~ Dr. James Mitchell, Chairman of Neuropsychiatry at the University of North Dakota School of Medicine
In the appearance-conscious culture of Southern California, it comes as no surprise that weight-loss surgeries are a popular medical procedure in the state. Over 15,000 bariatric surgeries are performed each year in California.
But as an exhaustive 2011 study shows, patients who undergo gastric-bypass surgery may end up swapping one addiction for another. The study followed over 12,000 bariatric surgeries over a period of 25 years.
The study, which was presented at the Digestive Disease Conference in Chicago, Illinois, found that gastric-bypass patients are four times as likely to need residential care for alcohol abuse, than the rest of the US population.
The Physical and Psychological Reasons for Addiction Transference
Bariatric surgery can be defined as any operation performed on a person’s stomach or intestines with the express goal of inducing weight loss.
For most patients this is an extreme “last resort” option, only chosen because they have thus far been unable to overcome their food addiction, and the excess weight is putting their health at risk.
As a group, bariatric surgery patients have a “two to three times greater chance of moving onto another substance addiction”, says Dr. Mitchell, but the risk is even higher for gastric-bypass recipients.
As the name suggests, gastric bypass is when the surgeon reduces the available size of the person’s stomach, thereby restricting the amount of food it takes to make them feel “full”. This new, smaller stomach portion is then connected to the small intestine, via the “bypass” portion of the operation.
Because the duodenum is bypassed, the body absorbs fewer nutrients and calories, which greatly facilitates weight loss.
Between the restriction and malabsorption, gastric bypass is extremely effective at helping a person lose weight. This is why it is so popular, accounting for approximately 80% of all bariatric weight-loss surgeries.
But this specific procedure also creates a significant hazard of developing a drinking problem, because the effects of any alcohol consumed become intensified.
Magdelena Plecka Ostlund, the lead researcher for the study, which was done at the Karolinska Institute in Sweden, says “The alcohol enters the small intestine rapidly, which results in a high and quick peak of alcohol in the blood.”
The other factor driving the addiction transference is mental. Dr. Lerner explains, saying, “All addictions are about fixing how one feels. Changing the nature of the addiction does not change the nature of the person.”
All of the underlying factors that contributed to the development of a food addiction, by the food overstimulating the brain’s pleasure center are still there after the surgery – the low self-esteem, depression, anxiety, etc. symptoms of a loss of pleasurable experiences and a decrease in dopamine.
What Can We Learn from All of This?
When the food addiction is removed but the other conditions are not addressed, the patient then attempts to find other substances to substitute for the good feelings associated with food, and because the weight-loss surgery did not “magically” fix their life. And of course, self-medication never works, because it is only a path down a slippery slope that leads to substance abuse.
When treating the resultant substance abuse – whether it is alcoholism or drug addiction – the disease has to be addressed on multiple levels. There is a genetic/biological component to addiction, along with environmental and behavioral factors. Any co-occurring disorders need to be treated at the same time as the substance abuse disorder.
The best evidence shows that behavioral modification therapy is the most effective way to combat addiction. In this way, new ways of coping with stresses and temptations are taught, and the suffering addict/alcoholic learns new behaviors, strategies, and life skills that they can substitute for old, self-destructive ones.
If you or someone you care about has had weight-loss surgery and are now struggling with alcohol or drugs, contact the caring and experienced professionals at Lasting Recovery. We are a nationally-accredited San Diego outpatient alcohol rehab program, and provide evidence-based treatment that will help you restore balance, control, and hope to your life.
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