Weight loss surgery & alcohol addiction

One third of bariatric patients develop alcohol use disorder with the peak onset being two years after surgery.

When I started sobriety coaching, I noticed a pattern in the people I was seeing. Many of them were people who'd had weight loss surgery and had gone on to develop an alcohol addiction.

Although I was initially surprised at how many of my clients had this history, it also made perfect sense. I only had to look back at my own history, having had bariatric surgery 12 years ago. The operation was a great success in terms of losing a significant amount of weight and improving my health outcomes but it had also accelerated my drinking problem to a crisis point.

Of course alcohol is not a part of the bariatric pre- and post-operative diet. My dietitian recommended that I stay away from alcohol for as long as possible to ensure good weight loss. At no stage was I ever warned there was a link between weight loss surgery and addiction.

When someone offered me a drink, it seemed like a good idea in the excitement of the moment.

A couple of months after my surgery, I was feeling pretty good. The weight was falling off me, which was such a relief and felt fantastic. I had started to eat solid foods after months of liquids and felt human again. When someone offered me a drink, it seemed like a good idea in the excitement of the moment. I brushed off the little voice inside my head which reminded me that once I started drinking, I couldn't stop. I decided I had been through a lot with the surgery and it was time to kick my heels up and live a little.

I got away with drinking wine again for a while, it seemed. My weight continued to go down and the extra calories from booze didn't seem to make much difference. It was nice to have the comfort of wine back in my life – a salve for stress and a way to have fun and reward myself. I knew it wasn't good for me and I knew that sooner or later, I would probably lose control of alcohol, because that is what always happened. But like any good addict, I blocked out that reality and danced happily in denial. In the moment, I felt like I had it all.

The perils of weight loss surgery and alcohol addiction

Two years after the surgery my weight loss has stopped. That's not unusual as the "honeymoon" period of weight loss after bariatric surgery is about 12 months. But, I was still drinking and I was not doing well in any area of my health. Normally a binge-drinker a few times a week, I was now drinking every night and blackouts were regular. Every few days I tried to stop but every time I failed. Once again, I'd found myself unable to break the lifelong addiction I had to alcohol.

Looking back, my drinking really took off after the surgery because alcohol replaced the role of food in my life. I could no longer overeat to comfort myself anymore, but necking a bottle of wine was no problem. But though alcohol was once again my best friend, it was also my worst enemy. It was time to stop for good although that was much easier said than done.

My experience is not uncommon. A study in 2024 recognised that one third of bariatric patients develop alcohol use disorder with the peak onset being two years after surgery.

When the food's no longer an option, the bottle can be, but it comes with a big price tag. People who've had bariatric surgery have less stomach lining. which has an enzyme that breaks down alcohol. So when they drink alcohol, they can't metabolise it as well as they did before. The effect of this is higher alcohol levels in the blood, which means you feel drunker, faster. This can lead to addiction problems with alcohol and cause weight gain.

Like me, many people not only end up with an alcohol addiction but also end up regaining weight because alcohol is loaded with empty calories. A bottle of wine can easily contain 600-700 calories and drive poor food choices, which can easily add up to stacking on weight all over again.

My relationship with food will forever be a challenge but now I mostly eat a healthy diet and my weight is stable.

Sobriety after weight loss surgery

When I stopped drinking for good 10 years ago, the effects on my health were instant and dramatic. I dropped 7kg in a month just from taking wine out of the picture. My eating naturally became more regulated and healthy because I wasn't constantly hung over with unstable blood sugar levels, looking for quick-fix snacks to make me feel better.

These days, my relationship with food will forever be a challenge but now I mostly eat a healthy diet and my weight is stable. I don't regret having weight-loss surgery at all – being able to lose a large amount of weight at the beginning of the journey was one of the best things I have ever done for my health. I don't even resent that having the surgery made my alcohol addiction much, much worse, very quickly. Ultimately, that crisis prompted me into getting sober for good, which is by far my greatest achievement – and it also saved my life.

If you have a problem with alcohol and want to stop but need help, sober coaching could help. Book a free Clarity Call with me to discuss, or contact me on 027 231 5970 or info@goodhealthcoach.co.nz.

Alcohol associated liver disease and bariatric surgery: Current perspectives and future directions published in World Journal of Gastrointestinal Surgery, 2024