99 Bottles of Beer
UPDATE: I read this on Monday...but just saw a special report on TV: NBC News. Seems the news has to find some way to make Gastric Bypass seem like a bad thing. --------------------------------------------------------- http://tinyurl.com/2co8cg Jun 18, 2007 9:57 PM EDT Alcohol Stronger After Obesity Surgery By SUDHIN THANAWALA, Associated Press Writer SAN FRANCISCO (AP) -- People who had obesity surgery got drunk after just one glass of red wine, researchers reported in a small study that was inspired by an episode on "The Oprah Winfrey Show." "A lot of people think they can have one glass of wine and be OK," said Dr. John Morton, assistant professor of surgery at Stanford University Medical Center, who is the study's lead author. "The concern here is they really can't." Morton has performed more than 1,000 gastric bypass, or stomach stapling, surgeries. He said he routinely warns his patients about drinking alcohol, but it wasn't until Winfrey discussed the issue on her show last October that the public really took notice. He said questions poured in. "I didn't find a whole lot in the literature, so that prompted the study," he said. The research team gave 36 men and women - 19 who had obesity surgery and 17 who did not - five ounces of red wine each to drink in 15 minutes. Using a breathalyzer, their alcohol levels were measured every five minutes until it returned to zero. More than 70 percent of the surgery patient**** a blood-alcohol level of 0.08 percent, which qualifies as legally intoxicated in California, and two reached levels above 0.15, Morton said. By contrast, most of the control group had levels below 0.05 percent, the study reported. Researchers also found that obesity patients took longer to sober up. After matching the control group with the patient group for age, gender and weight, they found the patients took 108 minutes on average to return to a zero blood-alcohol level versus 72 minutes for the control group. Morton said the obesity surgery patients don't produce as much of an enzyme that breaks down alcohol because their stomachs are smaller. Also, the alcohol passes to their small intestine faster, speeding up absorption, he said. The findings, which were presented recently at a meeting of bariatric surgeons, highlight an important warning for obesity patients: "Never have more than a couple of glasses in a single sitting, and don't drive afterward," Morton said. Meg Semrau, a nurse coordinator of Stanford's bariatric program who had gastric bypass surgery herself more than three years ago, said she noticed her tolerance for alcohol was lower after surgery. "I literally feel it within a couple of sips now," she said. "Flushing in the face, a kind of disequilibrium." While some experts took issue with the study's size and methodology, they said it basically confirmed what they had suspected for some time: People who have gastric bypass surgery are more sensitive to alcohol. Dr. Madelyn Fernstrom, director of the weight management center at the University of Pittsburgh Medical Center, said Morton's results support alcohol warnings normally given to gastric bypass patients. However, she called drinking five ounces of wine in 15 minutes an "artificial" test. No one - let alone bariatric surgery patients - would be advised to drink that amount of alcohol so quickly, she said. In fact, Fernstrom said patients are discouraged from drinking alcohol because it is a "waste of calories." "Alcohol is not part of a healthful diet for gastric bypass surgery patients," she said. "If this is a pleasant part of life to certain people on special occasions, it must be monitored and discussed with their surgeon." © 2007 The Associated Press. All rights reserved.
Recommendations on the Use of Alcohol After Surgery
A 32-year old male 5 months out from gastric bypass surgery was issued a DUI after attending his brother’s wedding reception. According to the patient, he had only consumed 2 glasses of champagne, although his blood alcohol levels were above the legal limits to operate a motor vehicle. A female patient, 50 years of age and one-year post-gastric bypas**** and killed a pedestrian with her automobile after having less than 2 glasses of wine. When police arrived she had difficulty with her coordination, slurred her words and seemed somewhat confused, although her alcohol test suggested that her blood alcohol levels were shy of the legal limit. Were these patients telling the truth about the amount of alcohol they had consumed or did their surgery affect the way the body absorbs or metabolizes alcohol?....... http://www.beyondchange-obesity.com/obesityResearch/precauti onsWithAlcohol.html for rest of story ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Popular Weight Loss Procedure Could Lead to Addiction
May 21, 2007 04:22 PM EDT
Obesity is a dangerous condition affecting 30% Americans.
