Addiction Transfer-Side effect of WLS and rapid weight loss

[Guest guest]

On the heels of a five-year boom in weight-loss surgeries,

researchers are observing an unusual phenomenon: Some patients stop

overeating, but they wind up acquiring new disorders such as

alcoholism, gambling addiction or compulsive shopping.

Some psychologists describe it as a type of " addiction transfer, " an

outcome of substance abuse treatment whereby patients swap one

compulsive behavior for another.

Estimates on the prevalence of new addictions after surgery vary.

Philip Schauer, president of the American Society for Bariatric

Surgery, estimates that about 5 percent of patients develop a new

compulsive behavior after surgery.

But psychologist Melodie head, who spoke at the society's

annual meeting in June, cited preliminary data suggesting that about

30 percent of patients struggle with new addictions.

One possible reason for the disparity: Alcohol problems can surface

several years later, when surgeons are no longer tracking patients

closely. And some patients may not see a link between their drinking

and the surgery.

For a variety of reasons -- including the fact that alcohol is high

in calories -- bariatric-surgery patients are often advised not to

drink alcohol for the first six months to a year after surgery. Most

bariatric centers screen patients for heavy alcohol use, and exclude

patients who exhibit signs of alcohol dependence.

Gastric bypass surgery involves sectioning off a small portion of

the stomach into a pouch that bypasses the first part of the small

intestine. As a result, alcohol passes rapidly into the intestine

where it is quickly absorbed into the bloodstream.

" You shorten the time to the brain so much that if you liked alcohol

before, you'll love it now, " says Mark Gold, professor of psychiatry

and neuroscience at the University of Florida College of Medicine.

Lap-band procedures don't have the same impact. The procedure

involves restricting part of the stomach with a silicon band but

doesn't change the absorption process.