I had surgery in November 2007. OCCASIONALLY I'll have a half a glass of wine (believe it or not, mixed with water and ice) with dinner or when socializing.  I joked with my sister that it hits me like a freight train, but then if I have a bite or two to eat the effects disappear just as quickly.

Sensibily she asked me about my blood alcohol level...what if I were out to dinner and had a small glass of wine and then wanted to drive home...EVEN IF I FELT SOBER....how would that show in my blood alcohol level? Does anyone know? Would ONE glass of wine show up as a higher amount in my blood because of surgery?

I do NOT drive, even after one glass (hubby does), I'm just curious about it.

I went for my 12 month follow up a couple of weeks ago and told the PA I talked with that I have an occasional glass of wine and she wasn't concerned, but I didn't ask her about the blood alcohol level.

hi  

yes your blood alcohol is higher (BAC) according to a  breatholizer BUT!!!!!!!! IT HASNT BEEN SHOWN YET IN ANY BLOOD WORK TESTING  that i have fund as of yet 

i`m currently going to court from a dui over 80   as i have had my surg done in 1989 one of the first in ontario canada

none of this information has been provided back then but have quickly learned  through new information that it will cause in a faults positive in a  breathalyzer test 

having no stomach  its can`t be processed  properly and enters system faster and leaves fast in some cases  but if your over drinkin it takes more time to leave your system  (PARTY DRINKING ) 

BE CAREFUL one drink will end you in the klink

all the best and good luck  

Due to our altered anatomy and the rapid absorbtion the BAC would be higher quicker, folks have reported DUI's DWI's on a gladss of wine or less! Good info to know also that addiction transfer is common!!! Here are al the articles I have! (not sure if all the links still are current!)

 

ARTICLES ON WLS AND ADDICTIONS
1. Recommendations on the Use of Alcohol After Surgery
By: Cynthia Buffington, Ph.D.
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?

A recent study reported in the British Journal of Clinical Pharmacology (1) 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 after an overnight fast, and blood alcohol levels were examined over a period of time. The data showed that blood alcohol levels of the gastric bypass patients were 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 a gastric bypass (or other surgical procedure that reduces the size of the stomach, i.e. biliopancreatic diversion with or without the duodenal switch, gastrectomy)? With the gastric bypass procedure, more than 95% of the stomach is bypassed. Alcohol passes directly from the stomach pouch, usually without restriction, into the intestines where, due to the large surface area of the intestines, alcohol is rapidly absorbed. In addition to anatomical changes that influence alcohol absorption, the bariatric surgical patient may be more sensitive to the effects of alcohol because of low calorie intake. Several studies found that alcohol absorption is more rapid and blood levels higher if alcohol is consumed on an empty stomach than if provided with a meal or drank soon thereafter (2-3). During the first several months following bariatric surgery, total daily calorie intake is quite low. Drinking alcohol, even small amounts, at this time, would increase significantly an individual's risk for intoxication.

Metabolic changes that occur with rapid weight loss, as well as the morbidly obese condition, can also alter the rate that the liver is capable of clearing alcohol from the body by the liver's primary pathway for alcohol metabolism. Reduced clearance of alcohol by this pathway may further increase blood alcohol levels and the risk for intoxication and alcohol toxicity (4-6). Metabolic changes that occur with massive and rapid weight loss may also increase the clearance of alcohol by a secondary pathway of alcohol metabolism that substantially increases the risk for liver damage while, at the same time, makes an individual more sensitive to the toxic and cancer-promoting effects of pollutants in the air, industrial solvents (such as those in household cleaners), and certain drugs (4-6). Alcohol use can also cause brain damage, a loss of consciousness or even death by reducing the supply of sugar (glucose) to the brain. Muscle, heart, liver and other tissues use fat and sugar (glucose) for fuel. The brain, however, needs sugar to function. To avoid a depletion of sugar, the body stores sugar in the form of glycogen. Glycogen stores, however, can be depleted in a short period of time with prolonged work or exercise, fasting or a diet low in carbohydrate. Furthermore, alcohol reduces the process that allows sugar to be stored as glycogen (7). The bariatric patient, particularly in the rapid weight loss period and if on a low carbohydrate diet, may have low amounts of stored sugar (glycogen). Drinking alcohol could deplete those stores and cause blood sugar levels to decline. The body, however, has another mechanism to maintain appropriate amounts of sugar in the body. This process is known as gluconeogenesis and is a chemical pathway that converts certain components of protein, lactic acid and other substances into sugar. However, alcohol reduces the production of sugar by this process (4-7) and can, thereby, cause hypoglycemia (low blood sugar).