In this group regular dieting often fails.
Bariatric surgery, like gastric bypass, can dramatically reduce weight.
One womanb named "Susan" says, "This is a size 20 and I'm now a 7/8." The surgery got her eating under control, but led her to a lose of control over her drinking, and her life.
Susan says, "In the morning it got to the point where I started having the shakes. I finally realized I had a problem and I was a full-fledged alcoholic. Where it went from drinking on the weekends, I was now drinking every single night half a bottle of scotch."
Susan realized she wasn't the only bariatric patient attending her Alcoholics Annoymous meetings.
She says, "In one of them in particular there are four of us that are gastrics. That can't just be a fluke."
She brought it to the attention of her surgeon Dr. Nestor de la Cruz Munoz who admits, "I think we've probably underdiagnosed some of these addiction disorders post operatively or after surgery because we haven't been looking for them in the past."
Doctors have known that when digestive systems are reduced and rerouted for gastric bypass, it takes less food to feel full and less booze to get drunk.
"We know that alcohol gets absorbed into the bloodstream faster after bypass because it doesn't sit in the stomach like it would normally."
Susan says, "One drink for me is like what it would take two or three drinks for the average person." Underlying psychological factors also increase the risk.
Melodie Moorehead, Ph.D., a bariatric surgery psychologist says, "For people who are eating for reasons beyond nutrition but rather to fill an empty void, and they're not able to turn to food anymore will find coping happening in other distractive, compulsive, destructive ways."
moorhead says a transfer of addiction happens when patients overindulge in alcohol, drugs, gambling, shopping or sex as replacements for food.
They're often caught completely by surprise. (sot: susan) "i was like, 'why has nobody talked about this?"
A recent survey in "Bariatric Times" found 28.4% of the gastric bypass patients said they had a problem with alcohol control.
Only 4.5% said they had a problem before surgery.
Dr. Moorehead is now producing educational materials so that patients aren't left not know how to deal with stressors in life they used to deal with through eating.
http://www.wsfa.com/global/story.asp?s=6546994&ClientType=Pr intable
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From BSCIs
e-Newsletter October 31st, 2006
____________________________________________From BSCIs e-Newsletter October 31st, 2006
Addiction and Weight Loss Surgery: A Social Worker's Perspective By Katie Jay, MSW; Director, National Association for Weight Loss Surgery
Here's a typical scenario. At her sister's wedding, Fiona, who had never been a big drinker, decided to try her first taste of alcohol after weight loss surgery (WLS). She had waited 11 months after surgery, had lost 115 pounds so far, and wasn't going to deny herself a glass of champagne on such an important day. And wow, did she enjoy that champagne! She sipped on a small drink, got a nice buzz, and laughed the evening away. No big deal.
Fiona didn't realize that gastric bypass patients will get drunker quicker and have higher blood alcohol levels after drinking smaller quantities of alcohol than people who have not had weight loss surgery.
Fiona Rekindles the "Pleasure" of a Mood-Altering Activity
After WLS, Fiona had done a pretty good job of changing her eating habits. She almost completely avoided sugar and ate mostly protein and veggies. She loved her success, but there was a part of her who missed indulging in food. When she tried the champagne, she felt self indulgent and relaxed in a way she hadn't in a long time (in about 11 months, actually).
The following week when Fiona was grocery shopping she decided to pick up a bottle of wine. It would be great to have a small glass before dinner sometimes, she thought. She poured herself a small glass when she got home from the store just to find out how it tasted and to quietly enjoy another little buzz.
Over time, Fiona began to sneak wine during the day. She hid it when her husband commented on her consumption. The behavior of wanting something forbidden, getting it, hiding it, and consuming it in private was so familiar to Fiona from her days of overeating that it was almost a relief to sneak the wine -- and she slowly built up the quantity she was drinking.
