Alcohol abuse after weight loss surgery?

Researchers gather at Radcliffe to investigate gut-brain communication
A small group of scientists gathered last week at the Radcliffe Institute for Advanced Study to share ideas about a medical mystery: the increasing evidence that some types of weight loss surgery affect not just the stomach, but the brain as well.
The procedures, two types of bariatric surgery known as gastric bypass and sleeve gastrectomy, physically bypass or remove a portion of the stomach. Used only for obese patients whose weight threatens their health, the surgeries have proven dramatically effective, reducing patients’ excess weight in the months and years following surgery by 50, 60, and even 80 percent.
The procedures were initially thought to work through simple physical means: Patients with smaller stomachs wouldn’t be able to eat as much, allowing them to lose weight and also giving them an opportunity to reform eating habits.
But in recent years, scientists have noticed side effects of the surgery that hint at something entirely different: that the surgery somehow affects not just the stomach, but the body’s broader metabolism and even the brain.
The Radcliffe event brought together scientists whose research is relevant to obesity and addiction to investigate an increased incidence of alcohol abuse among those who have had the surgery and, through that, the possible impact of the surgery on the brain circuits that control addiction.
The effect, reported in a handful of studies in recent years, was highlighted in June, when a large survey of more than 1,900 bariatric surgery patients was published in the Journal of the American Medical Association (JAMA). The survey showed that alcohol abuse increased significantly in the second year following gastric bypass surgery and that, among those reporting post-surgery alcohol problems, 60.5 percent hadn’t had drinking problems before.
The seminar was organized by two assistant professors at Harvard Medical School (HMS), Janey Pratt, co-director of the Weight Center at Harvard-affiliated Massachusetts General Hospital and assistant professor in surgery, and Stephanie Sogg, staff psychologist at the MGH Weight Center and assistant professor in psychology.
The first day was dominated by presentations from the 18 invited scientists on everything from background on the surgical procedures to the use of functional magnetic resonance imaging to monitor brain activity to the latest work on the chemical signals involved in hunger, fullness, the pleasurable aspects of eating, and addiction. The second day focused on future research, with discussion of collaborative projects and potential funding sources.
“It was the first time everybody was in one room together. The intellectual energy, it was amazing, one idea launched into another,” Sogg said. “The whole thing was just remarkable.”

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