After hundreds of thousands of weight loss surgeries have been performed in the last ten years, researchers are learning about a new phenomenon: a disproportionate number of weight loss surgery patients acquire new addictions. These addictions include alcohol, gambling, drugs, and sexual activity.
Many weigh-loss surgery centers are now including pre-surgery addiction counseling for patients. Psychologists call the problem “addiction transfer.” About 25 percent of alcoholics who relapse switch their addiction to another substance, such as opiates. Now treatment centers for substance abuse are seeing a surge of new clients who have had bariatric surgery. No longer able to satisfy their addiction to overeating, they become addicted to another behavior.
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The practice of switching one addiction for another has long been explained as fulfilling of a need the patient feels to fill an inner void. But researchers are beginning to believe that substance abuse is not just a psychological problem. Many now believe that swapping addiction behaviors has a neurological basis. New research shows that the biochemical causes of overeating are very closely related to those underlying other addictions, such as narcotics and alcohol addiction. Alcohol addiction is especially a danger for weight-loss surgery patients. Some bariatric surgery leaves the body metabolizing alcohol differently than it did before, making the effects of alcohol more powerful more quickly.
Clinical trials on using medication to fight addictions are under way across the nation. The drug Topomax, used now as an anti-epileptic drug, is being tested for its treatment of binge eating, gambling and alcoholism. Wellbutrin, long a drug used in fighting nicotine addiction, is being studied for its effectiveness in combating obesity, alcoholism, sex addictions and narcotic dependency.
At U.S. Bariatric in Orlando, Florida, therapists estimate that about 30 percent of weight-loss surgery patients have new addiction problems. This number comes from preliminary studies and the American Bariatric Association denies that the percentage is that high.
The most performed weight-loss surgery, gastric bypass, involves sectioning off a small pouch from the existing stomach. The first part of the small intestine is bypassed. The amount of small intestine bypassed affects the amount of calories absorbed from food. Thus, the surgery works in two ways. The much smaller stomach can hold only a small amount of food at a time, and the smaller amount of intestine means less is absorbed as the food passes into the intestine. The smaller amount of intestine also makes the absorption of alcohol faster. Many gastric bypass patients find the fast impact of alcohol on the brain a pleasant experience. Doctors theorize that drinking alcohol and overeating trigger the same reward sites in the brain.
Some studies using neuroimaging suggest that obese people and alcoholics both have abnormal levels of dopamine in their brains, contributing to cravings. They believe these people always feel something is lacking and that they need to boost the level of dopamine to feel good. Therefore, people who suffer from obesity are more likely to become addicted to alcohol if their addiction to food is eliminated.
Gastric bypass patients should be made aware of the dangers of addiction switching. More gastric bypass surgery centers are starting to include addiction counseling in their pre-surgery therapy. If patients have the facts and know that there may be dangers in their path, they are much more likely to recognize beginning symptoms of a problem, allowing them to take action before an addiction to another substance or activity makes inroads into their life.