Original article| Volume 3, ISSUE 5, P543-548, September 2007

Does gastric bypass alter alcohol metabolism?



      Morbid obesity is the leading public health crisis in the United States, with bariatric surgery as the only effective and enduring treatment for this disease. a concern has been raised, that, postoperatively, alcohol metabolism might be altered in gastric bypass patients. We hypothesized that alcohol metabolism in the postoperative gastric bypass patient would be altered.


      Of 36 subjects, 17 control and 19 postgastric bypass subjects each consumed 5 oz of red wine. They underwent an alcohol breath analysis every 5 minutes. The outcomes recorded included symptoms, initial peak alcohol breath level, and the time for alcohol breath levels to normalize.


      The gastric bypass group was on average 10 years older and had a greater weight and body mass index than the control group. The average time after gastric bypass was 2 years, with an average body mass index loss of 18 kg/m2 (51 kg/m2 before versus 33 kg/m2 after). The gastric bypass patients had a peak alcohol breath level of 0.08% and the controls had a level of 0.05%. The gastric bypass group needed, on average, 108 minutes to reach an alcohol breath level of 0; the control group reached this level after an average of 72 minutes. Both groups showed a similar postingestion symptom profile.


      In this study, alcohol metabolism was significantly different between the postgastric bypass and control subjects. Although the gastric bypass patients’ had a greater peak alcohol level and a longer time for the alcohol level to reach 0 than the controls, the gastric bypass group did not experience more symptoms than the control group. These findings provide caution regarding alcohol use by gastric bypass patients.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery for Obesity and Related Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Blanck H.M.
        • Dietz W.H.
        • Galuska D.A.
        • et al.
        State-specific prevalence of obesity among adults—United States, 2005.
        JAMA. 2006; 296: 1959-1960
        • National Institutes of Health Consensus Development Conference Panel
        Gastrointestinal surgery for severe obesity.
        Ann Intern Med. 1991; 115: 956-961
        • Yoon K.
        • Lee J.H.
        • Kim J.W.
        • et al.
        Epidemic obesity and type 2 diabetes in Asia.
        Lancet. 2006; 368: 1681-1686
        • Leibson C.L.
        • Williamson D.F.
        • Melton L.J.
        • et al.
        Temporal trends in BMI among adults with diabetes.
        Diabetes Care. 2001; 24: 1584-1589
        • McTigue K.M.
        • Harris R.
        • Hemphill B.
        • et al.
        Screening and interventions for obesity in adults.
        Ann Intern Med. 2003; 139: 933-949
        • Sjostrom L.
        • Lindroos A.K.
        • Peltonem M.
        • et al.
        Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery.
        N Engl J Med. 2004; 351: 2683-2693
        • Christou N.V.
        • Sampalis J.S.
        • Liberman M.
        Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients.
        Ann Surg. 2004; 240: 416-424
        • Buchwald H.
        • Avidor Y.
        • Braunwald E.
        • et al.
        Bariatric surgery: a systemic review and meta-analysis.
        JAMA. 2004; 292: 1724-1737
        • Escalona A.
        • Perez G.
        • Leon F.
        • et al.
        Wernicke’s encephalopathy after Roux-en-Y gastric bypass.
        Obes Surg. 2004; 14: 1135-1137
        • Grace D.M.
        • Alifieri M.A.
        • Leung F.Y.
        Alcohol and poor compliance as factors of Wernicke’s encephalopathy diagnosed 13 years after gastric bypass.
        Can J Surg. 1998; 41: 389-392
        • Hsu L.K.
        • Benotti P.N.
        • Dwyer J.
        • et al.
        Nonsurgical factors that influence the outcome of bariatric surgery: a review.
        Psychosom Med. 1998; 60: 338-346
        • Guisado Macias J.A.
        • Vaz Leal F.J.
        Psychopathological differences between morbidly obese binge eaters and non-binge eaters after bariatric surgery.
        Eat Weight Disord. 2003; 8: 315-318
        • Waters G.S.
        • Pories W.J.
        • Swanson M.S.
        • et al.
        Long-term studies of mental health after the Greenville gastric bypass operation for morbid obesity.
        Am J Surg. 1991; 161: 154-158
        • Klockhoff H.
        • Naeslund I.
        • Jones A.W.
        Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery.
        Br J Clin Pharmacol. 2002; 54: 587-591
        • Pickens R.W.
        • Hatsukami D.K.
