing skilled tasks.
- Alcohol aids in social relaxation, but too much alcohol may eliminate some necessary inhibitions – making it possible for patients to overeat without thinking of the consequences. While an indiscretion here or there is relatively harmless, over time, alcohol induced overeating can lead to stretching of the stomach pouch. The danger arises when the patient reverts back to bad eating habits, gets sucked into a cycle of drinking alcohol to enable them to consume more food, and eventually stretches the pouch permanently, causing weight gain.
Alcohol Dependence and Transference
A relatively uncommon, but possible consideration for bariatric patients is addiction transfer i.e. substituting the comfort of and dependence on eating (before surgery), for another addiction, like alcohol (or drugs, shopping, gambling or any other compulsion). While addiction transfer rates vary, it may affect a significant number of bariatric surgery patients. Addiction transference for the bariatric patient may be managed with open and honest communication with loved ones and our office, understanding the signs and risks and seeking help from a professional when these compulsions appear. Patients, therefore, need to be aware of the potential for addiction transfer and should keep their alcohol consumption to a minimum.
The Bottom Line
Simply put, alcohol consumption is not advisable after surgery. However, there will be times when you just want to have a small drink. Sometime within the first year, after the first six months, you will be cleared to consume alcohol. At this point, just exercise appropriate restraint and caution. Much like anything else after bariatric surgery, the key is moderation.
Most importantly, do not drive or operate machinery having consumed alcohol recently, no matter how small the amount – you truly will not know your blood alcohol level or level of impairment. And if you’re drinking to cope or get through the day, seek professional help.
As always, we want you to enjoy your life after bariatric surgery and encourage you to bring up the topic of alcohol consumption either at your next follow-up appointment or at one of our monthly support group meetings.
The topic of drinking alcohol after bariatric surgery was first published on our blog on April 20, 2011. We’ve added plenty of information to bring it up to date.