The short answer is yes, but with a few guidelines and precautions. Bariatric surgery is a tool to assist patients with weight management by controlling hunger and the amount of food the stomach can hold, but it is ultimately up to the individual to make healthy choices and lifestyle changes.

Alcohol is involved in nearly every social event in our culture, from weddings and parties to funerals and professional events. While moderate drinking may be included in a healthy lifestyle, there are some things to consider when it comes to consuming alcohol, especially after bariatric surgery.

Drinking heavily puts people at risk for many adverse health consequences, whether they have undergone bariatric surgery or not; but those who have had bariatric surgery are at a greater risk than others for developing complications.

Alcohol Metabolism

Alcohol is not absorbed by the body in the same way that food is. A small amount is absorbed by the tongue and lining of the mouth. The rest travels to the tissues of the stomach. Although some alcohol is metabolized by the stomach, most travels to the small intestine and then to the bloodstream, where it is circulated all around the body. Alcohol enters all body tissues except for bone and fat. Finally, alcohol is delivered to the liver for the last step in metabolism.

Alcohol absorption into the bloodstream is primarily regulated by the rate that alcohol empties into the intestines from the stomach.

Altered Metabolism

Research shows that blood alcohol levels increase quicker and faster due to altered metabolism after bariatric surgery. Because of reduced stomach capacity in both the sleeve and bypass procedures, bariatric surgery results in alcohol moving much more quickly from the stomach into the small intestines, and therefore increasing blood alcohol concentration much faster.

Additionally, there are fewer enzymes available in the stomach for alcohol processing, allowing larger amounts of alcohol to pass into the bloodstream.

Excess Calories

Alcoholic beverages can be high in calories but provide minimal nutrition; this concept is what is referred to as “empty calories.” Drinking alcohol can work against your weight loss goal. For example, wine contains twice the calories per ounce than regular soda does. Alcohol may also lower your inhibitions, leading to poor food choices or feelings of increased appetite.

Addiction Transfer

There are other considerations when it comes to bariatric surgery and alcohol. Addiction transfer, also referred to as cross addiction, occurs when individuals trade one harmful, compulsive behavior for another. In bariatric surgery, some individuals are at risk of trading compulsive or binge eating for compulsive or binge drinking.

Because food can no longer be a source of comfort, distraction or reward, individuals may turn to alcohol as a coping mechanism. For those dealing with an active addiction before surgery, treatment is essential. Those who have struggled with addiction in the past are encouraged to continue treatment and refrain from alcohol use.

Bariatric Surgery and Alcohol: Guidelines

Alcohol consumption is generally not recommended directly following bariatric surgery. However, over time, patients may choose to re-introduce alcohol. Substance use following bariatric surgery can significantly impact your physical health. The goal is to use alcohol responsibly without compromising your commitment to a healthy lifestyle.

Avoid alcohol for the first 6-12 months after surgery. Specific bariatric programs may have different guidelines; always follow your program's recommendations.

• When reintroducing alcohol after surgery, avoid carbonation and highly sweetened mixers.
• Remember that after surgery alcohol will affect you differently. You may feel the effects sooner, more intensely, and you may be at risk for low blood sugar.
• If you find yourself drinking regularly to cope with emotions or stress, seek help.
• Keep your bariatric team and primary care physician informed of your decision to use alcohol.