Perceived changes in alcohol effects after metabolic and bariatric surgery and one-year alcohol-related outcomes: the moderating role of anxiety.

BACKGROUND

Metabolic and bariatric surgery (MBS) is associated with changes in perceived alcohol effects, with stronger and faster effects often reported. However, the prospective implications of these changes remain unclear.

OBJECTIVES

To examine whether perceived changes in alcohol effects 6months after MBS predict alcohol-related outcomes at 1year and whether psychological vulnerability moderates these associations.

SETTING

Four Belgian hospitals.

METHODS

Two hundred and five adults were assessed preoperatively and at 6 and 12 months postoperatively (73.5% retention). Perceived changes in alcohol effects were measured at 6 months. Alcohol use, drinking motives, and anxiety were assessed at baseline and 12 months. Three separate 2 × 2 analyses of covariance tested main and interaction effects of perceived change (increase vs. no change) and anxiety (high vs. low) on 12-month outcomes, controlling for baseline levels. Bootstrap regression models assessed robustness.

RESULTS

At 6 months, 54.1% reported stronger and/or faster alcohol effects. Significant perceived change × anxiety interactions were observed for alcohol use (F(1,200) = 7.33, P < .01), enhancement motives (F(1,200) = 11.95, P < .001), and coping motives (F(1,200) = 6.94, P < .01). Interaction effects for enhancement (B = 1.23, P = .02) and coping motives (B = .96, P = .04) remained significant in bootstrap analyses, whereas the interaction for alcohol use was attenuated (B = 2.76, P = .09).

CONCLUSIONS

Perceived increases in postoperative alcohol effects were associated with stronger enhancement and coping motives, particularly among individuals with elevated anxiety. Assessing perceived alcohol sensitivity and psychological vulnerability may help identify patients at increased risk for alcohol-related problems.