Alcoholic Beverages - Question

Okay guys, New Years Eve is approching and I'm hosting a New Years Party. I just called my surgeons office and everyone except the receptionist is out on vacation (good for them), but non of them could answer me as to what I can drink if anything. I know champagne is probably out because of the bubbles. Rum is out because of the sugar content (isn't it made from sugar cane) I'm thinking vodka, but can I mix it with something? Please help. Thanks Pat 303/250.8/150

morning Pat... be careful with alcohol...I was told by my surgeon that I shouldn't drin****il 6 months post-op. Alcohol is basically sugar (or at least turns to sugar)..and on top of that since we've had surgery it now affects us much faster. If you are determined to drink Vodka...you can mix it with anything sugar free...crystal light or whatever you normally drink. I have a good friend that hasn't had WLS and she mixes Vodka with the Raspberry Crystal Light... btw...you're weight loss is great! 53 pounds in under 2 months...congrats! Happy New Year!! Linda

You can pretty much do anything that isnt mixed with something sugary like a pina colada or something like that. Maybe try a little OJ in the vodka and see how that goes...or even maybe a little wine. Just be careful b/c we aborbed alcohol a lot different now and it hits you before you know it. Lord do I know this. One time I got so drunk in a matter of about 20 minutes my husband said I was trying to go to the bathroom in the kitchen garbage can, and I so do not remember any of this! I just had about one and half glasses of wine! I am staying away from alcohol b/c not only is it dehydrating for me but it makes me super drunk, which I do not need either! Everyone is different just be alittle more cautious, that's all! Good Luck! Tavia

Hi Pat, I'm 7 months out now and my surgeon said I can try alcohol but within reason. While on a cruise 2 weeks ago I tried 1/2 a low carb beer, a kauluha and milk and a glass of sangria and had no problems with any of them. I tried them all on individual days and only had 1 of each just in case. My advise would be to be careful in choosing what you mix the vodka with. Enjoy your New Year's Party. Let us know how you make out. Cindee 310/223/???

i have read various on this topic. SOME surgeons say no drinking for a year! I never concerned cause i dont drink! GUESS i should ask my surgeon his rules LOL good luck and happy new year! BUT i have read to many posts about getting drunk pretty easy so be careful! LISA 310/188/???

i havent drank in 8 yrs so cant really answer you ...... Stacy

I had 2 oz of white zinfandel on Christmas eve (I drank it slowly, over about an hour) and it was wonderful and caused me no problems! I'm 10 weeks out and have trouble with some foods, but alcohol went down ok, GO FIGURE! Vi

