[DocSanae]

The question of alcohol, and when/how much is often asked on this board. Whenever this comes up, I have always posted to be cautious, because, for bypass patients, one glass equal what is 5 glasses for a person. This was a quote from a therapist's note that I ran across some time back.

The past 3 days, I spent at a seminar for my CME credits for my occupational safety and health specialist certification.

One of the lectures was on alcohol and alcoholism in the work place. During the lecture, the lecturer mentioned that of people who've had gasterectomy--have at least 2/3 of their stomach taken out due to cancer or refractive ulcers (Japanese who've had RNY bypass for weight loss iare still very very rare, but we have a lot of post ops who've had stomach surgeries for cancer or severe ulcers)--14% end up with alcoholism. He attributed the reason to the high alcohol concentration in the blood stream after gasterectomy, and said that the blood level is 3-4 times higher in comparison with non-ops.

It is true that genetic predisposition factors in to addiction, but where alcohol is concerned, the longer you have been drinking in amounts that hit the blood stream in higher concentrations, the more likely you are to become addicted. So, the high blood level post op is a dangerous factor, especially if you have other factors that may predispose you towards addiction and addiction transfer. Also, if you start drinking in your teens, you are more likely to become addicted.

Of course, not everyone becomes an alcoholic post op, and if you drink wisely and carefully, then it shouldn't be of any concern. However, it does pay to be cautious and wise.

[DocSanae]

Does anyone know if the concerns with alcohol consumption are differnt for lap-band surgery, since in reality we still have our whole stomach?

Since liquids just flow through the narrowing made by the band, but you have the rest of the stomach beyond, it wouldn't afftect you the same way with a small pouch and bypass.
However, alcohol in itself is empty calories, so, you'll be getting in calories that countermand your effort--to get in less calories and enable you to lose weight.

[DocSanae]

<snip>The glass the I had it in was an 8oz tumbler glass. <snip> 2 glasses (about 8oz each) of the red wine and I think about 4-5　glasses of the blush<snip>

I hope you realize how many calories you got in with the drinks. Please be aware that3.5 fl oz wine= 85 kcals, a glass(2.5-8oz) of cocktail can range anything from 150-over 300kcals. Just for that, and also because they don't contain any nutrients you need, you are adding up unwanted calories. In other words, you got in at least 200 extra on your first try, 400-600 extra on your second experiment. It is going to slow down your weight loss in a big way, and I honestly don't think it's worth the trouble finding out how you deal with it. Plus, even if you feel your head is clear, your body is going to react in a different way, which can get you into trouble big time with the law if you make certain mistakes with your decision.

[DocSanae]

I hope those of you who read this, will note that the very first post simply related the fact of effect of alcohol on gasterectomy patients in general (not specifically weight loss GBS patients) as noted by a dr who specializes in alcoholism.

My primary concern and objective of starting this thread is because the effect of alcohol on anyone with a small pouch rather than a full stomach, can turn out to be devastating, and hit the person when he/she is least expecting it.

If you can stick to the very occasional pleasurable drinking of a glass of wine or so, that's fine. However, I know too many people--even those on this board--who have developed more serious issues than just getting trashed. Getting out of the bad cycle can be very very difficult. The bigger problem is, it can catch you unawares. You may think you are doing fine, but suddenly, you aren't. I am not saying anyone in particular is especially courting danger, I am saying that if you are going to enjoy alcohol, make SURE it's occasional, and make SURE it's only a glass or so. If you don't mix alcohol with gasoline, then, you're doing very well there. But there are those who have found themselves in trouble in this quarter. I am just warning post ops in general, just in case there is someone who is unaware, that the effect of alcohol will be totally different from pre op, so you need to tread carefully, until you are sure of your how you react, including dumping, because alcohol does cause dumping with many people. Also, you may not react the same every time, so don't depend on being fine with a certain amount and/or a certain beverage that you've tried at home. It may still take you unawares when away from home.

Data relased in the US says that the number of addiction transfer to alcohol for WLS patients is anywhere from 5-30%, and the 14% number that the lecturer stated, pretty much hits where we(those who are used to dealing with and assessing such statistics) would expect as a very realistic number.

