Ann Surg：减肥手术或增加患者对酒精和药物的滥用风险

刊登在国际杂志Archives of Surgery上的一篇研究报告中，来自纽约肥胖营养研究中心的研究者揭示了，接受减肥手术的病人或增加其物质滥用的风险，物质滥用包括药物滥用、酒精滥用及过度吸烟等。尤其是那些进行腹腔镜Roux-Y形吻合术的患者，其在术后酒精滥用的风险会明显增加。

研究者表示，药物、酒精或者食物会在大脑中引发某种效应，从而使得接受减肥手术的患者在术后表现出贪吃、滥用的症状。研究者分析了来自155个病人（其接受了减肥手术，含132个女性）的调查问卷，每一位病人在调查问卷中都会填写其手术前、术后1个月、3个月、6、12、24个月的饮食情况和物质滥用情况。

通过分析，研究者发现减肥手术后的患者确实立马减少了其食物的摄取，而且这种情况并不能维持长达3个月，随后患者就明显增加了其对物质的摄入，而且在此后长达24个月的时间内，患者明显增加了对药物、酒精以及烟草的使用频率和用量。

另外，接受腹腔镜Roux-Y形吻合术（LRYGB）的患者也表现出了术后对酒精滥用的风险。基于当前研究，接受RYGB的患者明显增加了其使用酒精的风险，当向患者推荐LRYGB手术时，需要衡量其所带来的益处和风险，比如也应该考虑患者的个人及家族酒精滥用或者依赖历史等情况。

与减肥相关的拓展阅读：

• Diabetes Care：不符合手术标准的肥胖患者也能从减肥手术中获益
• Biochem Pharmacol：大部分的减肥药物可以强烈的影响其他药物的疗效
• Heart：减肥手术或降低患者心脏疾病和中风风险
• Ann Surg：减肥手术或增加结直肠癌风险
• ACC：减肥现金奖励最有效 更多信息请点击：有关减肥更多资讯

Substance Use Following Bariatric Weight Loss Surgery

Objective To assess substance use before and after bariatric weight loss surgery (WLS). There is a paucity of research investigating the occurrence of substance use following bariatric WLS. It was hypothesized that patients who underwent WLS would exhibit an increase in substance use (drug use, alcohol use, and cigarette smoking) following surgery to compensate for a marked decrease in food intake. Design Prospective study. Setting A major urban community hospital. Participants A total of 155 participants (132 women and 23 men) who underwent WLS were recruited from a preoperative information session at a bariatric surgery center. Intervention Participants received either laparoscopic Roux-en-Y gastric bypass surgery (n = 100) or laparoscopic adjustable gastric band surgery (n = 55). Participants completed questionnaires to assess eating behaviors and substance use at preoperative baseline and 1, 3, 6, 12, and 24 months after surgery. Main Outcome Measure Substance use as assessed by the Compulsive Behaviors Questionnaire. Results Participants reported significant increases in the frequency of substance use (a composite of drug use, alcohol use, and cigarette smoking, hereafter referred to as composite substance use) 24 months after surgery. Specifically, participants experienced a significant increase in the frequency of composite substance use from baseline to 24 months after surgery (P = .02), as well as significant increases from 1 month, 3 months, and 6 months to 24 months after surgery (all P ≤ .002). In addition, participants who underwent laparoscopic Roux-en-Y gastric bypass surgery reported a significant increase in the frequency of alcohol use from baseline to 24 months after surgery (P = .011). The response rate to the survey was 61% at 1-month follow-up, 41% at 3-month follow-up, 43% at 6-month follow-up, 49% at 12-month follow-up, and 24% at 24-month follow-up. Conclusions Patients may be at increased risk for substance use following bariatric WLS. In particular, patients who undergo laparoscopic Roux-en-Y gastric bypass surgery may be at increased risk for alcohol use following WLS. Our study is among the first to document significant increases in substance use following WLS using longitudinal data.