Some people who struggle to lose weight turn to gastric bypass surgery in hopes of quick and lasting results. While this operation can make a difference for some patients initially, it could lead to a host of problems in the long term – and one surprising one is a higher risk of death due to substance use.
Research that was recently published in the journal Surgery for Obesity and Related Diseases showed that the death rate from causes related to alcohol and drugs in people who have undergone Roux-en-Y gastric bypass operations is triple that seen among the general public.
Over the course of seven years, researchers from the University of Pittsburgh followed nearly 2,500 adults who had undergone bariatric surgery, and their profile was similar to the typical population who gets this procedure – 79 percent female and 86 percent white with a median age of 46 at the time of the operation. They were compared to people of similar demographics who had not gotten the procedure.
In the seven-year follow-up period, ten participants died from causes related to using alcohol or drugs. Six were unintentional drug overdoses, one was intentional, one was an overdose of unknown intent, and two were from alcoholic liver disease. All of them had undergone Roux-en-Y specifically, a type of gastric bypass that shortens the intestine and reduces the size of the stomach. It’s a popular procedure that made up 72 percent of the bariatric operations in the study’s sample.
To make their comparison, the researchers used a scientific measure known as “person years” that considers the number of people in a study as well as how much time each spends in the study. The alcohol and drug-related death rate for the general population matches on sex, race, age and calendar year was 30.5 deaths for every 100,000 person-years; the rate for those who had gotten Roux-en-Y gastric bypass was 80 for every 100,000 person years. These deaths took place five years after surgery, on average.
The study’s authors point out that the demographical group of those who undergo bariatric surgery tends to have a low risk of substance-related death in general. Unfortunately, other studies have shown that Roux-en-Y changes how the body reacts to drugs and alcohol, which could well be a driving factor behind the loss of life in these cases.
The researchers believe that new clinical screening tools are needed so doctors can identify those at a high risk of substance use-related problems. People who have undergone bariatric surgery generally experience the effects of alcohol more quickly and after fewer drinks than the average person, so current questionnaires used to screen for substance use problems, which ask about the number and frequency of alcoholic drinks people consume, are not adequate in this population. Instead, the researchers say they should be asked about how alcohol makes them feel, whether it interferes with their activities, or if their loved ones believe they have a problem.
Gastric bypass can make mental health issues worse
It’s also important that primary care doctors are made aware of these risks because the deaths occurred so long after the surgery. This is especially important because some people who undergo bariatric surgery may be transferring an addiction to food to one of alcohol or drugs instead.
A different study involving nearly 25,000 patients found that bariatric surgery might exacerbate any underlying mental health issues a person has or even create new ones. In the 10-year study, people who underwent the procedure were two to three times more likely to end up in the hospital, emergency room, or an outpatient clinic for a psychiatric illness some time after their operation.
These studies should certainly give anyone who is considering such a procedure serious pause, especially when there are lots of safer ways to get your weight under control, such as via mindful eating, limiting foods like sugar and white flour that trigger overeating, and exercising regularly.
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