Prevalence of and Risk Factors Associated with Alcohol Overconsumption at 2 Years After Bariatric Surgery

Siikaluoma, Lara; Stenberg, Erik; Raoof, Mustafa

doi:10.1007/s11695-022-06060-6

Cited by 5 publications

(8 citation statements)

References 27 publications

(43 reference statements)

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“…Thus, this allows us to suggest that the HSB diet consumption can trigger an obsessivecompulsive-like disorder in mice and that our model can be applied in studies related to bariatric surgery in humans, mainly regarding the relationship of this procedure with alcohol consumption. Studies show that in the 2-year postoperative follow-up to bariatric surgery, about 8.3% of patients develop disorders related to alcohol use (78)(79)(80). In general, it is believed that there is a transfer from compulsive eating to ethanol high consumption and loss of inhibitory control in individuals after bariatric surgery, which potentiates preference for the substance, as observed in the Switch groups (Switch + EtOH, Switch Il6 KO + EtOH, and Switch Nfat KO + EtOH) (81)(82)(83).…”

Section: Discussionmentioning

confidence: 99%

Animal model for high consumption and preference of ethanol and its interplay with high sugar and butter diet, behavior, and neuroimmune system

et al. 2023

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IntroductionMechanisms that dictate the preference for ethanol and its addiction are not only restricted to the central nervous system (CNS). An increasing body of evidence has suggested that abusive ethanol consumption directly affects the immune system, which in turn interacts with the CNS, triggering neuronal responses and changes, resulting in dependence on the drug. It is known that neuroinflammation and greater immune system reactivity are observed in behavioral disorders and that these can regulate gene transcription. However, there is little information about these findings of the transcriptional profile of reward system genes in high consumption and alcohol preference. In this regard, there is a belief that, in the striatum, an integrating region of the brain reward system, the interaction of the immune response and the transcriptional profile of the Lrrk2 gene that is associated with loss of control and addiction to ethanol may influence the alcohol consumption and preference. Given this information, this study aimed to assess whether problematic alcohol consumption affects the transcriptional profile of the Lrrk2 gene, neuroinflammation, and behavior and whether these changes are interconnected.MethodsAn animal model developed by our research group has been used in which male C57BL/6 mice and knockouts for the Il6 and Nfat genes were subjected to a protocol of high fat and sugar diet intake and free choice of ethanol in the following stages: Stage 1 (T1)—Dietary treatment, for 8 weeks, in which the animals receive high-calorie diet, High Sugar and Butter (HSB group), or standard diet, American Institute of Nutrition 93-Growth (AIN93G group); and Stage 2 (T2)—Ethanol consumption, in which the animals are submitted, for 4 weeks, to alcohol within the free choice paradigm, being each of them divided into 10 groups, four groups continued with the same diet and in the other six the HSB diet is substituted by the AIN93G diet. Five groups had access to only water, while the five others had a free choice between water and a 10% ethanol solution. The weight of the animals was evaluated weekly and the consumption of water and ethanol daily. At the end of the 12-week experiment, anxiety-like behavior was evaluated by the light/dark box test; compulsive-like behavior by Marble burying, transcriptional regulation of genes Lrrk2, Tlr4, Nfat, Drd1, Drd2, Il6, Il1β, Il10, and iNOS by RT-qPCR; and inflammatory markers by flow cytometry. Animals that the diet was replaced had an ethanol high preference and consumption.Results and discussionWe observed that high consumption and preference for ethanol resulted in (1) elevation of inflammatory cells in the brain, (2) upregulation of genes associated with cytokines (Il6 and Il1β) and pro-inflammatory signals (iNOS and Nfat), downregulation of anti-inflammatory cytokine (Il10), dopamine receptor (Drd2), and the Lrrk2 gene in the striatum, and (3) behavioral changes such as decreased anxiety-like behavior, and increased compulsive-like behavior. Our findings suggest that interactions between the immune system, behavior, and transcriptional profile of the Lrrk2 gene influence the ethanol preferential and abusive consumption.

