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JCOM Abstract

J Clin Outcomes Manage 
2013 Oct;20(10):470-480
Post-bariatric surgery substance use disorders: prevalence predictors, management, and prevention
Saules KK, Reslan S

Abstract Objective: To review the evidence on post-bariatric surgery substance use disorders (SUDs), including a discussion of management and prevention. Methods: Review and integration of the published literature on emergence of post-bariatric SUDs with our own ongoing work in this area. Results: Emerging evidence suggests that post-bariatric surgery patients—particularly those who have had the Roux-en-Y gastric bypass and possibly gastric sleeve procedures—are at risk for developing SUDs, and about two-thirds of these cases represent new-onset SUDs, not relapses to pre-existing conditions. There are compelling physiological and psychological reasons why bariatric patients may be at risk for SUDs after surgery. Addressing patients’ abilities to make myriad post-surgical adjustments without engaging in problematic behavioral patterns may be of paramount importance to optimize bariatric outcomes and prevent postoperative SUDs. Conclusion: We advocate a paradigm shift in which behavioral health providers become more involved after surgery in assisting bariatric patients manage dramatic adaptations regarding appearance, body image, interpersonal relationships, and health behaviors to optimize bariatric outcomes over the long term.

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