Usually when blood sugar levels fall, there are certain hormones produced that restore blood sugar levels to normal. However, when someone drinks alcohol, the response of these hormones to low blood sugar is blunted. To make matters worse, hormone responses to low blood sugar are also blunted or depressed in postoperative bariatric patients (8). The bariatric patient, therefore, would have a much higher risk of becoming hypoglycemic (having low blood sugar) than someone who drinks that has not had the surgery, particularly if the patient drinks alcohol during the rapid weight loss period. Since the brain and nervous system need sugar for fuel, low blood levels could adversely affect neuromuscular and cognitive functions, causing a loss of coordination and balance, slurred speech, poor vision, and confusion. These are all conditions that mimic those associated with intoxication. The patient described earlier, who appeared extremely intoxicated even though her blood alcohol levels were not high, may have been hypoglycemic. Low blood sugar, over a period of time, can result in a 'black out' or loss of consciousness, brain and nerve damage, and even death. The use of alcohol after surgery could also cause irreversible brain and nerve damage, coma and possible death by inhibiting the absorption of important vitamins, including B-complex vitamins such as thiamin (B1) or vitamin B12. Alcohol inhibits the absorption of thiamin and other B-complex vitamins, reduces activation of certain vitamins, and stimulates the breakdown of vitamin A, pyridoxine, and folate (4-6). These vitamins may already be deficient in bariatric patients because of nutrient restriction, malabsorption or impartial digestion of foods produced by the prospective surgery. Alcohol use, then, would compound the negative effects that bariatric surgery has on vitamin/mineral status and increase the risk for associated health problems, including nerve and brain damage, defects in metabolism, a decrease in the ability of the body to heal, low immunity, fatigue and more. Alcohol has numerous other toxic effects in the body. Not only does alcohol cause liver disease but also negatively affects other tissues. Alcohol's influence on the heart inflammation (myocarditis), a loss of heart tissue (cardiomyopathy), and irregular heart beats (arrthymias) that can lead to sudden death. Skeletal muscle is particularly susceptible to alcohol with loss of skeletal muscle fibers and strength. Alcohol also causes inflammation of the intestinal tract, gastritis, pancreatic, acid reflux disease and increased risk for gastric and esophageal cancer. And, alcohol causes damage, often irreversible, to the brain and nervous system.

In addition to the numerous health problems that drinking alcohol after surgery may cause, the bariatric patient should also be cautious of alcohol addiction. 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 tendency 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 Austrian psychologist, Dr. Elisabeth Ardelt, addiction transfer may occur in as many as 25% to 30% 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 liquer contains 160 calories. Are there guidelines for using alcohol after surgery? Presently, there are no official guidelines that have been established pertaining to the use of alcohol after having bariatric surgery. However, based upon knowledge of changes in the absorption and metabolism of alcohol, coupled with the metabolic state of the bariatric patient at various stages postoperatively (4), the following suggestions are recommended · Do NOT drink alcohol during the rapid weight loss period. · When drinking, remember that small amounts of alcohol can cause intoxication or can result in low blood glucose with serious consequences. · Do not drive or operate heavy equipment after drinking alcohol, even small amounts. · Eat if you plan to have a drink. · Make certain to take your bariatric vitamin and mineral supplements. Cynthia Buffington, Ph.D. Cynthia Buffington, Ph.D., is the Director of Research for The Obesity Wellness Center

