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Alcohol and bariatric surgery – what is allowed and what isn’t? Thinking about what to do about alcohol after bariatric surgery can be overwhelming. Your doctor says no alcohol, but your best friend that also had bariatric surgery is having a couple drinks every weekend. Talk about confusion! Let’s learn what the research tells us.
Alcohol Guidelines: General and Not Specific to Bariatric Surgery
Before digging into the guidelines of alcohol use after bariatric surgery let’s define the general guidance on alcohol use for adults in the United States. Moderate drinking is defined as one drink per day for women and two drinks per day for men. The definition of one drink is 12 ounces of beer, 8 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits or liquor (1).
After bariatric surgery the general guidelines do not apply and need to be modified. This is depending on several factors including type of surgery performed, individual tolerance, and how the alcohol is influencing weight loss goals.
With gastric bypass surgery research shows that absorption of alcohol is altered. The re-routing of the digestive tract accelerates the absorption of alcohol into the bloodstream. The alcohol also takes longer to clear from the body (2).
In sleeve gastrectomy surgery the alteration to alcohol metabolism is less clear. There have been some studies that show changes to how alcohol is processed in the body, while other studies show that this surgery does not change alcohol metabolism much (2).
Calories in Alcohol and Weight Loss After Bariatric Surgery
Regardless of whether bariatric surgery changes the way alcohol is metabolized in the body, it is important to not forget that alcohol may make weight loss more difficult.
The main reason why alcohol can make weight loss challenging is down to one thing: CALORIES! Alcohol provides high amounts of non-nutritious calories that can wreak havoc on your weight loss journey.
Two glasses of wine per night can add nearly 1700 calories per week. Over time that can add up to weight gain or inadequate weight loss after bariatric surgery. Instead consider a low-calorie mocktail and some stress relieving activities to round out your evening. Try out a hike or yoga class for girl’s night instead of happy hour.
The other problem with alcohol consumption is that it may lower your inhibitions. Feeling less aware of your choices could lead to eating more food than you had planned or eating a larger quantity of calorie dense foods. Making a habit of this is a recipe for weight regain or not meeting weight loss goals.
Lower Calorie Options Instead of Alcohol After Bariatric Surgery:
If you’re not drinking alcohol, what should you have? Alternate options include water of course, but when you’re in a fun mood, who wants that? Infused water – made with vegetables, fruit, herbs, or herbal tea bags has endless combinations of flavors.
Another easy beverage option is flavored water. Add your pick of many brands of powders and liquids to plain water for delicious flavor. Coffee and tea are another choice that may be served hot or cold and in many different flavors.
Mocktails are another option. One quick search around Pinterest can show you lots of options.
Make sure when looking through mocktail recipes that you find ones that are bariatric-friendly. Bariatric friendly means not carbonated and made with low-sugar ingredients. High-sugar beverages can lead to dumping syndrome and symptoms of intolerance after bariatric surgery.
Start with this super easy recipe!
Blueberry Summer Mocktail:
- Blueberry Herbal Tea (I used this one by Celestial Seasonings)
- 3 slices lemon
- 3 slices ginger
Brew herbal tea according to package instructions along with the lemon and ginger.
Pour over ice and enjoy!
Choosing the Best Alcohol Options
If you are going to have alcohol, what kind is vegan and the best option after bariatric surgery? Many people do not tolerate carbonation well after bariatric surgery so beer or a hard seltzer is likely not the preferred choice. The other option to avoid would be soda-including diet, remember, carbonation??
Additionally avoid regular fruit juice as a mixer with alcoholic beverages. Most people who have had bariatric surgery have trouble tolerating regular fruit juice. It may cause dumping syndrome and general feelings of food intolerance (nausea, abdominal pain, and/or diarrhea).
There are many vegan options when it comes to hard liquor. Vodka is almost always vegan, along with whiskey, tequila, gin, and rum. Instead of the juice or soda use a low calorie mixer for a more bariatric friendly drink.
Vegan wine can be more tricky to find. Brands may have some types of wine that are vegan and others that are not. Use a directory such as Barnivore to figure out vegan options.
Cross Addiction or Addiction Transfer with Alcohol After Bariatric Surgery
A more serious reason to limit or avoid alcohol after bariatric surgery is the risk of cross addiction or addiction transfer after bariatric surgery. Cross addiction or addiction transfer is defined as trading a dependence or unhealthy relationship with food before surgery to a different addiction (such as alcohol) after surgery.
Research paints a mixed picture when it comes to alcohol use disorder (AUD) after bariatric surgery. According to the American Society for Metabolic and Bariatric Surgery (ASMBS) there are some studies showing a reduction in prevalence of AUD after bariatric surgery and some studies showing a slight increase. It is important to be aware that it is possible for the risk of AUD to increase after bariatric surgery (2).
Other Health Risks of Drinking Alcohol After Bariatric Surgery
Keeping alcohol intake to a minimum is also important for overall health, whether you have had bariatric surgery or not. Drinking alcohol beyond a moderate amount on a regular basis may increase risk of various types of cancer including breast, mouth, throat, esophagus, liver, and colon. Other health issues resulting from alcohol intake include high blood pressure, stroke, dementia, depression, and anxiety (1).
Alcohol and certain medications do not mix well. For example, alcohol can increase risk of hypoglycemia (low blood sugar) in people with diabetes that are on certain medications. These medications include insulin, sulfonylureas (glipizide, glimepiride, and glyburide), and meglitinides (repaglinide and nateglinide).
The reason why alcohol may lead to a low blood sugar in people with diabetes is related to metabolism of alcohol. After consuming alcohol the liver becomes preoccupied with metabolizing the alcohol so it is unable to rescue the body from low blood sugar as it normally would. The liver would normally treat a low blood sugar by taking stored sugar (glycogen) and releasing it into the bloodstream; this normally happens during periods of fasting.
Healthy Stress Relief Instead of Alcohol After Bariatric Surgery
So, the question remains: what are some healthy options for stress relief and fun? Instead of happy hour with friends, what about yoga class or a hike with friends? Or my personal favorite: craft night!
Stress relief and behavioral health are of utmost importance after bariatric surgery. Many bariatric programs offer support groups, group classes, and 1:1 appointments with mental health professionals. Take advantage and participate in these regularly to maintain your mental health after bariatric surgery instead of turning to alcohol.
Self-medicating for anxiety and depression with alcohol after bariatric surgery can happen without the right support and care. If you’re finding that self care and general stress-relieving activities aren’t doing enough, reach out for help. Either your family doctor or bariatric surgery program can provide a referral to a mental health professional.
Final Thoughts About Alcohol After Bariatric Surgery
In conclusion, the majority of evidence points to limiting the use of alcohol but it may be used. Understanding the risk involved with alcohol consumption after bariatric surgery so that you can make an educated decision on what is right for you is of great importance. Keep the resources offered by your bariatric surgery program at the top of your mind if you are struggling.
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- “Drinking Too Much Alcohol Can Harm Your Health. Learn the Facts.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Feb. 2021, www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm.
- Parikh, Manish, Jason M. Johnson, and Naveen Ballem. “ASMBS position statement on alcohol use before and after bariatric surgery.” Surgery for Obesity and Related Diseases 12.2 (2016): 225-230.
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Ashley Krautkramer, RD, CSOWM, CD, CDCES is a vegan and bariatric nutrition expert with more than six years of experience. She is a board certified specialist in obesity and weight management.