        • Spicer J.W.
        • et al.
        Relapse by alcohol abusers.
        Alcohol Clin Exp Res. 1985; 9: 244-247
        • Krampe H.
        • Stawicki S.
        • Wagner T.
        • et al.
        Follow-up of 180 alcoholic patients for up to 7 years after outpatient treatment: impact of alcohol deterrents on outcome.
        Alcohol Clin Exp Res. 2006; 30: 86-95
        • Jones A.W.
        • Beylich K.M.
        • Bjorneboe A.
        • et al.
        Measuring ethanol in blood and breath for legal purposes: variability between laboratories and between breath-test instruments.
        Clin Chem. 1992; 38: 743-747
        • Lindberg L.
        • Brauer S.
        • Wollmer P.
        • et al.
        Breath alcohol concentration determined with a new analyzer using free exhalation predicts almost precisely the arterial blood concentration.
        Froensic Sci Int. 2006; (Epub Sep 13)
        • Wynne H.A.
        • Wood P.
        • Herd B.
        • Wright P.
        • Rawlins M.D.
        • James O.F.W.
        The association of age with the activity of alcohol dehydrogenase in human liver.
        Age Ageing. 1992; 21: 417-420
        • Chrostek L.
        • Jelski W.
        • Szmitkowski M.
        • Puchalski Z.
        Gender-related differences in hepatic activity of alcohol dehydrogenase isoenzymes and aldehyde dehydrogenase in humans.
        J Clin Lab Anal. 2003; 17: 93-96
        • Horowitz M.
        • Collins P.J.
        • Harding P.E.
        • Shearman D.J.
        Gastric emptying after gastric bypass.
        Int J Obes. 1986; 10: 117-121
        • Lee S.L.
        • Chau G.Y.
        • Yao C.T.
        • Wu C.W.
        • Yin S.J.
        Functional assessment of human alcohol dehydrogenase family in ethanol metabolism: significance of first-pass metabolism.
        Alcohol Clin Exp Res. 2006; 30: 1132-1142
        • Hsu L.K.G.
        • Betancourt S.
        • Sullivan S.P.
        Eating disturbances before and after vertical banding gastroplasty: a pilot study.
        Int J Eat Disord. 1996; 19: 23-24
        • Hsu L.K.G.
        • Sullivan S.P.
        • Benotti P.N.
        Eating disturbances and outcome of gastric bypass surgery: a pilot study.
        Int J Eat Disord. 1997; 21: 385-390
        • Brosin H.W.
        The psychiatric aspects of obesity.
        JAMA. 1954; 155: 1238-1239
        • Bruch H.
        The emotional significance of the preferred weight.
        Am J Clin Nutr. 1957; 5: 192-196
        • Kleiner K.D.
        • Gold M.S.
        • Frost-Pineda K.
        • et al.
        Body mass index and alcohol use.
        J Addict Dis. 2004; 23: 105-118
        • Dutta S.
        • Morton J.M.
        • Shepard E.
        • et al.
        Methamphetamine use following bariatric surgery in an adolescent.
        Obes Surg. 2006; 16: 780-782
        • Bulik C.M.
        • Sullivan P.F.
        • Kendler K.S.
        Medical and psychiatric morbidity in obese women with and without binge eating.
        Int J Eat Disord. 2002; 32: 72-78
        • Stewart S.H.
        • Brown C.G.
        • Devoulyte K.
        • et al.
        Why do women with alcohol problems binge eat?.
        J Health Psychol. 2006; 11: 409-425
        • de Zwaan M.
        Binge eating disorder and obesity.
        Int J Obes Relat Metab Disord. 2001; 25: S51-S55
        • Martin P.R.
        • Singleton C.K.
        • Hiller-Sturmhofel S.
        The role of thiamine deficiency in alcoholic brain disease.
        Alcohol Res Health. 2003; 27: 134-142
        • Grace D.M.
        • Alfieri M.A.
        • Leung F.Y.
        Alcohol and poor compliance as factors in Wernicke’s encephalopathy diagnosed 13 years after gastric bypass.
        Can J Surg. 1998; 41: 389-392
        • Kesse E.
        • Clavel-Chapelon F.
        • Slimani N.
        • et al.
        Do eating habits differ according to alcohol consumption?.
        Am J Clin Nutr. 2001; 74: 322-327
        • Bujanda L.
        The effects of alcohol consumption upon the gastrointestinal tract.
        Am J Gastroent. 2000; 95: 3374-3382
        • Stampfer M.J.
        • Colditz G.A.
        • Willett W.C.
        • et al.
        A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women.
        N Engl J Med. 1988; 319: 267-273
        • Wannamethee S.G.
        • Camargo Jr, C.A.
        • Manson J.E.
        • et al.
        Alcohol drinking patterns and risk of type 2 diabetes mellitus among younger women.
        Arch Intern Med. 2003; 163: 1329-1336
        • Baum-Baicker C.
        The health benefits of moderate alcohol consumption: a review of the literature.
        Drug Alcohol Depend. 1985; 15: 207-227