Alcohol use risk in adolescents 2 years after bariatric surgery

Background Problematic alcohol use and increased sensitivity postoperatively in adult weight loss surgery patients heightens concerns. No data have characterized these behaviors in adolescents—a gap, given adolescent alcohol use and heavy drinking are public health concerns. Objective To examine alcohol use behavior in adolescents who underwent weight loss surgery across the first two post-operative years in comparison to nonsurgical adolescents. Setting Five academic medical centers. Methods Utilizing a prospective controlled design, adolescents undergoing weight loss surgery (n = 242) and nonsurgical adolescents with severe obesity (n = 83) completed the Alcohol Use Disorders Test. Analyses included 216 surgical (M_age = 17.1 ± 1.5, M_BMI = 52.9 ± 9.3, 91.8% female, 67.6% white) and 79 nonsurgical participants (M_age = 16.2 ± 1.4, M_BMI = 46.9 ± 6.1, 82.3% female, 53.2% white), with baseline data and at 12 or 24 months postoperatively. Results The majority reported never consuming alcohol within the year before surgery (surgical, 92%; nonsurgical, 91%) or by 24 months (surgical, 71%; nonsurgical, 74%), when alcohol use disorder approached 9%. Among alcohol users at 24 months (n = 52 surgical, 17 nonsurgical), 35% surgical and 29% nonsurgical consumed 3+drinks on a typical drinking day; 42% surgical and 35% nonsurgical consumed 6+drinks on at least 1 occasion. For the surgical group, alcohol use changed as a function of older age (odds ratio [OR] = 2.47, P = .01) and lower body mass index (OR = .94, P<.001). Greater percent change in weight (0–24 mo) was associated with increased odds of alcohol use at 24 months (OR = 1.01, 95% confidence interval: 1.002–1.02). Conclusion Alcohol use was lower than national base rates. Alcohol use disorder rates and harmful consumption raise concerns given extant adult literature. Alcohol education focused on harm reduction (i.e., lower consumption, managing situations conducive to alcohol-related harm) and monitoring by healthcare providers as patients mature is indicated.