RE: Alcoholic Beverages - Question Alcohol after WLS: Every surgeon/program is different, but our program recommended we avoid alcohol for a yr postop (some even make u sign a contract!)...It is a gastric irritant (don't want to get a ulcer in the pouch!) and beer/champagne has carbonation which many do not tolerate, and the sugar may make you dump big time, and it is empty calories so can add to wt loss slowing/regain...(Many also switch addictions from food to alcohol!) as well as it may be absorbed a lot quicker and affect us many times more than pre-op (ex. one beer may act like a 6 pack)..also in the scheme of things the liver is so taxed at breaking down the fat (and we may have preexisting fatty livers due to obesity!) cirrhosis can happen if you try and add alcohol also (not one beer but on the more frequent side I am referring to)...now dont get me wrong I am not saying alcohol is a no no forever, just think about your health and the possible repercussions..It is also easy for us to switch addictions...Just my 2 cents as I care about us all! I haven't touched it in 3 yrs, never was a big part of my life preop! I mademy protein shakes in my magic bullet withice, sugar free syrups so they are like strawberry daquiris w/o the alcohol! there are SF mixes out there also..davinics has a simple sugar (sf version w/ splenda), they also have kahlua, irish creme, b52 among others.. I like vanilla protein powder 3 ice cubes 8 oz water splash kahlua, splash irish creme for a mudslide kinda thing or I also add dash sf coffee syrup! http://www.zilchmixers.com/ http://www.bajabob.com/ http://www.davincigourmet.com/ I also added 3 articles I have on alcohol and wls! Jamie Ellis RN, MS, NPP Lap RNY 10/9/02 Dr. Singh, Albany, NY 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 Dr. King, Albany, NY ~~~~~~~~~~~~~~~~~~~~~~~~ Alcohol Use in the Bariatric Patient Cynthia Buffington, Ph.D. Silhouette Excessive alcohol intake resulting in inebriation could lower sexual inhibitions and impair good judgment, increasing the risk for pregnancy and sexually transmitted disease. Gastric bypass may not only cause emotional and hormonal changes that raise sexual desires but also increases the risk of inebriation when drinking alcohol. Even years after surgery, the gastric bypass patient has higher blood alcohol levels after consuming an alcoholic beverage than does someone who has not had the surgery. This is because the procedure bypasses most of the stomach (where some alcohol is normally broken down) and the first part of the gut. Alcohol consumed rapidly passes through the stomach pouch and dumps directly into the portion of the gut (jejunum) that has the largest surface area available for absorption. The heightened absorption of alcohol increases the risk of intoxication, which could have serious ramifications when operating an automobile, performing a skilled task, or using clear judgment in making decisions, including the decision to engage in sex. During the early postoperative period or any time while on a protein-only diet, use of alcohol may have far more detrimental consequences than intoxication, including memory loss, brain damage, coma and even death. How is this possible? The brain and nervous tissue require sugar as fuel to function. To avoid low levels, the body stores sugar in the form of glycogen. However, glycogen stores can be depleted in a short period of time with starvation or when consuming a diet low in carbohydrate. When sugar supply declines, the body has two back-up mechanisms that help to provide the brain and nervous system the fuel required to function. One of these mechanisms involves a chemical pathway that produces sugar, a process known as gluconeogenesis. With a protein-only diet, energy needed to run this pathway is supplied by incomplete breakdown of fat into ketones, a process known as ketosis. Ketones can be used by all tissue (including the brain) for fuel, and can also be converted into sugar by gluconeogenesis. The production of ketones is what causes the sweet or distinct smell in the urine and on the breath during the rapid weight loss period following gastric bypass. And, during this period, it is extremely important that alcohol NOT be consumed. Why? Alcohol inhibits ketosis and, thereby, gluconeogenesis. This means the brain and nerves are depleted of the fuel needed to function. The effects of fuel depletion include disorientation, confusion, semi-consciousness, coma and even death. Drinking alcohol after surgery, therefore, could have far more serious consequences than a loss of sexual inhibition. Based on this information, should the gastric bypass patient totally refrain from drinking alcohol? Alcohol should NOT be consumed during the rapid weight loss period or while on an all-protein diet. After this time, however, there is no reason an occasional drink should not be enjoyed, provided the consumer is aware that a small amount of alcohol can produce an inebriating effect and, having such knowledge, takes the appropriate steps to assure their safety, including having available protection in the event of heightened sexual desire. http://www.bbvitamins.com/research_Article_5.aspx ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Precautions When Using Alcohol after Bariatric Surgery? Cynthia Buffington, Ph.D. Beyond Change, July 2003 A 36-year old female gastric bypass patient left a party after having only two alcoholic beverages, drove her car into oncoming traffic, causing the death of a 12-year old child*. Her blood alcohol level was above the legal limit for the operation of a motor vehicle and was far higher than would have been expected from the two alcoholic beverages she claimed to have consumed. Was the patient telling the truth about the amount of alcohol she drank at the party or did her surgery affect the way her body absorbed or metabolized the alcohol? A recent study reported in the British Journal of Clinical Pharmacology found that the gastric bypass procedure significantly affects alcohol absorption and its inebriating influence. According to the study protocol, a group of gastric bypass patients, three years post-surgery, and their non-surgical controls consumed an alcoholic drink containing 20% v/v alcohol (95% ethanol), and blood alcohol levels were examined over a period of time. The data showed that blood alcohol levels of the gastric bypass patients were far higher and required much less time to peak than those of the non-surgical controls. The more rapid absorption of alcohol and heightened blood alcohol levels would cause the bariatric patient to have a more pronounced feeling of inebriation during and shortly after drinking. And, such effects could have serious ramifications with regard to