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How Do Individuals Develop Alcohol Use Disorder After Bariatric Surgery? A Grounded Theory Exploration
Ruth Yoder1, Padraig MacNeela2, Ronan Conway2,3
1School of Psychology, National University of Ireland, Galway and Weight Management Service, St. Columcille's Hospital, Loughlinstown, County Dublin, Ireland.
Obesity Surgery
|October 17, 2017
Summary
Following Roux-en-Y gastric bypass (RYGB) surgery, some patients develop alcohol use disorder (AUD). A new theory suggests this occurs as behavioral substitution, termed "filling the void," to cope with unresolved psychological issues.
Area of Science:
- Bariatric Surgery Research
- Addiction Psychiatry
- Psychological Health
Background:
- Roux-en-Y gastric bypass (RYGB) is effective for severe obesity.
- A subset of RYGB patients develop new-onset alcohol use disorder (AUD).
- The etiology of post-RYGB AUD remains poorly understood.
Purpose of the Study:
- To construct a theory explaining AUD development in RYGB patients.
- To understand the mechanisms behind problematic drinking post-RYGB.
- To provide a framework for the phenomenon of 'filling the void'.
Main Methods:
- Semi-structured interviews with eight RYGB patients diagnosed with AUD.
- Data collected from patients attending a public hospital outpatient weight management service.
- Analysis using constructivist grounded theory methodology.
Main Results:
- Patients' core concern was 'unresolved psychological issues'.
- These issues were managed by 'external coping mechanisms', initially 'eating to cope'.
- 'Filling the void' describes substituting eating with drinking alcohol to manage psychological symptoms post-RYGB.
Conclusions:
- The 'filling the void' theory explains AUD behavioral substitution as 'addiction transfer'.
- This framework details the process and characteristics of AUD development post-RYGB.
- Increased psychological support is recommended for RYGB patients post-surgery.
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