References: Klockhoff et al. Br J Clin Parmacol 54:587-91, 2002. Jones et al. J Forens Sci 36:376-85, 1991, Hahn et al. Alc Alcohol 32:501-5, 1997. Buffington CK. www.BariMD.com (A review of alcohol absorption and metabolism in the bariatric patient), 2005. Lieber et al. Mt Sinae J Med 67:84-94, 2000. Lieber et al. Am J Clin Nutr 58:430-42, 1993. Mokuda et al. Annal Nutr and Metabolism 48:276-280, 2004. Guldstrand et al. Metabolism 52:900-7, 2003. http://www.beyondchange-obesity.com/obesityResearch/precauti onsWithAlcohol.html

2. Caution When Using Alcohol after Bariatric Surgery                   
By Cynthia Buffington, Ph.D.
 

3. Alcohol Use in the Bariatric Patient
Cynthia Buffington, Ph.D. in Silhouette
http://www.bbvitamins.com/research_Article_5.aspx

4. Alcoholism Following Weight Loss Surgery
http://www.wlscenter.com/NLArchive/may_1_2006.htm

5. After weight-loss surgery, some find new addictions
http://www.azcentral.com/offbeat/articles/0718wsj-addiction- transfer18-ON.html#

6. Patient Perspective:
My Battle with Alcohol After Bariatric Surgery
- by Patty Worrells  http://www.bariatrictimes.com/displayArticle.cfm?articleID=a rticle276

(SNIP) At about six months out, I tried a shot of tequila. Wow! Do you know that it takes 17 seconds for a shot to go from my mouth into my bloodstream as a bariatric patient? And it’s different! This is like putting a needle in my vein and mainlining tequila. Seventeen seconds and BOOM! What a ru**** was fun. Many of us began to enjoy it. We were coming out of hiding and being the life of the party for the first time in our lives. It was all so innocent.

We were warned that drinking alcohol would be different after surgery—that when we did take a drink, we needed to be careful because it would affect us differently with our new anatomy. We were not warned, nor do I think they even knew, that it could grab hold of us so quickly and strongly that some of us would become totally addicted to this new substance. We traded our comfort with food for acceptance and comfort with alcohol. (SNIP)
7. Perspective:
Alcohol and the Gastric Bypass Patient
by Cynthia K. Buffington, PhD Perspective:
http://www.bariatrictimes.com/displayArticle.cfm?articleID=a rticle273

8. 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.

9.  Popular Weight Loss Procedure Could Lead to Addiction http://www.wsfa.com/global/story.asp?s=6546994&ClientType=Pr intable

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What You Need to Know About Transfer Addiction

Katie Jay 

No one likes to think of themselves as an addict. When I first realized I was addicted to alcohol nearly 25 years ago, I was somewhat shocked -- even though my behavior with alcohol was clearly out of control.

My Friend Lory Helped Me Get Sober

Alcohol and life cir****tances had turned me into a major depressive mess. Every time I got drunk, I cried. As you can imagine, I was not very fun to be around.

When I showed up at Lory's apartment with my usual six pack, ready to share my woes, she said, "You can't come in if you bring that beer."

I'll Always Be Grateful to Lory

Thank God someone had the courage to set a limit with me. I don't know how long my misery would have lasted if Lory had not taken the risk to help me out of my denial.

I Got Sober at Age 23

I went through a month-long, in-patient treatment program. And have been sober every since.

But I Did Experience a Transfer Addiction

When I got sober, I turned to food for comfort. At first I didn't think anything of it. But, over time I realized I was as obsessed with food as I had been to alcohol -- and it was destroying my health.

Many Who Have WLS Struggle with Food Addiction

It's like a dance. You spend a lot of time obsessing about who (which unhealthy food) you want to dance with, a lot of time getting ready for the dance (cruising the grocery aisles, reading cookbooks, snooping around in the kitchen), and then you "dance" with one of your trigger foods.

Are You Dancing with an Addiction?

I know the word addiction is loaded with meaning for people. A stigma exists, it's true. But it's insane to not address an addiction just because it's uncomfortable to do so.