A member of this board, who is also a very good friend of mine and a long time post op, developed alcoholism a year after surgery. I know this person experienced personal hell, including total denial of the issue to the point of thinking that the person was going crazy, bad enough to think that some day soon might kill some one, bad enough to sit out the entire night with a gun in the lap contemplating suicide, before finally coming to terms and honestly admitting to alcoholism, and taking the steps to control the demons.
I have received personal requests of help from other members too, so this concerns me very much.

After going through all the effort and time and emotional and physical ups and downs to be approved for this surgery, having it, then going through the emtional and physical ups and downs of the actual phase of losing weight, everything that a post op does to regain a healthy life and be physically reborn to be able to become *alive* again, it makes me very very sad that some people trip up because of this, and let go of the productive life that they had built. Alcohol isn't something that you absolutely need to maintain phsyical life, the way food is. It's on the same level as smoking. It can add some color to life, but one doesn't absolutely need it for a certain effect, even if it's socializing. It's something that can be replaced with a less harmful (in regards to health) thing. I know how much effort you all put into being successful with this surgery, I know how much heartaches you go through to achieve the desired effects. So, I just hope none of you will find themselves in a spot where they have difficulty in controlling things that could have been controlled and avoided in the first place. because if that happens, then, it's a tragedy.

I am not saying that everyone who drinks will go this route. I am saying that it is a trap that may lay ahead of you, so be sure to control it, the same way you have to control your eating.
For those of you who are less than a year out, for those of you who are not yet at your goal weight, you are adding extra stuff that you don't need, which will hinder your weight loss, so I do advise strongly against alcohol unless it is a very very occasional small sip. Once your are at your goal, and maintenance is going well, an occasional social drink here and there is quite fine, so long as it isn't for the buzz, nor the temptation of the buzz become frequent.

Medically speaking, addiction transfer from food to alcohol is a very real thing, physically as well as mentally, on the brain cell level as well. The pleasure receptor in the brain for food, drugs and alcohol are right next to each other. So some people (not everyone), start seeking the stimulus of the pleasure receptor from alcohol to replace the stimulus that the food pleasure receptor no longer sends out because of the lack of food. This can cause alcohol dependence to develop more easily than under other circumstances.

Another thing to note is that the sudden high concentration of alcohol in the blood stream compared to a *normie*, means that the alcohol hits the liver in that high concentration. Once in a long while won't be an issue, but if it's often, then alcoholic liver damage can develop at a lower amount and shorter time than with a normal stomach, even if one doesn't have alcoholism.

This is my view as a physician on alcohol and weight loss surgery.
How you interpret this, is up to you, but please keep in mind that I put this thread up and am writing everything with definite medical data and opinions and concerns as a trained medical professional. It is nothing personal, it is a vey straightforward medical lecture that any dr who knows and deals with what I do would give.

[DocSanae]

I am going to add one more point.
I think it best to totally avoid alcohol the first two years, until you have finished losing weight, and are into maintenance. For one, you don't need the extra calories from alcohol during your weight loss stage. Two, you will have to deal with a lot of emotional/mental changes while your physical change is going on. In fact, this can be as much, sometimes even more, a mental trip as it is a physical trip. Alcohol has psychotic effects. While you are trying to adjust emotionally to your physical changes, and also most likely, how people treat you once your weight starts melting away, and you don't have the comfort of food, you are going to have to develop an alternate coping mechanism. You should work to develop a productive coping mechanism, and alcohol can get in the way of this, because it can temporarily numb your feelings.
Once you have reached goal, and can spare a few calories, and you have a good coping mechanism in place, then, you can enjoy that occcasional drink socially. By then, you may have found out that you don't need alcohol to enjoy a night out, too.

[DocSanae]

Here's the link to a report on a new study on alcohol after weight loss surgery.
Impaired Alcohol Metabolism after Gastric Bypass Surgery: A Case-Crossover Trial

In essence. The peak level of alcohol as tested by a breathanalyzer is approximately 4 times higher post op, and despite the illusion that you recover quickly, actually, the time it takes is twice as long post op, for the level to go back to zero.