Change in consumption patterns for treatment-seeking patients with alcohol use disorder post-bariatric surgery

Objective: The aim of this study is to describe the clinical phenotype of alcohol use disorder (AUD) treatment-seeking patients with Roux-en-Y Gastric Bypass Surgery (RYGB) history; and to compare it to AUD obese non-RYGB controls. Methods: Retrospective study of electronic medical records for all patients 30-60 years treated at the Mayo Clinic Addiction Treatment Program, between June, 2004 and July, 2012. Comparisons were performed with consumption patterns pre-RYGB and at time of treatment; excluding patients with AUD treatments pre-RYGB. Results: Forty-one out of 823 patients had a RYGB history (4.9%); 122 controls were selected. Compared to controls, the RYGB group had significantly more females [n = 29 (70.7%) vs. n = 35 (28.7%) p < 0.0001]; and met AUD criteria at a significantly earlier age (19.1 +/- 0.4 vs. 25.0 +/- 1 years old, p = 0.002). On average, RYGB patients reported resuming alcohol consumption 1.4 +/- 0.2 years post-surgery, meeting criteria for AUD at 3.1 +/- 0.5 years and seeking treatment at 5.4 +/- 0.3 years postoperatively. Pre-surgical drinks per day were significantly fewer compared to post-surgical consumption [2.5 +/- 0.4 vs. 8.1 +/- 13, p = 0.009]. Prior to admission, RYGB patients reported fewer drinking days per week vs. controls (4.7 +/- 0.3 vs. 5.5 +/- 1.8 days, p = 0.02). Neither RYGB, gender, age nor BMI was associated with differential drinking patterns. Conclusion: The results of this study suggest that some patients develop progressive AUD several years following RYGB. This observation has important clinical implications, calling for AUD-preventive measures following RYGB. Further large-scale longitudinal studies are needed to clarify the association between RYGB and AUD onset. (C) 2014 Elsevier Inc. All rights reserved.