Once you seek help and get started on a program of recovery, you'll be amazed at how quickly your shame slips away.

Addictions Are Physiological and Psychological

Many people mistakenly believe addiction is only a mental problem. While there is a mental/emotional component to addiction, there is also a major physical component.

Addictions have a strong physiological basis, even if you are addicted to shopping.

Addiction Involves Wanting to Change Your Mood

When we engage in addictive behavior, we are attempting to change our brain chemistry so we can feel better. Addiction, the way I look at it, is really self medication.

There Are Healthier Ways to Make Yourself Feel Better

The tragedy of addiction is that the substance (or behavior) that soothes you also harms you. If you don't want that substance or behavior to "own" your life, you have to let go.

When you address your addiction(s) head on; whether it's food, alcohol, shopping, sex, or something else; you have a shot at overcoming it.

If you suspect you have an addiction, here are some strategies you can use to begin to deal with it:

1) Admit you are doing the dance. All good recovering addicts know the first step is to admit you have a problem. So, admit it ... first to yourself, and then to someone who can help you. Please feel free to write to me if you would like to tell someone, but don't know who to turn to.

2) Find a new dance partner. It can help to substitute a healthy behavior for an unhealthy one. For example, I drink peppermint tea at bedtime every night instead of eating a bowl of chocolate ice cream. I know this doesn't sound like a very good trade, but after having the tea maybe 100 nights in a row (yes, it takes time) I love it, crave it, and feel very satisfied with it.

3) Find a new place to dance. Leave that dance hall of shame and find a new place to go. Try to avoid hanging out in the kitchen or in front of the TV with a snacking family. Instead, go for a walk, visit the library, or try a 12-step meeting. I do all three. (I love libraries because they are a grand distraction and they don't have food.)

4) Learn new steps. Being addiction free can feel strange at first. Awkward. You will have to learn how to cope in completely different ways. You will have to let go of some friends, and make new friends. You will have to work at finding healthier ways to respond to life's challenges. This is why it's good to get help. You can learn from others who understand your situation.

5) Practice. Letting go of an addiction is not an event. It is a process that takes time and attention. Know that practicing new steps makes the dance of life less fun for a short while, but once you get the hang of it, look out! You'll be dancin' with the stars.

Did You Have WLS Hoping for a Better Life?

I know I did. If you are struggling with an addiction -- or if you don't know if you are addicted -- talk to someone knowledgeable about it.

As I said, I'm happy to help. Call my toll-free number or send me a note by email, and I'll help you find the right help for you.

Toll free:  (877) 746-5759 (Eastern time zone)
Email:  [email protected]

Warm regards,
Katie

Katie Jay, MSW, is director of the National Association for Weight Loss Surgery and a certified life coach. Get the free report, "The 10 Most Common Mistakes Weight Loss Surgery Patients Make," when you sign up for her free e-mail newsletter at www.10WLSmistakes.com.

http://www.nawls.com/public/548print.cfm

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http://www.medpagetoday.com/Psychiatry/Addictions/5943

Happy Hour?

(Patient Story)

By: Jessica Fischer
Category: Weight Loss Surgery

 

I think I’ve been hearing those words, or some variation of them, for at least ten years. They never made much of an impact on me though until about two years ago, somewhere around the first anniversary of my gastric bypass. I remember my doctor telling me not to drink for three to six months after surgery, and I knew that wouldn’t be an issue. I wasn’t much of a drinker. In fact by the time I was 25 years old I could probably count on one hand the amount of times I had actually been drunk.

My 26th birthday fell about four months post-op. I was down about 75 pounds, and feeling great. My friends took me out to this amazing restaurant owned by a celebrity chef, which I had wanted to try. At dinner I decided to order a sangria. Half way through my first glass of wine I was loaded. I had never been so quickly and easily affected by alcohol before. It really threw me for a loop. Presurgery even though I didn’t drink very often I could certainly have a couple drinks without feeling anything more than a little flushed. Suddenly, I was sitting at my birthday dinner drunk, and ordering a second glass of wine.

