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Postoperative factors associated with hazardous alcohol use after metabolic and bariatric surgery

Surg Endosc. 2026 Aug 10. doi: 10.1007/s00464-026-13270-x. Online ahead of print.

ABSTRACT

INTRODUCTION: There is an increased risk of hazardous alcohol use following metabolic and bariatric surgery (MBS). Identifying risk factors of hazardous alcohol use, particularly factors that may differentiate risk among those with regular postoperative alcohol consumption, would inform postoperative monitoring.

METHOD: Participants (N = 100) who were up to 5 years post-MBS and were consuming alcohol at least 2-3 times per month completed an assessment as part of a larger study. Measures assessed hazardous alcohol use, drinking motives, psychiatric symptoms, and disordered eating behaviors.

RESULTS: Participants were primarily female (87.0%), White (49.0%) or Black (44.0%), with a mean age of 48 years. Approximately 1 in 5 met the threshold for hazardous alcohol use. In bivariate analyses, clinically significant symptoms of depression (OR = 4.88, p = .01) and anxiety (OR = 8.21, p < .001) were associated with the presence of hazardous alcohol use. All four types of drinking motives were associated with greater likelihood of hazardous alcohol use: social (OR = 1.10, p = .03), coping (OR = 1.33, p < .001), enhancement (OR = 1.24, p < .001), and conformity (OR = 1.25, p = .01). Emotional eating scores and the presence of a food addiction were not significantly associated with hazardous alcohol use (p > .05). In a multivariable analysis, only the coping drinking motive remained statistically significant (OR = 1.26, p = .003).

CONCLUSION: Drinking to cope with negative emotions may be a factor associated with increased risk of hazardous drinking among individuals who regularly consume alcohol after MBS. Interventions aimed at improving coping strategies could mitigate risk of hazardous alcohol use.

PMID:42576078 | DOI:10.1007/s00464-026-13270-x

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