Drunkenness Comes Faster After Gastric Surgery

Oprah show revelations sparked a study into the phenomenon

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HealthDay Reporter

THURSDAY, June 14, 2007 (HealthDay News) -- Oprah Winfrey's influence may now reach into medical science: her show led researchers to confirm that gastric bypass causes people to get drunk faster.

The reason, scientists say, is that bypass surgery cuts the amount of alcohol metabolized by the stomach.

The weight-loss procedure also seems to extend the time people need to sober up, the team said.

The research has implications for the 150,000 Americans who have already undergone this procedure and the thousands more who may be considering it.

"At the end of the day, this is the only enduring and effective intervention for morbid obesity," stressed study senior author Dr. John Morton, director of bariatric surgery at Stanford Hospitals and Clinics. "We don't want to deny them, but we want to make sure they are fully prepared to meet these challenges after surgery."

"This might let folks know to be a little more careful if they have a drink," added Dr. Joaquin Rodriguez, assistant professor of surgery at Texas A&M Health Science Center College of Medicine and chief of minimally invasive surgery at Scott & White Hospital in Temple. "They need just to be aware that the same amount of alcohol may affect them differently than someone who hasn't had a gastric bypass," said Rodriguez, who was not involved in the research.

Study lead author Judith Hagedorn, a medical student at Stanford University, is scheduled to present the data June 14 at the annual meeting of the American Society for Bariatric Surgery, in San Diego.

In October 2006, Winfrey aired a show called "Suddenly Skinny," which noted that gastric-bypass patients often felt they had faster alcohol absorption after the surgery. Also discussed was "addiction transfer," when a person swaps his or her food addiction for an alcohol addiction.

Winfrey and her producers are clearly up on current health trends: Obesity is one of the leading, if not the leading, public health crisis in the industrialized world. More than 60 percent of adult Americans are overweight, 23.9 percent are obese and 3 percent are extremely obese. Being overweight can lead to a slew of life-threatening problems, including diabetes, heart disease and even cancer.

According to the new study, bariatric surgery -- especially gastric bypass, which reduces the size of the stomach and adds a bypass around part of the small intestine -- is the most effective treatment for morbid obesity.

After the Oprah episode, Morton, who has performed about 1,000 such surgeries, was inundated with questions from patients. "This prompted me to dig a little deeper to find data and, much to my surprise, I didn't find a whole lot of data," he said.

Rodriguez said, "There are a couple of other reports that have shown similar things, but it's mostly anecdotal. Patients come in and say they had wine or a margarita and got drunk really fast."

So, Morton undertook his own study involving 19 people who had had gastric bypass surgery at least one year prior and 17 control subjects without such histories. Each participant was asked to consume five ounces of red wine.

All participants then underwent an alcohol breath analysis every five minutes until the levels reached zero.

The gastric bypass patients had a peak alcohol level of 0.08 percent, vs. 0.05 percent for the controls. In some states, 0.08 is considered intoxicated, Morton said.

The gastric patients also needed an average of 108 minutes to get back to zero, while the controls needed an average of 72 minutes.

"The alcohol peaked higher and stayed around longer," Morton said.

Also, the gastric bypass patients reported the same symptoms, even though their breath alcohol levels were higher.

"This led us to think that some of patients may have high breath alcohol level and not be aware of it," Morton said. "One drink may be too much, especially if you are going to have a drink and drive."

The main reason for this enhanced susceptibility to alcohol is that the surgery bypasses the stomach, which is one of two places the enzyme responsible for metabolizing alcohol is present, Morton said.

"If you're bypassing the stomach, you're bypassing most of the ability to metabolize alcohol," he added.

According to one survey, 83 percent of gastric bypass patients consume alcohol after surgery and all of them need to be cautious for any number of reasons.

"Sometimes alcohol use after surgery can wreck havoc on weight maintenance," Morton said. "Alcohol relaxes you on the outside, and on the inside, too. With alcohol, patients can be able to eat a little bit more because of the relaxation of the lower esophageal sphincter and the intestine as well."

Also, as patients start to lose weight, they often become more socially active, a pastime that often includes alcohol.

"This is also something patients have to be aware of," Morton said. "The bottom line is alcohol use after gastric bypass should be used with caution, and certainly patients shouldn't have even a single drink and drive."

More information

There's more on this type of surgery at the American Society for Bariatric Surgery.

SOURCES: John Morton, M.D., director, bariatric surgery, Stanford Hospitals and Clinics, Stanford University Medical Center; Stanford, Calif.; Joaquin Rodriguez, M.D., assistant professor of surgery, Texas A&M Health Science Center College of Medicine, and chief, minimally invasive surgery, Scott & White Hospital, Temple; June 14, 2007, presentation, annual meeting, American Society for Bariatric Surgery, San Diego

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