driving an automobile or performing other skilled tasks such as operating heavy machinery, piloting a plane or any other task that may influence the safety of the individual or that of others. Why would alcohol absorption be higher for someone who has had gastric bypass (or any other surgical procedure that reduces the size of the stomach and bypasses the upper portion of the gut)? With the gastric bypass procedure, 95% of the stomach and the upper gut (duodenum and a portion of the jejunum) are bypassed. Alcohol passes directly from the stomach pouch, usually without restriction, into the second portion of the gut, known as the jejunum. This portion of the gut has a large surface area and readily and rapidly absorbs the alcohol. In addition to anatomical changes in GI tract that influence alcohol absorption, the gastric bypass patient (or patient having had any bariatric procedure), may also be more sensitive to the intoxicating effects of alcohol because of the reduced calorie intake caused by the surgery. A number of studies have found that alcohol absorption is far higher if fasting or when consumed on an empty stomach than if provided with a meal or drank soon thereafter. During the first several months following gastric bypass or any other bariatric surgical procedure, total daily calorie intake is quite low. Drinking alcohol, even small amounts, at this time, would increase significantly an individual's risk for intoxication. In the rapid weight loss period following bariatric surgery, alcohol consumption could have far more serious consequences than inebriation, namely brain damage, coma and death. How is this possible? Muscle, heart, liver and other tissues use fat and sugar (glucose) for fuel. The brain, however, requires sugar (glucose) to function. To avoid low sugar, the body stores sugar in the form of glycogen. However, glycogen stores can be depleted in a short period of time with prolonged work or exercise, starvation or a diet low in carbohydrate. When this happens, the body has two back-ups mechanisms that help to provide the brain and nervous system the sugar required to function. One of the mechanisms whereby sugar is produced is a process called gluconeogenesis, a chemical pathway that converts certain components of protein, lactic acid and other substances into sugar. Fat cannot be converted into sugar. However, the production of sugar by gluconeogenesis is run by energy produced by the incomplete breakdown of fat into ketone bodies via a process known as ketosis. Ketone bodies can be used by all tissues, including the brain, for fuel. And, ketones can also be converted into sugar via gluconeogenesis. In this way, the brain and nervous system can function normally, even during times of low calorie intake, such as during the rapid weight loss period following bariatric surgery. The production of ketones is what causes the sweet or distinct smell in the urine and on the breaths of bariatric patients during the rapid weight loss period after surgery. And, during this time, it is extremely important that alcohol NOT be consumed. Why? Alcohol inhibits gluconeogenesis and ketosis. This means the brain and nerves are depleted of the fuel needed to function. The consequences of such fuel depletion initially are disorientation, confusion, semi-consciousness, coma and, ultimately, death. The detrimental effects of alcohol on the brain's fuel supply can also cause accidents, such as the hypothetical situation described below. A bariatric patient, four weeks after surgery, had a couple of drinks and drove to the post office. But, instead of walking into the post office to get her mail, she drove her car through the front window. She claimed to have 'blacked out' before the accident and had no memory of the event. People standing by said she was disoriented and, presumably, intoxicated. Fortunately, someone provided her a beverage containing sugar that helped her to regain full consciousness, preventing coma or even death, as well as an evening in jail. Drinking alcohol in the early postoperative period may have other adverse effects on health. Frequent vomiting, low calorie intake, not taking multivitamins and malabsorption may cause a number of vitamin and mineral deficits, including thiamin. Alcohol further reduces the absorption of thiamin, causing severe deficits and a condition known as Beriberi (see May 2003 issue of Beyond Change). Beriberi, in turn, may cause congestive heart failure, nerve damage, muscle cramping and pain, crippling, brain damage, a loss of memory and inability to learn, confusion, disorientation, coma and death. Addiction transfer is yet another precaution to be considered with regard to alcohol. The prevalence of food addiction and associated eating abnormalities, i.e. binge eating, carbohydrate cravings, are high among individuals with morbid obesity. With bariatric surgery, the addictive tendencies for food and aberrant eating behavior are considerably improved. However, individuals with addictions often transfer their addiction to yet another substance, such as alcohol. According to the findings of one study, addiction transfer may occur in up to 25% of bariatric patients. Drinking alcohol after surgery may also reduce maximal weight loss success. Alcohol has no nutrient benefits and contains high numbers of calories that may cause weight gain or prevent weight loss. One 12-ounce can of beer, for instance, contains 150 calories; 3.5 ounces of wine contains 70 calories; 1.5 ounces of gin, rum, vodka or whiskey contains between 97 and 124 calories; and 1.5 ounces of liquor contains 160 calories. Based on all the information provided above, should the bariatric patient abstain from alcohol totally? The bariatric patient should absolutely NOT drink alcohol during the rapid weight loss period and definitely not if consuming no or low carbohydrates, not taking vitamin and mineral supplements, vomiting frequently, or not able to keep their food down. However, with time, there is no reason an individual should not be able to enjoy an occasional drink, provided they are aware that it only takes a small amount of alcohol to produce an inebriating effect. With such knowledge, appropriate precautions should be taken, such as waiting a sufficient length of time after drinking to drive or perform other skilled tasks. *the age of the individuals involved in the accident described and some details have been changed so that those involved may remain anonymous http://www.bbvitamins.com/research_Article_4.aspx ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ http://www.barimd.com/myNewsletterPage.php?pageNo=5&practiceId=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). ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~