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New-Onset Substance Use Disorder After Gastric Bypass Surgery: Rates and Associated Characteristics

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Abstract

Background

Substance use disorder (SUD) may develop de novo for a subgroup of weight loss surgery patients, particularly those who have had the Roux-en-Y gastric bypass (RYGB) procedure. The present study examined the rate of SUD in a broad sample of RYGB patients and identified associated behavioral and psychological factors.

Methods

Participants included 143 RYGB patients; the majority were women (n = 120; 83.9 %) and white (n = 135; 94.4 %). Participants completed a web-based survey assessing retrospective accounts of presurgical substance use, eating pathology, family history, and traumatic history, postsurgical substance use, life stressors, and global trait-like measures (emotion dysregulation, impulsivity, sensation-seeking, and coping skills).

Results

A subgroup (n = 28, 19.6 %) of post-RYGB patients met criteria for probable SUD; however, the majority of those who met SUD criteria postsurgery (n = 19, 68 %) did not report a pre-RYGB SUD history. Family history of substance abuse, poor coping skills, and potential life stressors were related to post-RYGB SUD, particularly for the new-onset group. Additionally, the majority of those who met criteria for pre-RYGB SUD (n = 21, 70 %) did not continue to meet SUD criteria following RYGB.

Conclusions

Findings highlight a subgroup of post-RYGB patients reporting new-onset SUD, which is unexpected among middle-aged women. Importantly, findings also indicate that many patients with presurgical SUD did not relapse postsurgery. Assessing for family history of SUD and coping skills at the presurgical evaluation is recommended. Future research should identify psychological and physiological risk factors for SUD postsurgery and examine protective factors of those who discontinue substance use postsurgery.

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References

  1. Conason A, Teixeira J, Hsu C, et al. Substance use following bariatric weight loss surgery. JAMA Surg. 2013;148(2):145–50.

    Article  PubMed  Google Scholar 

  2. Ertelt TW, Mitchell JE, Lancaster K, et al. Alcohol abuse and dependence before and after bariatric surgery: a review of the literature and report of a new data set. Surg Obes Relat Dis. 2008;4(5):647–50.

    Article  PubMed  Google Scholar 

  3. Fogger SA. McGuinness. The relationship between addictions and bariatric surgery for nurses in recovery. Perspect Psychiatr Care. 2012;48(1):10–5.

    Article  PubMed  Google Scholar 

  4. King WC, Chen J-Y, Mitchell JE, et al. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA. 2012;307(23):2516–25.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  5. Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.

    Article  PubMed  Google Scholar 

  6. Ostlund MP, Backman O, Marsk R, et al. Increased admission for alcohol dependence after gastric bypass surgery compared with restrictive bariatric surgery. JAMA Surg. 2013;148(4):374–7.

    Article  PubMed  Google Scholar 

  7. Saules KK, Wiedemann A, Ivezaj V, et al. Bariatric surgery history among substance abuse treatment patients: prevalence and associated features. Surg Obes Relat Dis. 2010;6(6):615–21.

    Article  PubMed  Google Scholar 

  8. Hajnal A, Zharikov A, Polston JE, et al. Alcohol reward is increased after Roux-en-Y gastric bypass in dietary obese rats with differential effects following ghrelin antagonism. PLoS One. 2012;7(11):e49121.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  9. Thanos PK, Subrize M, Delis F, et al. Gastric bypass increases ethanol and water consumption in diet-induced obese rats. Obes Surg. 2012;22(12):1884–92.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Wiedemann AA, Saules KK, Ivezaj V. Emergence of new onset substance use disorders among post-weight loss surgery patients. Clin Obes. 2013;3(6):194–201.

    Article  Google Scholar 

  11. Hagedorn JC, Encarnacion B, Brat GA, et al. Does gastric bypass alter alcohol metabolism? Surg Obes Relat Dis. 2007;3(5):543–8.

    Article  PubMed  Google Scholar 

  12. Steffen KJ, Engel SG, Pollert GA, et al. Blood alcohol concentrations rise rapidly and dramatically after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9(3):470–3.

    Article  PubMed  Google Scholar 

  13. Raebel MA, Newcomer SR, Reifler LM, et al. Chronic use of opioid medications before and after bariatric surgery. JAMA. 2013;310(13):1369–76.

    Article  PubMed  CAS  Google Scholar 

  14. Ivezaj V, Saules KK, Wiedemann AA. “I didn’t see this coming”.: why are postbariatric patients in substance abuse treatment? Patients’ perceptions of etiology and future recommendations. Obes Surg. 2012;22(8):1308–14.

    Article  PubMed  Google Scholar 

  15. Reslan S, Saules KK, Greenwald MK, et al. Substance misuse following Roux-en-Y gastric bypass surgery. Subst Use Misuse. 2014;49(4):405–17.

    Article  PubMed  Google Scholar 

  16. Spitzer R, Yanovski S, Marcus M. The Questionnaire of Eating and Weight Patterns-Revised (QEWP-R). New York: New York State Psychiatric Institute; 1993.