I can look back now and honestly say that night is the first I can identify as the beginning of my problems with alcohol. That was my “trigger" night. The way those two glasses of wine made me feel was unexpected but, it reminded me of something I had felt before. For four months after my surgery I had been working so hard on doing things right and eating well, and not eating the foods I had come to depend on I didn’t even realize how much I missed that feeling of escape. Now, I was replacing food with liquor. Of course I didn’t recognize that at the time. I thought I was just having fun. Going out and experiencing life the way so many of my friends had been. I was thinning down enough to fit into a world I had never been a part of. And what a world it was.

A whirlwind of trendy clubs and beautiful people. Late nights, early mornings, and lots of booze. I lost myself in a universe that had been closed to me before. I went on a binge. I drank heavily and often for about a year and a half. In the grand scheme of things I know that doesn’t seem like a long time. It was long enough for me to change so profoundly from someone I knew and understood into someone I could hardly stand. I would go out seeking escape and attention and wake up sick, and lost. I started to bury my feelings and drink more. I abandoned my morals. I made irrational, unhealthy decisions. I was excusing my behavior by blaming the drinks, and the new body, and the idea that I was still young and discovering myself. The truth is I always knew who I was I just wanted an excuse to screw up and still be able to forgive myself.

I finally got to a point where that didn’t work anymore. I was forgetting entire blocks of time; I was putting my safety in danger. I was pushing away the people who meant the most to me all in search of some kind of escape. I couldn’t eat away my feelings anymore, but I could certainly pound a few drinks, and forget all about the hole inside of me. I think I was born with an addictive personality. I was just trading the addictions.

One day I woke up and realized I had not gone through a major life changing surgery, and lost 170 pounds only to sabotage that triumph, by running myself into the gutter with alcohol. I am happy and grateful to say that I have been sober for 8 months. I am in therapy, and I have been lead down a new road of discovery where it’s okay to be fl awed and it’s okay to be lost as long as I am constantly working myself, and not replacing one unhealthy habit with another.

When I sat down to write this piece I was worried about my image. I was embarrassed. I have been labeled a “gastric bypass role model" because my surgery was so successful. And here I am telling my community that I have been weak. That I have folded under pressure. But, I thought if this is something I went through; I bet I’m not the only one. So many people are afraid to come forward and talk about some of the scary stuff, the things we don’t expect or have coping mechanisms to deal with after surgery. I can’t be the only person who has gone through addiction replacement, or has had trouble adjusting to my new body, and my new life. That’s why I finished writing it. That’s why I’m speaking out. That’s why I’m honest. Because I know I’m not alone.

I consider myself one of the lucky ones. I have been blessed with a two sided viewpoint on life. I have lived in two distinct worlds. I can get out and tell my story, and hopefully help others who struggle with the same things I have. So, now I’m ready for another round, only this time I think I’ll have a water.

Jessica Fisher is a stand-up comedienne who shares her emotional ups, downs and struggles as she tries to make sense of her life and career after WLS. For information on Jessica Fisher’s film “What’s So Funny," or to book her for speaking engagements please visit Jessica’s website www.jessicajess.com.

WLS Lifestyles - www.wlslifestyles.com - Copyright 2005

http://www.wlslifestyles.com/printer-friendly.php?id=98


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Drunkenness Comes Faster After Gastric Surgery
Thursday, June 14, 2007

Oprah show revelations sparked a study into the phenomenon

By Amanda Gardner
HealthDay Reporter

THURSDAY, June 14 (HealthDay News) -- Oprah Winfrey's influence may now reach into medical science: her show led researchers to confirm that gastric bypass causes people to get drunk faster.

The reason, scientists say, is that bypass surgery cuts the amount of alcohol metabolized by the stomach.

The weight-loss procedure also seems to extend the time people need to sober up, the team said.

The research has implications for the 150,000 Americans who have already undergone this procedure and the thousands more who may be considering it.