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Section: Discussionmentioning

confidence: 99%

Animal model for high consumption and preference of ethanol and its interplay with high sugar and butter diet, behavior, and neuroimmune system

et al. 2023

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“…70 When using phosphatidylethanol (PEth) as a screening tool, the prevalence of alcohol overconsumption 2 years after gastric bypass was 8.3%, compared to 3.5% preoperatively. 71 The transition from abusing food to alcohol and other substances is difficult to study but needs to be further examined. So is the increased number of suicides and non-fatal selfharm events (adjusted HR 3.16), when comparing gastric bypass to a matched intensive lifestyle group for 149,582 person-years.…”

Section: Effect On Other Conditionsmentioning

confidence: 99%

“…After matching individuals with diabetes who had undergone gastric bypass with those not surgically treated for obesity, we could verify several side effects, such as abdominal pain and malnutrition, including a 92% higher risk for anemia, and that alcohol abuse was three times as great as in the control group 70 . When using phosphatidylethanol (PEth) as a screening tool, the prevalence of alcohol overconsumption 2 years after gastric bypass was 8.3%, compared to 3.5% preoperatively 71 . The transition from abusing food to alcohol and other substances is difficult to study but needs to be further examined.…”

Section: Effect On Obesity‐related Diseases and Other Conditionsmentioning

confidence: 99%

Results from the Scandinavian Obesity Surgery Registry: A narrative review

Sundbom,

Näslund,

Ottosson

et al. 2023

Obesity Reviews

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SummaryIn 2007, the Scandinavian Obesity Surgery Registry (SOReg) was started by the profession to monitor the results of bariatric surgery and to provide a high‐quality database for research. In the end of August 2023, SOReg contains 88,379 patients (body mass index [BMI] 41.7 kg/m2, 41.2 years, 77.1% females, gastric bypass 76.8%). In this narrative review, we demonstrate that preoperative weight loss is of value and that the laparoscopic double omega‐loop technique is highly suitable for gastric bypass. Closing the mesenteric openings is, however, important. Swedish bariatric surgery has low mortality, and our results are comparative to those of other countries. Significant long‐term improvements are found in common obesity‐related diseases such as diabetes, hypertension, and sleep apnea. Furthermore, the risk for cardiac failure and major adverse cardiovascular events is significantly reduced. Pregnancy‐related outcomes are also improved. Gastric bypass results in significant improvements in quality of life and seems to be cost saving. We have revealed that low socioeconomic status is associated with reduced chance of undergoing bariatric surgery and inferior outcomes. Of note, we have performed several randomized clinical trials within the registry database. In conclusion, high‐quality national registry databases, such as SOReg, are important for maintaining high‐quality care and present a platform for extensive research.

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“…Recent research also demonstrates an increase in AUD prevalence and high-risk drinking after sleeve gastrectomy (SG). 6,[8][9][10] Wong et al 11 found the prevalence of high-risk drinking increased from 13.4% before SG to 22.7% one year afterward. Recent data suggest there is no difference between RYGB and SG regarding the risk of postoperative problematic alcohol use.…”

Section: Introductionmentioning

confidence: 99%

‘We're outside the norm again because of the thing that allowed us to be inside the norm’: An interpretative phenomenological analysis of the experience of developing an alcohol use disorder after bariatric surgery

Er,

Flahault,

Etienne

2023

Clinical Obesity

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SummaryStudies indicate that bariatric surgery is associated with an increased risk of alcohol use disorder (AUD). It is considered some patients develop the disorder after surgery, without having antecedents of preoperative alcohol problems. This qualitative study aimed to explore the experiences of people who developed AUD postoperatively and understand how they make sense of the onset of this disorder. A semi‐directed interview was carried out with eight adults who had undergone bariatric surgery and developed AUD de novo postoperatively. Data were analysed using interpretative phenomenological analysis. Four superordinate themes emerged: (1) ‘losing control over drinking and self after surgery’; (2) ‘feelings of guilt, shame and loss contrasted with perceptions of still being lucky’; (3) ‘trying to make sense of the onset of AUD’; and (4) ‘retrospective evaluation of bariatric surgery and preoperative information’. These themes indicated loss of control was a central aspect of participant's experiences of postoperative alcohol consumption. AUD was associated with negative emotions and cognitions, but several participants still considered themselves lucky. All tried to make sense of this disorder's onset; many felt they would not have developed AUD if they had not undergone surgery. The onset of AUD influenced their current perceptions and feelings about surgery and the preoperative information regarding AUD risks. Taken together, these results provide insight into the subjective experience of suffering from new‐onset AUD post‐surgery. However, more studies are necessary to gain a better understanding of the physical and psychological implications of postoperative AUD.

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Prevalence of and Risk Factors Associated with Alcohol Overconsumption at 2 Years After Bariatric Surgery

Cited by 5 publications

References 27 publications

Animal model for high consumption and preference of ethanol and its interplay with high sugar and butter diet, behavior, and neuroimmune system

Animal model for high consumption and preference of ethanol and its interplay with high sugar and butter diet, behavior, and neuroimmune system

Results from the Scandinavian Obesity Surgery Registry: A narrative review

‘We're outside the norm again because of the thing that allowed us to be inside the norm’: An interpretative phenomenological analysis of the experience of developing an alcohol use disorder after bariatric surgery

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