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Calif. treatment center sees unexpected cohort of obesity surgery patients

April 29, 2010
by Gary A. Enos, Editor
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Clients are reporting complications associated with drinking

An unusual pattern has emerged in recent months at the New Dawn Recovery Centers addiction treatment operations near Sacramento, Calif.: A steady number of patients who have undergone gastric bypass surgery, many with little more than a social drinking history, are presenting with serious alcohol-related problems.

The facility’s medical director, David Smith, MD, says many individuals who have had the obesity treatment procedure report difficulty controlling their drinking post-surgery. He says some describe a scenario of becoming intoxicated more quickly than they did before the surgery, while others will drink large amounts and receive no warning of problems before getting “clobbered.”

Medical literature lists an ongoing problem with alcohol as a factor that could eliminate an obese person from consideration for gastric bypass surgery, a procedure that is generally considered only for severely overweight individuals who have already tried a number of other weight-loss measures. But Smith says some of the problems New Dawn has seen involve people who have engaged in social drinking, which might mean that broader warnings targeting candidates for the surgery should be implemented.

“If alcohol abuse is in someone’s past and now they’re a moderate user, they shouldn’t drink at all,” Smith says. “If someone is at the two-to-three drinks a day level, these folks really need to not be drinking.”

Smith points out that research has described a more rapid peak of alcohol absorption in individuals who have had the surgery, in which a plastic band or surgical staples are used to create a pouch at the top of the stomach to reduce its size. But he adds that he is not familiar with any medical descriptions of what many patients have described as “the lid coming off” when they try to resume moderate levels of drinking post-surgery.

Once these patients enter treatment, they present with a variety of complicating issues, including issues around body image as they have begun to lose significant weight, Smith says.

New Dawn is in the process of organizing an August meeting in its community, where it hopes to educate centers that perform the obesity surgery to be aware of a subject that they might want to discuss in advance with their patients.

“They need to give patients a full education that this could be a consequence of the surgery,” Smith says. “This is potentially a completely preventable form of alcoholism.”

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