    Google Scholar 

  17. Arnow B, Kenardy J, Agras S. The Emotional Eating Scale: the development of a measure to assess coping with negative affect by eating. Int J Eat Disord. 1995;18(1):79–90.

    Article  PubMed  CAS  Google Scholar 

  18. Selzer ML. The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. Am J Psychiatry. 1971;127(12):1653–8.

    PubMed  CAS  Google Scholar 

  19. Westermeyer J, Yargic I, Thuras P. Michigan Assessment-Screening Test for Alcohol and Drugs (MAST/AD): evaluation in a clinical sample. Am J Addict. 2004;13(2):151–62.

    Article  PubMed  Google Scholar 

  20. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA. 1999;282(18):1737–44.

    Article  PubMed  CAS  Google Scholar 

  21. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.

    Article  PubMed  CAS  Google Scholar 

  22. Norbeck JS. Modification of recent life event questionnaires for use with female respondents. Res Nurs Health. 1984;7(1):61–71.

    Article  PubMed  CAS  Google Scholar 

  23. Sarason IG, Johnson JH, Siegel JM. Assessing the impact of life changes: development of the Life Experiences Survey. J Consult Clin Psychol. 1978;46(5):932–46.

    Article  PubMed  CAS  Google Scholar 

  24. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav. 2004;26(1):41–54.

    Article  Google Scholar 

  25. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt Impulsiveness Scale. J Clin Psychol. 1995;51(6):768–74.

    Article  PubMed  CAS  Google Scholar 

  26. Hoyle RH, Stephenson MT, Palmgreen P, et al. Reliability and validity of a brief measure of sensation seeking. Personal Individ Differ. 2002;32(3):401–14.

    Article  Google Scholar 

  27. Carver CS. You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med. 1997;4(1):92–100.

    Article  PubMed  CAS  Google Scholar 

  28. Green BL. Psychometric review of Trauma History Questionnaire (Self-report). In: Stamm BH, Varra EM, editors. Measurement of stress, trauma and adaptation. Lutherville: Sidran; 1996.

    Google Scholar 

  29. Wee CC, Mukamal KJ, Huskey KW, Davis RB, Colten ME, Bolcic-Jankovic D. et al (2014) High-risk alcohol use after weight loss surgery. Surg Obes Relat Dis.

  30. Davis JF, Schurdak JD, Magrisso IJ, et al. Gastric bypass surgery attenuates ethanol consumption in ethanol-preferring rats. Biol Psychiatry. 2012;72(5):354–60.

    Article  PubMed  CAS  Google Scholar 

  31. Cooper ML, Russell M, George WH. Coping, expectancies, and alcohol abuse: a test of social learning formulations. J Abnorm Psychol. 1988;97(2):218–30.

    Article  PubMed  CAS  Google Scholar 

  32. Cooper R, Hildebrandt S, Gerlach AL. Drinking motives in alcohol use disorder patients with and without social anxiety disorder. Anxiety Stress Copin. 2014;27(1):113–22.

    Article  CAS  Google Scholar 

  33. Thomas SE, Randall CL, Carrigan MH. Drinking to cope in socially anxious individuals: a controlled study. Alcohol Clin Exp Res. 2003;27(12):1937–43.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was performed at Eastern Michigan University and St. Vincent Bariatric Center of Excellence, USA. Preparation of this manuscript was supported by the Eastern Michigan University Department of Psychology, the EMU Graduate School, the Blue Cross Blue Shield Michigan Foundation, and St. Vincent Bariatric Center of Excellence. We would like to acknowledge members of the first author's dissertation committee. The committee chair was second author, Dr. Karen K. Saules, and committee members included Drs. Anne Eshelman, Tamara Loverich, and Kenneth Rusiniak. We would like to also acknowledge Katharine Hudson and Dr. David Creel for their assistance in participant recruitment.

Conflict of Interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, P.O. Box 208098, New Haven, CT, 06520, USA

    Valentina Ivezaj

  2. Department of Psychology, Eastern Michigan University, 611 W. Cross Street, Ypsilanti, MI, 48197, USA

    Valentina Ivezaj & Karen K. Saules

  3. Bariatric Center of Excellence, St. Vincent Carmel Hospital, 13430 North Meridian, Suite 168, Carmel, IN, 46032, USA

    Leslie M. Schuh

Authors
  1. Valentina Ivezaj
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  2. Karen K. Saules
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  3. Leslie M. Schuh
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Correspondence to Valentina Ivezaj.

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Ivezaj, V., Saules, K.K. & Schuh, L.M. New-Onset Substance Use Disorder After Gastric Bypass Surgery: Rates and Associated Characteristics. OBES SURG 24, 1975–1980 (2014). https://doi.org/10.1007/s11695-014-1317-8

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  • DOI: https://doi.org/10.1007/s11695-014-1317-8

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