"At the end of the day, this is the only enduring and effective intervention for morbid obesity," stressed study senior author Dr. John Morton, director of bariatric surgery at Stanford Hospitals and Clinics. "We don't want to deny them, but we want to make sure they are fully prepared to meet these challenges after surgery."

"This might let folks know to be a little more careful if they have a drink," added Dr. Joaquin Rodriguez, assistant professor of surgery at Texas A&M Health Science Center College of Medicine and chief of minimally invasive surgery at Scott & White Hospital in Temple. "They need just to be aware that the same amount of alcohol may affect them differently than someone who hasn't had a gastric bypass," said Rodriguez, who was not involved in the research.

Study lead author Judith Hagedorn, a medical student at Stanford University, is scheduled to present the data June 14 at the annual meeting of the American Society for Bariatric Surgery, in San Diego.

In October 2006, Winfrey aired a show called "Suddenly Skinny," which noted that gastric-bypass patients often felt they had faster alcohol absorption after the surgery. Also discussed was "addiction transfer," when a person swaps his or her food addiction for an alcohol addiction.

Winfrey and her producers are clearly up on current health trends: Obesity is one of the leading, if not the leading, public health crisis in the industrialized world. More than 60 percent of adult Americans are overweight, 23.9 percent are obese and 3 percent are extremely obese. Being overweight can lead to a slew of life-threatening problems, including diabetes, heart disease and even cancer.

According to the new study, bariatric surgery -- especially gastric bypass, which reduces the size of the stomach and adds a bypass around part of the small intestine -- is the most effective treatment for morbid obesity.

After the Oprah episode, Morton, who has performed about 1,000 such surgeries, was inundated with questions from patients. "This prompted me to dig a little deeper to find data and, much to my surprise, I didn't find a whole lot of data," he said.

Rodriguez said, "There are a couple of other reports that have shown similar things, but it's mostly anecdotal. Patients come in and say they had wine or a margarita and got drunk really fast."

So, Morton undertook his own study involving 19 people who had had gastric bypass surgery at least one year prior and 17 control subjects without such histories. Each participant was asked to consume five ounces of red wine.

All participants then underwent an alcohol breath analysis every five minutes until the levels reached zero.

The gastric bypass patients had a peak alcohol level of 0.08 percent, vs. 0.05 percent for the controls. In some states, 0.08 is considered intoxicated, Morton said.

The gastric patients also needed an average of 108 minutes to get back to zero, while the controls needed an average of 72 minutes.

"The alcohol peaked higher and stayed around longer," Morton said.

Also, the gastric bypass patients reported the same symptoms, even though their breath alcohol levels were higher.

"This led us to think that some of patients may have high breath alcohol level and not be aware of it," Morton said. "One drink may be too much, especially if you are going to have a drink and drive."

The main reason for this enhanced susceptibility to alcohol is that the surgery bypasses the stomach, which is one of two places the enzyme responsible for metabolizing alcohol is present, Morton said.

"If you're bypassing the stomach, you're bypassing most of the ability to metabolize alcohol," he added.

According to one survey, 83 percent of gastric bypass patients consume alcohol after surgery and all of them need to be cautious for any number of reasons.

"Sometimes alcohol use after surgery can wreck havoc on weight maintenance," Morton said. "Alcohol relaxes you on the outside, and on the inside, too. With alcohol, patients can be able to eat a little bit more because of the relaxation of the lower esophageal sphincter and the intestine as well."

Also, as patients start to lose weight, they often become more socially active, a pastime that often includes alcohol.

"This is also something patients have to be aware of," Morton said. "The bottom line is alcohol use after gastric bypass should be used with caution, and certainly patients shouldn't have even a single drink and drive."