Thankfully, Fiona was participating in group therapy with a social worker who specialized in weight loss surgery at the time. When one of the other group members shared about getting into a car accident and being arrested for driving drunk, Fiona felt uncomfortable. She had driven to pick up her son from soccer the prior evening after she had a small glass of wine. At the time she knew she was tipsy.
Still, she poured herself more wine when she got home from group and drank it in the basement playroom, because her husband almost never went down there.
Fiona didn't have to get arrested for drunk driving to really "get" that she had a problem. Everything came to a head when her son found an empty wine bottle in his toy box in the basement, while Fiona had another mother and son over for a play date. Fiona was completely humiliated.
Embarrassed and ashamed, Fiona called her therapist to talk about what happened, and the therapist referred her to a social worker who specializes in substance abuse.
With the help of the therapist and a support group for substance abusers, Fiona was able to get on the road to recovery quickly.
But, why did Fiona Turn into an Alcoholic Overnight?
Fiona simply switched one addiction for another. It's not uncommon for a person who gives up one addictive behavior to pick up another addictive behavior. Fiona had quit using food as a soothing substance in her life. The alcohol came in and filled that void.
Switching addictions is also demonstrated when a person develops an unhealthy relationship with eating and exercise following weight loss surgery.
Exercise can become a way to compensate for overeating, and can turn into what is called exercise bulimia. It's not bad to exercise as part of a plan to control one's weight. But if the overeating becomes excessive, and then the exercise becomes obsessive -- that's a problem. Your physical health can be threatened -- not to mention your peace of mind.
The other common addiction people switch to is spending. Many weight loss surgery patients get such a kick out of shopping for new clothes they get a little carried away - and then they get hooked. Having been so burdened by obesity in the past, weight loss surgery patients begin to leave the house more, because they're now physically able to, and they shop more frequently. Shopping can morph into a mood-changing activity, and hence, an addiction.
What Can People Do in Fiona's Situation?
Several steps can be taken to address the experience of switching addictions:
1. Identify your addiction(s) and the extent to which it is (they are) ruling your life.
2. Educate yourself about a particular addiction by doing research and talking to professionals who have knowledge and experience in that area.
3. Seek out a knowledgeable social worker if you are unable to control your addictive behavior on your own.
4. Join a support group that addresses your specific addiction, such as overeaters anonymous, alcoholics anonymous, debtors anonymous, etc. Remember, addictions are very common and nothing to be ashamed of. But, they are hard to get rid of in isolation. Get help if you are struggling. And keep in mind any addictions left untreated absolutely will take over your life.
Katie Jay, MSW, is the Director of the National Association for Weight Loss Surgery (www.nawls.com) and is author of the courageous book, Dying to Change: My Really Heavy Life Story, How Weight Loss Surgery Gave Me Hope for Living.
BSCI is pleased to participate in a global survey on Response to Alcohol After Bariatric Surgery. We would like your input as we continue to elevate care for WLS patients.
Please visit this link http://www.surveymonkey.com/s.asp?u=749492407167 Your participation remains completely anonymous. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
http://www.barimd.com/myNewsletterPage.php?pageNo=5&practice Id=7
Caution When Using Alcohol after Bariatric Surgery By Cynthia Buffington, Ph.D.
Have you noticed a change in your ability to drink alcohol since your gastric bypass surgery? Have you found that you are more sensitive to the effects of alcohol now than before surgery? Most bariatric patients claim that they are now far more sensitive to alcohol and can feel its intoxicating effects after having only a few sips of their drink. Some patients have even been issued a DUI after having one or two alcoholic beverages. What are the causes for these conditions in patients who consume alcohol after surgery?
In the person with normal gut anatomy, alcohol passes into the stomach where some of the alcohol is metabolized (oxidized) and a small amount is absorbed. Most of the alcohol consumed, however, passes from the stomach into the intestines where it is very rapidly absorbed into the blood stream. The faster the rate that alcohol leaves the stomach, the more alcohol that is absorbed by the intestines and the higher the blood alcohol levels. Food slows the rate that alcohol drains into the intestines from the stomach, whereas, the opposite is true when alcohol is consumed on an empty stomach.
