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Research Letter |

Effect of Roux-en-Y Gastric Bypass Surgery Converting 2 Alcoholic Drinks to 4

Marta Yanina Pepino, PhD1,2; Adewole L. Okunade, PhD1,2; J. Christopher Eagon, MD1,2; Bruce D. Bartholow, PhD3; Kathleen Bucholz, PhD, MPH, MPE4; Samuel Klein, MD1,2
[+] Author Affiliations
1Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri
2Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St Louis, Missouri
3Department of Psychological Sciences, University of Missouri, Columbia
4Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
JAMA Surg. 2015;150(11):1096-1098. doi:10.1001/jamasurg.2015.1884.
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This study evaluates the effect of Roux-en-Y gastric bypass on the pharmacokinetics and subjective effects of ingested alcohol, using arterialized blood samples and a validated questionnaire.

Roux-en-Y gastric bypass (RYGB) is the most common bariatric surgical procedure performed in the world.1 Although RYGB surgery causes a marked reduction in food intake and induces remission of food addiction,2 it is associated with an increased risk of developing alcohol use disorders.3 It is likely that RYGB-related changes in gastrointestinal anatomy alter the pharmacokinetics and subjective effects of ingested alcohol,4 which contributes to the increased risk of alcohol use disorders. However, results from previous studies are limited because (1) blood alcohol concentrations (BACs) were measured in venous blood samples, which underestimates the peak BAC delivered to the brain in patients who have had RYGB surgery, and (2) the subjective effects of alcohol have not been assessed using validated questionnaires. The purpose of the present study was to evaluate the effect of RYGB on the pharmacokinetics and subjective effects of ingested alcohol, using arterialized blood samples and a validated questionnaire.

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Figure.
Blood Alcohol Concentrations (BACs) and Subjective Feelings of Drunkenness After Alcohol Ingestion

A and B, Participants who had Roux-en-Y gastric bypass (RYGB) surgery (hereafter referred to as the RYGB+ group) and participants who were scheduled to have, but have not yet had, RYGB surgery (hereafter referred to as the RYGB group) consumed a 0.5-g/kg fat-free mass of alcohol (equivalent to approximately 2 standard alcoholic beverages). For each time point, scores on feelings of drunkenness on the alcohol day were subtracted from scores on the placebo day. Eight women were in the RYGB+ group, and 9 women were in the RYGB group. C and D, Five women in the RYGB group were retested at a mean (SD) 9.7 (1.6) months after RYGB surgery and 28% (10%) weight loss. The BAC limit for driving in the United States is also the BAC threshold for binge drinking defined by the National Institute on Alcohol Abuse and Alcoholism. The point estimates are mean values. Error bars indicate +SEM.

aValue significantly different from “RYGB” or “before RYGB” value, P < .05.

bValue significantly different from baseline value, P < .05.

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