Increased alcohol intake and alcohol use disorder following bariatric surgery: potential mechanisms

Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most effective weight loss procedures for severe obesity. However, there is recent evidence of increased alcohol intake and new onset alcohol use disorder (AUD) by 2 years following both operations. Although the two surgeries differ anatomically, they lead to similar increased drinking. The mechanisms behind increased alcohol intake post-surgery remain unclear. One theory is that with a marked reduction in food intake post-surgery, there is an "addiction" transfer from food to alcohol intake. Another theory implicates the higher rate of absorption of alcohol post-SG and post-RYGB for the increased alcohol intake. Elucidating the mechanisms could help provide new therapeutic targets for preventing increased alcohol intake and AUD, as well as identify measures that could be used in a clinical setting to help predict the likelihood of AUD. These findings could also help guide the development of new surgical procedures that do not lead to increased alcohol intake.