In the rapid weight loss period following gastric bypass (and other bariatric surgeries), food intake is low and alcohol is rapidly absorbed, increasing the risk for intoxication and toxicity. Certain bariatric procedures also alter the anatomy of the stomach in such fashion as to substantially increase the absorption of alcohol. With the gastric bypass, for instance, a small pouch is created from the larger stomach and the pouch is attached to the intestines. Under these conditions alcohol passes directly from the pouch into the intestines and is immediately absorbed into the blood, increasing alcohol levels and the risk for intoxication. This is one of the reasons that the gastric bypass patient often ‘feels’ the effects of their drink after having only a few sips. It is also why the gastric bypass patient is more sensitive to alcohol and why alcohol is far more toxic to their health.
Elevated blood alcohol levels and alcohol toxicity with bariatric surgery may occur for several additional reasons. Alcohol that is absorbed into the body dissolves in the water content of tissues but not in fat. Most bariatric patients, particularly in the early weight loss period, have a substantial amount of body fat and are also somewhat dehydrated due to difficulty in consuming sufficient amounts of water. Under these conditions, alcohol levels are higher than if hydration status and fat mass were normal.
In addition to elevated alcohol levels, the rate of alcohol clearance by the liver of the bariatric patient may be altered. Once absorbed, most of the alcohol in the body (~90%) is cleared (oxidized) by the liver. However, in the early postoperative period, various metabolic changes associated with rapid weight loss and the morbidly obese condition can interfere with the rate and the mode that alcohol is cleared from the body, increasing the individual’s risk for alcohol toxicity.
Alcohol not only has toxic effects on the liver, causing liver disease, but also has numerous other adverse health consequences, including brain and nervous tissue damage, a loss of skeletal muscle and heart tissue, irregular heart beats and increased risk for sudden death, inflammation of the heart, the liver and GI tract, pancreatitis, gastritis, gastroesophageal reflux disease (GERD), and numerous other serious health problems. In addition, alcohol causes changes in normal liver metabolism, inhibiting the production of sugar and increasing the risk for hypoglycemia (low blood sugar) and its associated health problems, including the possibility for irreversible brain and nerve damage, unconsciousness, and even death.
Regular use of alcohol could also cause permanent brain and nerve damage, coma and death through the effects of alcohol on vitamin and mineral status. Alcohol interferes with the absorption and activation of many important vitamins, such as thiamin, vitamin B12, and other B-complex vitamins, and causes an increased breakdown of vitamin A, folate, and pyridoxine. Gastric bypass and certain other bariatric procedures also cause deficiencies in these vitamins. Therefore, drinking alcohol, at any time after surgery, could substantially increase the risk for nutrient deficiencies and associated adverse health problems including nerve and brain damage, defects in metabolism, low immunity, fatigue and more.
If you are a bariatric surgical patient, should you drink alcohol? Due to metabolic changes with rapid weight loss that can alter the distribution and clearance of alcohol in the body, drinking in the early postoperative period (~9 to 12 months) should be avoided and could have very serious health consequences. After weight loss stabilizes, however, an individual should be able to have a drin****asionally if the patient understands that only a small amount of alcohol can have intoxicating effects and takes appropriate precautions, such as: 1) always eat food before drinking alcohol; 2) never drive a motor vehicle after having a drink (remember only a small amount – even one drink can increase blood levels above the legal driving limit possibly resulting in a DUI, an accident, or worse).
a few more articles.. http://www.bbvitamins.com/research_Article_5.aspx Alcohol Use in the Bariatric Patient Cynthia Buffington, Ph.D. or this one: http://www.bbvitamins.com/research_Article_4.aspx Precautions When Using Alcohol after Bariatric Surgery? Cynthia Buffington, Ph.D. I send as informational only!!!thanks for sharing yours! I collect esp to fwrd to my support groups! :-)
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
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