Patient Perspectives on the Course of Alcohol Use After Metabolic and Bariatric Surgery: Implications for Prevention, Intervention, and Future Research

Despite substantial benefits of metabolic and bariatric surgery (MBS), up to 1 in 5 patients develop an alcohol use disorder (AUD) within 5 years post-operatively. Cognitive-behavioural processes that are relevant to the reinitiation and escalation of alcohol use post-MBS are not well understood. Through content analysis of 20 patient interviews, we explored the course of alcohol use among individuals 6 months to 5 years post-MBS and examined potential differences by level of use. Over half (55%) of the participants reported high alcohol use, most described a gradual reintroduction to alcohol post-MBS, and escalation to misuse was thought to occur at an accelerated pace (i.e., potentially within months). Pre-operative intentions, attitudes/beliefs about post-MBS alcohol use, social factors, mood, visual cues, and post-MBS biological changes were reported to influence the course of post-MBS alcohol use. Although most features did not differ widely between those with higher versus lower alcohol consumption, reinitiating alcohol less than 12 months post-operatively and certain attitudinal factors (i.e., minimising the risks) may relate to greater alcohol use post-MBS. Findings illustrate the importance of early and long-term monitoring of post-MBS alcohol use. Several implications for early intervention and future research are discussed.