Before weight loss surgery, many of our patients enjoyed the occasional, or maybe not so occasional, alcoholic beverage. From beer to wine to spirits, there’s no shortage of options. For some, the idea of having to give up alcohol is a genuine concern. As such, we want to talk about the guidance we offer as it relates to alcohol both in the early and later postoperative periods.
Before we delve more deeply into alcohol and bariatric surgery, we must consider why you may be asking this question. If you are still in the preop phase, and you are already wondering when you can get back to alcohol and/or “junk” foods, for that matter (let’s collectively call them indulgences), you may wish to consider if you are ready for bariatric surgery. Remember, this is a significant lifestyle change, and quitting alcohol is probably one of the more minor sacrifices you’ll have to make in the grand scheme. As such, be honest with yourself, and be sure you are ready for the sacrifices you will make for your health and weight loss.
Alcohol in Early Recovery
There is no circumstance in which you should consume an alcoholic beverage within the first six months after your bariatric procedure. There are several reasons for this.
First, alcohol is a diuretic, which promotes the outflow of hydration. Hydration is a key to success and health early in the postoperative phase, so we must avoid any habits that work against that. You may be interested to know that one of the most common reasons for readmission to the hospital after a bariatric procedure is dehydration, and that’s why we are so adamant about properly hydrating after your surgical procedure. Your stomach space will be limited – use it wisely!
Second, alcohol can be an irritant to the gastric pouch. The irritation can, in turn, throw off your dietary schedule after surgery and cause significant problems or even malnutrition. This is an important concern and another reason to avoid alcohol for at least the first six months after surgery.
Alcohol can also reduce the absorption of critical nutrients, including vitamin B12. The mechanisms involved in bariatric surgery, especially gastric bypass, may limit the absorption of B12 as well, and the combination of these factors may cause a deficiency, which leads to significant physical and psychological impairments.
Lastly, many alcoholic drinks are also carbonated. Carbonation is the enemy of a new, smaller stomach pouch. Not only does it fill you up when you should be eating higher-density proteins, but it can also stretch your stomach if consumed regularly. An occasional stretch is usually only painful but does not have long-term consequences. Longer-term, continuous consumption of carbonated beverages can stretch your stomach pouch and make you regain weight in the future.
Longer-Term Alcohol Consumption
After the first six months, you can liberalize your alcohol consumption somewhat. Unfortunately, alcohol is converted to sugar in the body and can be a “sugar bomb,” especially when mixers are used. This is a diet buster and ultimately works against your longer-term goals. You must also be cautious when consuming alcohol after bariatric surgery, especially gastric bypass, as alcohol passes into the sensitive lining of the small intestine with less time spent in the stomach. This rapid emptying into the small intestine can lead to unexpected inebriation, causing impairment with fewer drinks and potentially creating legal issues even if you believe you are “under the limit” based on your pre-surgery tolerances.
Lastly, while it is relatively rare, there is something known as addiction transference. Some patients who use food as an emotional crutch may turn to another substance of abuse, which can be alcohol or even drugs. If you feel like you are looking for a drink more often than you usually would, or if drinking interferes with your life, it’s essential that you speak to your bariatric surgeon and a mental health specialist to understand what the cause and address it early before it becomes an actual problem.
We know that alcohol is often the cornerstone of a social gathering, and we do not expect you to eliminate alcohol from your life entirely unless you want to. However, you must remember that it is a toxin, and your body reacts differently to it after bariatric surgery than before. Limiting your alcohol consumption is a critical part of success after surgery.