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1.
Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up.  Obes Surg. 2000;10(3):233-23910929154PubMedGoogle ScholarCrossref
2.
Garb J, Welch G, Zagarins S, Kuhn J, Romanelli J. Bariatric surgery for the treatment of morbid obesity: a meta-analysis of weight loss outcomes for laparoscopic adjustable gastric banding and laparoscopic gastric bypass.  Obes Surg. 2009;19(10):1447-145519655209PubMedGoogle ScholarCrossref
3.
Buchwald H, Avidor Y, Braunwald E,  et al.  Bariatric surgery: a systematic review and meta-analysis.  JAMA. 2004;292(14):1724-173715479938PubMedGoogle ScholarCrossref
4.
 Suddenly skinny [transcript]. The Oprah Winfrey Show. Harpo Productions. October 24, 2006
5.
 Sóuter E, Shapiro E, Sheff-Cahan V. Trading one addiction for another. People. April 9, 2007
6.
Spencer J. The new science of addiction. Wall Street Journal. July 18, 2006:D1
7.
Saules KK, Wiedemann A, Ivezaj V, Hopper JA, Foster-Hartsfield J, Schwarz D. Bariatric surgery history among substance abuse treatment patients: prevalence and associated features.  Surg Obes Relat Dis. 2010;6(6):615-62120207591PubMedGoogle ScholarCrossref
8.
Ertelt TW, Mitchell JE, Lancaster K, Crosby RD, Steffen KJ, Marino JM. Alcohol abuse and dependence before and after bariatric surgery: a review of the literature and report of a new data set.  Surg Obes Relat Dis. 2008;4(5):647-65018420465PubMedGoogle ScholarCrossref
9.
King WC, Chen JY, Mitchell JE,  et al.  Prevalence of alcohol use disorders before and after bariatric surgery.  JAMA. 2012;307(23):2516-252522710289PubMedGoogle Scholar
10.
Buffington CK. Alcohol use and health risks: Survey results.  Bariatric Times. 2007;4:21-23http://bariatrictimes.com/2007/03/25/alcohol-use-and-health-risks-survey-results/. Accessed August 23, 2012Google Scholar
11.
Kazdin AE. Symptom substitution, generalization, and response covariation: implications for psychotherapy outcome.  Psychol Bull. 1982;91(2):349-3657071264PubMedGoogle ScholarCrossref
12.
Niego SH, Kofman MD, Weiss JJ, Geliebter A. Binge eating in the bariatric surgery population: a review of the literature.  Int J Eat Disord. 2007;40(4):349-35917304586PubMedGoogle ScholarCrossref
13.
Wang GJ, Volkow ND, Thanos PK, Fowler JS. Similarity between obesity and drug addiction as assessed by neurofunctional imaging: a concept review.  J Addict Dis. 2004;23(3):39-5315256343PubMedGoogle ScholarCrossref
14.
Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology.  Philos Trans R Soc Lond B Biol Sci. 2008;363(1507):3191-320018640912PubMedGoogle ScholarCrossref
15.
Volkow ND. This is your brain on food: interview by Kristin Leutwyler-Ozelli.  Sci Am. 2007;297(3):84-8517784628PubMedGoogle ScholarCrossref
16.
Lent MR, Swencionis C. Addictive personality and maladaptive eating behaviors in adults seeking bariatric surgery.  Eat Behav. 2012;13(1):67-7022177401PubMedGoogle ScholarCrossref
17.
Yanovski SZ. Binge eating disorder: current knowledge and future directions.  Obes Res. 1993;1(4):306-32416350580PubMedGoogle ScholarCrossref
18.
Johnson WG, Kirk AA, Reed AE. Adolescent version of the questionnaire of eating and weight patterns: reliability and gender differences.  Int J Eat Disord. 2001;29(1):94-9611135341PubMedGoogle ScholarCrossref
19.
Elder KA, Grilo CM, Masheb RM, Rothschild BS, Burke-Martindale CH, Brody ML. Comparison of two self-report instruments for assessing binge eating in bariatric surgery candidates.  Behav Res Ther. 2006;44(4):545-56015993381PubMedGoogle ScholarCrossref
20.
Celio AA, Wilfley DE, Crow SJ, Mitchell J, Walsh BT. A comparison of the binge eating scale, questionnaire for eating and weight patterns-revised, and eating disorder examination questionnaire with instructions with the eating disorder examination in the assessment of binge eating disorder and its symptoms.  Int J Eat Disord. 2004;36(4):434-44415558644PubMedGoogle ScholarCrossref
21.
Little RJA. A test of missing completely at random for multivariate data with missing values.  J Am Stat Assoc. 1988;83(404):1198-1202Google ScholarCrossref
22.
Graham JW. Missing data analysis: making it work in the real world.  Annu Rev Psychol. 2009;60(1):549-57618652544PubMedGoogle ScholarCrossref
23.
Singer J, Wilson J. Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. New York, NY: Oxford University Press; 2003
24.
Woodard GA, Downey J, Hernandez-Boussard T, Morton JM. Impaired alcohol metabolism after gastric bypass surgery: a case-crossover trial.  J Am Coll Surg. 2011;212(2):209-21421183366PubMedGoogle ScholarCrossref
25.
Heinberg LJ, Ashton K, Coughlin J. Alcohol and bariatric surgery: review and suggested recommendations for assessment and management.  Surg Obes Relat Dis. 2012;8(3):357-36322425058PubMedGoogle ScholarCrossref
26.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption–II.  Addiction. 1993;88(6):791-8048329970PubMedGoogle ScholarCrossref
27.
Bischof G, Reinhardt S, Grothues J, Meyer C, John U, Rumpf HJ. Development and evaluation of a screening instrument for alcohol-use disorders and at-risk drinking: the brief alcohol screening instrument for medical care (BASIC).  J Stud Alcohol Drugs. 2007;68(4):607-61417568967PubMedGoogle Scholar
28.
Selzer ML. The Michigan alcoholism screening test: the quest for a new diagnostic instrument.  Am J Psychiatry. 1971;127(12):1653-16585565851PubMedGoogle Scholar
Original Article
ONLINE FIRST
February 2013

