Alcohol and Other Addictive Disorders Following Bariatric Surgery: Prevalence, Risk Factors and Possible Etiologies

Steffen, Kristine J.; Engel, Scott G.; Wonderlich, Joseph; Pollert, Garrett A.; Sondag, Cindy

doi:10.1002/erv.2399

Cited by 91 publications

(58 citation statements)

References 51 publications

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“…Furthermore, an interesting possibility is that some subtypes of obesity might be at higher risk for developing addictive behavior (33). For instance, some post-bariatric surgery patients seem to exhibit increased rates of addictive problems (226–228). This phenomenon is commonly referred to as “cross addiction” or “addiction transfer.”…”

Section: Resultsmentioning

confidence: 99%

Overlapping Neural Endophenotypes in Addiction and Obesity

et al. 2017

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Impulsivity refers to a tendency to act rapidly without full consideration of consequences. The trait is thought to result from the interaction between high arousal responses to potential rewards and poor self-control. Studies have suggested that impulsivity confers vulnerability to both addiction and obesity. However, results in this area are unclear, perhaps due to the high phenotypic complexity of addictions and obesity. Focusing on impulsivity, the aim of this review is to tackle the putative overlaps between addiction and obesity in four domains: (1) personality research, (2) neurocognitive tasks, (3) brain imaging, and (4) clinical evidence. We suggest that three impulsivity-related domains are particularly relevant for our understanding of similarities between addiction and obesity: lower self-control (high Disinhibition/low Conscientiousness), reward sensitivity (high Extraversion/Positive Emotionality), and negative affect (high Neuroticism/Negative Emotionality). Neurocognitive studies have shown that obesity and addiction are both associated with increased impulsive decision-making and attention bias in response to drug or food cues, respectively. Mirroring this, obesity and different forms of addiction seem to exhibit similar alterations in functional MRI brain activity in response to reward processing and during self-control tasks. Overall, our review provides an integrative approach to understand those facets of obesity that present similarities to addictive behaviors. In addition, we suggest that therapeutic interventions targeting inhibitory control may represent a promising approach for the prevention and/or treatment of obesity.

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Section: Resultsmentioning

confidence: 99%

Overlapping Neural Endophenotypes in Addiction and Obesity

et al. 2017

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“…Furthermore, analyses of the relationship between problem foods and substance use onset failed to control for current or previous psychiatric morbidity, success of surgery, or current quality of life. Moreover, we would suggest caution in arguing that such foods are addictive based on the contentious concept of addiction transfer [20]. …”

Section: Characterising (Potentially) Addictive Foodsmentioning

confidence: 99%

Sugar addiction: the state of the science

2016

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PurposeAs obesity rates continue to climb, the notion that overconsumption reflects an underlying ‘food addiction’ (FA) has become increasingly influential. An increasingly popular theory is that sugar acts as an addictive agent, eliciting neurobiological changes similar to those seen in drug addiction. In this paper, we review the evidence in support of sugar addiction.MethodsWe reviewed the literature on food and sugar addiction and considered the evidence suggesting the addictiveness of highly processed foods, particularly those with high sugar content. We then examined the addictive potential of sugar by contrasting evidence from the animal and human neuroscience literature on drug and sugar addiction.ResultsWe find little evidence to support sugar addiction in humans, and findings from the animal literature suggest that addiction-like behaviours, such as bingeing, occur only in the context of intermittent access to sugar. These behaviours likely arise from intermittent access to sweet tasting or highly palatable foods, not the neurochemical effects of sugar.ConclusionGiven the lack of evidence supporting it, we argue against a premature incorporation of sugar addiction into the scientific literature and public policy recommendations.

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“…1 However, evidence is mounting that Roux-en-Y gastric bypass (RYGB) increases the risk of developing an alcohol use disorder (AUD). 2-5 Pharmacokinetic studies provide evidence that RYGB, but not laparoscopic adjustable gastric band (LAGB), is associated with higher peak blood alcohol concentration, which is reached more quickly compared to presurgery status or non-surgical controls. 2,5 Additionally, rodent models suggest that RYGB increases alcohol reward sensitivity via a neurobiological mechanism, independent of changes in alcohol absorption.…”

Section: Introductionmentioning

confidence: 99%

“…2-5 Pharmacokinetic studies provide evidence that RYGB, but not laparoscopic adjustable gastric band (LAGB), is associated with higher peak blood alcohol concentration, which is reached more quickly compared to presurgery status or non-surgical controls. 2,5 Additionally, rodent models suggest that RYGB increases alcohol reward sensitivity via a neurobiological mechanism, independent of changes in alcohol absorption. 2,5 Hypothesized pathways include changes to the ghrelin system and altered genetic expression in regions of the brain associated with reward circuitry.…”

Section: Introductionmentioning

confidence: 99%

Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study

King

Chen

Courcoulas

et al. 2017

Surgery for Obesity and Related Diseases

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229

156

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Background Empirical evidence suggests Roux-en-Y gastric bypass (RYGB) increases risk of developing alcohol use disorder (AUD). However, prospective assessment of substance use disorders (SUD) following bariatric surgery is limited. Objective To report SUD-related outcomes following RYGB and laparoscopic adjustable gastric banding (LAGB). To identify factors associated with incident SUD-related outcomes. Setting Ten US hospitals. Methods The Longitudinal Assessment of Bariatric Surgery-2 is an observational cohort study. Participants self-reported past-year AUD symptoms (determined by the Alcohol Use Disorders Identification Test), illicit drug use (cocaine, hallucinogens, inhalants, phencyclidine, amphetamines, or marijuana), and SUD treatment (counseling or hospitalization for alcohol or drugs) presurgery and annually postsurgery for up to seven years through January 2015. Results Of 2348 participants who underwent RYGB or LAGB, 2003 completed baseline and follow-up assessments (79.2% women, baseline median age 47 years, median body mass index 45.6). The year-5 cumulative incidence of postsurgery onset AUD symptoms, illicit drug use, and SUD treatment were 20.8% (95%CI, 18.5-23.3), 7.5% (95%CI, 6.1-9.1), and 3.5% (95%CI, 2.6-4.8), respectively, post-RYGB, and 11.3% (95%CI, 8.5-14.9), 4.9% (95%CI, 3.1-7.6), and 0.9% (95%CI, 0.4-2.5) post-LAGB. Undergoing RYGB vs. LAGB was associated with higher risk of incident AUD symptoms (AHR=2.08 [95%CI, 1.51-2.85]), illicit drug use (AHR=1.76 [95%CI, 1.07-2.90]) and SUD treatment (AHR=3.56 [95%CI, 1.26-10.07]). Conclusions Undergoing RYGB vs. LAGB was associated with twice the risk of incident AUD symptoms. One-fifth of participants reported incident AUD symptoms within 5 years post-RYGB. AUD education, screening, evaluation, and treatment referral should be incorporated in pre- and postoperative care.

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Alcohol and Other Addictive Disorders Following Bariatric Surgery: Prevalence, Risk Factors and Possible Etiologies

Cited by 91 publications

References 51 publications

Overlapping Neural Endophenotypes in Addiction and Obesity

Overlapping Neural Endophenotypes in Addiction and Obesity

Sugar addiction: the state of the science

Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study

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