Alcohol After Weight Loss Surgery: Yes, No, Maybe?
Some of us who have had bariatric surgery and run our Support Groups, occasionally go to Happy Hour, drink champagne on birthdays and New Years Eve, have a glass of red wine before a glorious steakhouse dinner and even order poolside cocktails while vacationing in Mexico.
If you do not want to drink alcohol, or if you do not drink, we respect and support your decision - this may not be a helpful article for you.
We offer strong opinions and guidelines for those of you who may consider having a cocktail at some point after your bariatric surgery. We have always felt that it's important to have open and honest discussions about drinking, so folks know what to expect, are able to handle themselves and always remain safe.
Let's Get Real
'Just Say No' or extreme warnings of alcoholism do not work - it is better that we have an adult level of conversation with the understanding that a moderate percentage of us are going to have an alcoholic beverage at some point. Not everyone has deep seated emotional issues or is at risk for 'transfer addiction'. The fact is that there is just a slightly higher rate of alcoholism in the bariatric population than in a similar non bariatric population. That is not to be ignored, but not everyone who has bariatric surgery becomes an alcoholic, as life after surgery emulates real life.
Surgery less than a year ago? THE ANSWER IS NO! Done.
If you have had your Sleeve or RNY or Lap Band surgery less than a year ago: No Alcohol - No Further Discussion. Your liver and organs are under great stress in this first year due to the massive amount of weight lost. Waste materials from fat metabolization are being processed by the liver, which is why you should not add alcohol to this detox. Your surgeon or medical professional will confirm this. You have your entire life ahead of you - just don't drink that first year. Some surgeons are 'allowing' alcohol at six months and that's fine if that is the sentiment of your team. We stick to one year as that is of the majority.
What could possibly go wrong?
If you are more than one year post op and you are thinking about having a drink, understand that we no longer digest the alcohol in a 'big ole handbag of a stomach' before it passes to the intestines. The alcohol dribbles through a four ounce pouch into the intestine where it is absorbed at near full proof potency and the effects can be greatly magnified - meaning we can get horribly drunk very quickly. Not just a little tipsy, but incoherent, sloppy, fall down, incapacitated, dangerously drunk. What can happen is not pretty and I have witnessed a bariatric post-op loaded into an ambulance at a bariatric event (not one of ours) after foolishly doing tequila shots with her peers. So please take warnings seriously.
Honey, I'd Like You to Meet My Boss... Boo!
Even if you have been an experienced social drinker before your bariatric surgery, do not experiment in public. A member once shared that she was planning her first post op drink at her wedding and asked what we recommended. We told her SPARKLING WATER WITH AN ORANGE SLICE. I cannot think of a worse time to try first alcohol other than a class reunion, office Christmas party, or your husbands inauguration. If you have made the decision to drink socially, have a few sips of wine or a very weak drink that does not contain sugared mixers at home or a friends house. You may honestly hate the way it makes you feel or fall fast asleep. A bariatric friend of mine gets very tired after a few sips of a cocktail and then gets a headache. Not fun - so she generally chooses to not drink and is fine with her decision.
THIS IS YOUR MOTHER SPEAKING
The most important rule is to never drink unless you are with someone who you can trust with your life. If you were to get very sick or pass out, you would have to rely on that person for help as you could be completely disabled by the alcohol. Casual friends, co-workers, or your Match.com date do not understand the reality of alcohol poisoning to a bariatric patient. I know someone who threw up into her wine glass at a restaurant table and then passed out. The casual acquaintances who bought her 'another and another drink' over her weak objections, did not understand the implications. Other bariatric friends have drunk dialed me from bathrooms or parking lots of bars at 2am - alone and incoherent. Never put yourself in a situation where you are in danger, but that would be the same if we had not had surgery, yes? (my mother was wise in her teachings)
No Mas Tequila Shooters
No Shots Ever - you could actually die of alcohol poisoning. My husband and I run with a tequila loving crowd of friends but I do not drink straight tequila (or any alcohol shots), even when its 2am at Sloppy Joe's in Key West, the band is rockin', someone decides we're 'all' doing shots of Don Julio and I find one in my hand. It is not tempting, because it's non-negotiable for me. This also means NO FIREBALL SHOTS - you want to hit the dance floor, not the floor. Do not cave to peer pressure. I have tossed my tequila shot over my shoulder into the crowd far behind me - no one notices, no one cares.