Substance Use Following Bariatric Weight Loss Surgery

Author Affiliations

Author Affiliations: New York Obesity Nutrition Research Center (Drs Conason, Hsu, and Geliebter and Ms Puma), Division of Minimally Invasive Surgery (Dr Teixeira), St Luke’s–Roosevelt Hospital Center, Columbia University, and Long Island University, C.W. Post (Dr Knafo), New York.

JAMA Surg. 2013;148(2):145-150. doi:10.1001/2013.jamasurg.265
Abstract

Objective To assess substance use before and after bariatric weight loss surgery (WLS). There is a paucity of research investigating the occurrence of substance use following bariatric WLS. It was hypothesized that patients who underwent WLS would exhibit an increase in substance use (drug use, alcohol use, and cigarette smoking) following surgery to compensate for a marked decrease in food intake.

Design Prospective study.

Setting A major urban community hospital.

Participants A total of 155 participants (132 women and 23 men) who underwent WLS were recruited from a preoperative information session at a bariatric surgery center.

Intervention Participants received either laparoscopic Roux-en-Y gastric bypass surgery (n = 100) or laparoscopic adjustable gastric band surgery (n = 55). Participants completed questionnaires to assess eating behaviors and substance use at preoperative baseline and 1, 3, 6, 12, and 24 months after surgery.

Main Outcome Measure Substance use as assessed by the Compulsive Behaviors Questionnaire.

Results Participants reported significant increases in the frequency of substance use (a composite of drug use, alcohol use, and cigarette smoking, hereafter referred to as composite substance use) 24 months after surgery. Specifically, participants experienced a significant increase in the frequency of composite substance use from baseline to 24 months after surgery (P = .02), as well as significant increases from 1 month, 3 months, and 6 months to 24 months after surgery (all P ≤ .002). In addition, participants who underwent laparoscopic Roux-en-Y gastric bypass surgery reported a significant increase in the frequency of alcohol use from baseline to 24 months after surgery (P = .011). The response rate to the survey was 61% at 1-month follow-up, 41% at 3-month follow-up, 43% at 6-month follow-up, 49% at 12-month follow-up, and 24% at 24-month follow-up.

Conclusions Patients may be at increased risk for substance use following bariatric WLS. In particular, patients who undergo laparoscopic Roux-en-Y gastric bypass surgery may be at increased risk for alcohol use following WLS. Our study is among the first to document significant increases in substance use following WLS using longitudinal data.

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