Alcohol Use After Bariatric Surgery: A Comprehensive Review of Current Knowledge and Research Gaps

In recent years, there has been increased research on alcohol consumption following bariatric surgery. This review aimed to synthesise existing quantitative research on this topic and identify knowledge gaps in the literature. A comprehensive search was performed across Medline, PsychInfo and Scopus. Studies involving human participants who underwent bariatric surgery and reporting postoperative alcohol consumption were considered. A total of 88 studies were included. Overall, most longitudinal studies found an increased prevalence of problematic alcohol consumption (PAC) post-surgery. Risk factors for postoperative PAC remain poorly understood. Explanatory hypotheses include addiction transfer theory, changes in alcohol pharmacokinetics, and increased rewarding effects of alcohol postoperatively. While the addiction transfer theory lacks empirical support, further research is needed to understand how alterations in alcohol metabolism may lead to problematic consumption in some cases. We found only one study on alcohol's rewarding effects post-surgery. Regarding the consequences of PAC, body weight seems unaffected while alcohol-related hospitalizations, liver disease and mortality post-surgery are all increased. Few studies referred to interventions aiming to prevent or treat PAC postoperatively. In conclusion, while the increase in PAC prevalence after bariatric surgery is well documented, substantial knowledge gaps remain regarding its risk factors, underlying mechanisms, potential consequences and the development of prevention and treatment strategies.