Super Serious Stuff...
Some bariatric post ops develop what some call a 'transfer addiction'; once bariatric surgery renders them unable to eat large volumes of food for comfort they switch to something else and that could be alcohol. If you had a pre-op food 'compulsion' and find yourself drinking much more than an occasional cocktail, please seek therapy and get help. There is no shame in therapy. Transfer addictions seem real for some and I do not minimize the impact for those who destroy their own lives.
FYI: In 2012, a study in JAMA Surgery found a small increase in alcohol use disorders for patients after gastric bypass, but no evidence of higher rates after lap banding. Unlike gastric bypass or sleeve, banding does not permanently alter the design of the stomach. The difference between the two types of surgeries suggests that alcohol abuse is related to structural changes from gastric bypass or sleeve. The study also found no increase in patient's use of other drugs, including cigarettes, or compulsive behaviors such as gambling. The study concluded that if it were an 'addiction transfer', it would been seen across the board in all bariatric procedures.
Be very aware that the same emotional issues leading some to morbid obesity is what leads others to drink - once eating is not an option, drinking may provide a similar outlet. We know it was never the food, so please, if you switch to alcohol... tell us, call someone... please get help.
For Those Without Issues, CU@Happy Hour
I stick up for responsible post op use of alcohol. Most of us can enjoy an occasional drink without incident - much like in non bariatric life. I do not think that because a small percentage of folks have a problem with alcohol that the rest of us can't have a cocktail. I have taken criticism for my stand on alcohol, even though I have never hidden the fact that I do drink socially. To grandstand about alcohol being bad and take the position that no one should drink after bariatric surgery would be ignorant as to how people function. People party, people drink, people celebrate - we can make believe they don't, or we can discuss safe choices.
Before my bariatric surgery in 2001, I lived a very social lifestyle that included alcohol. My husband and I are 'cocktails and dinner' kind of people and end our week by heading to Happy Hour on Friday afternoon. I am a responsible and experienced drinker but even so I once made a mistake at a party that got me horribly drunk. Know what is in your glass and make sure you can trust the people you're with in case something goes wrong. Never drink and drive. These are the same warnings that apply whether or not someone has had bariatric surgery.
NO FROZEN MARGARITAS
Frozen Margaritas can have 50 to 100 grams of sugar in them. Frozen Strawberry Margaritas and Pina Coladas are even higher. Generally frozen fruity drinks are a huge NO for people who have had obesity surgery. Take note that the 'Real Housewives' on BRAVO order vodka and soda. I choose flavored vodka over lots of ice in a tall glass filled with club soda OR WATER and a big squeeze of lime. The ice deflates almost all carbonation in the soda water. This concoction has fewer than 100 calories and there is zero sugar. Sip slowly. Ditto for wine, tall glass with lots of ice and dilute it with club soda.
Make a rule: 2 Drink Max
Make a standing rule for yourself that at no time will you ever have more than 2 drinks. We really cant handle more than that - our surgery has changed our anatomy.
Are They Still Called Shirley Temples?
If you have made the decision that you are not going to drink alcohol, walk proudly with your San Pellegrino Water in a Glass with a Maraschino Cherry - walking around a party without a glass is an invitation to well-meaning friends asking repeatedly about your not drinking and them wanting to 'get you a drink'. If you drink regular water in a wine glass no one will question you. The cherry identifies it as a cocktail and is festive. No one cares what you are drinking, as long as you are drinking something. Don't feel pressured - this is not 8th grade - stand down anyone who questions you.