Weight loss and alcohol
Patients after undergoing bariatric surgery have various dietary restrictions and limitations, but one point that is often overlooked is whether patients can or cannot drink alcohol.
Alcohol consumption, either in small or big amounts, takes commonplace in today’s society. Be it a glass of wine at dinner or even alcohol abuse, most people consume alcohol. As doctors, we always encourage patients to, first and foremost, not consume alcohol, especially in bigger quantities.
Where does alcohol go?
When patients have any bariatric surgery, all the factor that are involved in alcohol metabolism (weight, liver function, food intake and production of the enzyme alcohol dehydrogenase) are significantly altered, especially in those patients that undergo Gastric Sleeve Surgery, where part of their stomach is cut off. When patients consume alcohol, it is mostly absorbed by the intestines and then passes to the blood stream. But, after bariatric surgery, since they have less absorption surface, alcohol stays less time in their stomachs, which then goes straight to intestines and is absorbed into the blood circulation a lot quicker. Patients can experience stronger effects of alcohol even with fewer amounts, and those effects would last longer. If, for example, a patient was able to drink two or three glasses of wine, after surgery, they might be able to drink only one glass and feel like if they had ingested an entire bottle.
In a recent study, a group of patients that had bariatric surgery was compared to a control group that had not undergone bariatric surgery. Both groups drank 5 ounces of wine (after fasting for 2 hours). Patients that had undergone bariatric surgery had a higher peak in breath alcohol level of 0.08% (which is considered legally drunk in some states) versus 0.05% in the control group1.
Another key factor in alcohol consumption after surgery is that due to the fact that patients can develop a faster addiction to any alcohol substance, due to the quantities needed to develop such a condition, are substantially less than before.
One very important metabolic factor in alcohol consumption is that alcohol can cause hypoglycemia (low blood sugar), especially in bariatric surgery patients with sudden loss of weight and low carbohydrate diets, can result in depleted glycogen (the form in which the body stores sugar) and also reduce gluconeogenesis (the way how the body creates glucose from other substances in the body). And since the brain and neurological tissue require glucose as their main nutrients, the low quantities of glucose can lead to adverse effects in neurological and cognitive functions such as slurred speech, loss of balance, confusion, and poor vision.
Why we encourage less alcohol consumption…
Patients are always encouraged to reduce or eliminate alcohol consumption from their diet due to the fact that their ability to “handle their liquor” is considerably reduced and the metabolic factors that can cause severe neurological conditions can lead to poor health. The main goal of bariatric surgery is the wellbeing of the patient; therefore it’s always recommended to abstain, if possible from alcoholic beverages.