SOURCES: John Morton, M.D., director, bariatric surgery, Stanford Hospitals and Clinics, Stanford University Medical Center; Stanford, Calif.; Joaquin Rodriguez, M.D., assistant professor of surgery, Texas A&M Health Science Center College of Medicine, and chief, minimally invasive surgery, Scott & White Hospital, Temple; June 14, 2007, presentation, annual meeting, American Society for Bariatric Surgery, San Diego

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ASBS: Alcohol Effects Altered after Bariatric Surgery Download Complimentary Slide Presentation

By Crystal Phend, Staff Writer, MedPage Today Published: June 15, 2007 Reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine. Earn CME/CE credit for reading medical news

SAN DIEGO, June 15 -- Gastric bypass surgery alters alcohol metabolism -- as many surgeons and patients suspected -- leading to faster peaks and prolonged effects without an increase in symptoms, researchers found. Action Points   Explain to interested patients that the study suggests caution in the use of alcohol even a year or more after gastric bypass surgery.   Inform patients who have undergone bariatric surgery that their blood alcohol concentration after a drink may be higher than indicated by their symptoms. In a case-control study, blood alcohol concentration peaked about 0.03% higher and took 40 minutes longer to dissipate among patients who had undergone bariatric surgery than in those who had not (P=0.004 and P=0.001), reported John M. Morton, M.D., M.P.H, of Stanford University, and colleagues.   "Alcohol after gastric bypass surgery should be approached with caution," Dr. Morton said here at the American Society of Bariatric Surgeons meeting.   He decided to investigate when patients swamped his office with concerns prompted by a segment on Oprah Winfrey's television show that focused on women who became addicted to alcohol following weight-loss surgery.   "We've always kind of counseled patients to be careful with alcohol after surgery," Dr. Morton said. "I was surprised to see there wasn't much work in the area."   All of the factors involved in alcohol metabolism -- weight, liver function, food intake, and production of the enzyme alcohol dehydrogenase -- are "profoundly altered" by gastric bypass surgery, he said.   But only one prior study from Sweden had looked at the issue, and only in 11 women.   So, the researchers studied 19 patients who had undergone gastric bypass surgery at least a year before and 17 volunteers matched for age, gender, and weight who had not had bariatric surgery.   About 20% of participants in both groups were male. Drinking history and patterns were similar between groups. However, the surgery group was older (average 47 versus 37, P=0.023) and heavier (200.8 versus 149.8 lbs., P=0.0012).   After fasting for at least two hours, participants were asked to drink 5 ounces of red wine over a 15 minute period. The investigators measured their breath alcohol level initially then every five minutes until it reached zero.   They found that the patients who had undergone bariatric surgery had a higher peak breath alcohol level at 0.08% -- which is legally drunk in some states -- compared with 0.05% in the control group (P=0.004).   Furthermore, the gastric bypass group took almost 40 minutes longer to completely metabolize the alcohol (time to zero 108 versus 72 minutes, P=0.001).   Age- and weight-adjusted breath alcohol curves showed significantly higher levels at each time point for the gastric bypass patients compared with the controls.   Gastric bypass surgery was "by far the most significant predictor of time to return to zero for breath alcohol levels," Dr. Morton said, compared with the other significant predictors (gender, body mass index, and starting level).   Notably, patients reported no significant differences in symptoms between groups in a survey.   This was "a little bit disturbing because if these patients don't have feedback to know that their blood alcohol level is high they may be lulled into thinking that their alcohol is okay and keep drinking," Dr. Morton said.   Another implication, he added, is that they don't get the same "high" from alcohol as they did before surgery, which may contribute to "addiction transfer," or the substitution of one habit-eating-for another. In this case, drinking.   Overall, the findings suggest that patients undergoing gastric bypass surgery need to be counseled to approach alcohol intake after surgery with caution, he said.   "Can you can enjoy a glass of wine in your home? Absolutely," he said. "But you have to be aware that the alcohol level is going to be higher and stay higher longer than it did before surgery."   In a situation where patients would be driving, "even one glass of wine may be too much" after gastric bypass surgery, he said, and two is probably the limit.   Dr. Morton reported having received an educational grant from Ethicon EndoSurgery and being a consultant for Bariatric Partners, Exploramed, and IntraPace.

Additional source: American Society for Bariatric Surgeons meeting Source reference: Morton JM, et al "Does Gastric Bypass Alter Alcohol Metabolism?" ASBS meeting 2007.