Alcohol consumption patterns up to 10 years after bariatric surgery: using the highly specific biomarker phosphatidylethanol.

BACKGROUND

The increasing prevalence of obesity has led to a rise in bariatric surgery as an effective intervention for weight loss and associated co-morbidities. However, concerns persist regarding increased alcohol consumption after surgery.

OBJECTIVES

To objectively assess long-term changes in alcohol use after bariatric surgery, we used the highly specific alcohol biomarker phosphatidylethanol (PEth).

SETTING

Kalmar County Hospital, Sweden.

METHODS

This longitudinal cohort study included 1238 patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy at Kalmar County Hospital from 2010 to 2020. Patients were divided into 2 cohorts based on preoperative PEth sampling (n = 327 with, n = 911 without). PEth levels were measured before surgery and at intervals up to 10 years postoperatively, using .30 μmol/L (approximately 210 ng/mL) as the threshold for heavy alcohol use.

RESULTS

Mean PEth concentrations increased from .07 to .38 μmol/L (P < .001) in men and from .06 to .11 μmol/L nonsignificantly in women. The proportion of patients that postoperatively exceeded the heavy drinking threshold rose significantly over time. At 5 years, 37.5% of men and 4.8% of women had PEth values above .30 μmol/L (both P < .001). Men were at significantly higher risk (odds ratio: 7.89, 95% confidence interval: 3.76-16.57; P < .001). This pattern remained consistent at the 10-year follow-up.

CONCLUSIONS

Alcohol consumption, as measured by PEth, increased significantly after bariatric surgery, particularly in men. These findings support routine postoperative alcohol screening and suggest incorporating PEth testing into long-term follow-up protocols.