Substance Misuse Following Roux-en-Y Gastric Bypass Surgery Posted online on October 8, 2013. (doi:10.3109/10826084.2013.841249) Summar Reslan1, Karen K Saules1, Mark K Greenwald2 and Leslie M. Schuh3 1Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA 2Department of Psychiatry and Behavioral Neurosciences, Substance Abuse Research Division, Wayne State University School of Medicine, Detroit, Michigan, USA 3Bariatric Center of Excellence, St. Vincent Carmel Hospital, Carmel, Indiana, USA
Bariatric physicians (Drs. Brenda Cacucci, David Diaz, Christopher Evanson, John Huse, Margaret Inman, and Douglas Kaderabek) at the St. Vincent Bariatric Center of Excellence allowed access to patient records, and Katharine Hudson contacted potential subjects to inquire about their willingness to participate in this investigation. A poster based on the findings of this study was presented at The Obesity Society’s 2012 Annual Scientific Meeting.
Address correspondence to Mrs Summar Reslan MS, Department of Psychology, Eastern Michigan University, 611 West Cross Street, Ypsilanti, MI 48197, USA; E-mail: firstname.lastname@example.org.
Post-bariatric surgery patients are overrepresented in substance abuse treatment, particularly those who have had the Roux-en-Y gastric bypass (RYGB) procedure. The severity of the substance use disorder (SUD; i.e., warranting inpatient treatment) and related consequences necessitate a better understanding of the variables associated with post-RYGB SUDs. This investigation assessed factors associated with post-RYGB substance misuse. Post-RYGB patients (N = 141; at least 24 months postsurgery) completed an online survey assessing variables hypothesized to contribute to post-RYGB SUDs. Fourteen percent of participants met criteria for postoperative substance misuse. Those with a lower percent total weight loss (%TWL) were more likely to endorse substance misuse. Family history of substance misuse was strongly associated with postoperative substance misuse. Eating-related variables including presurgical food addiction and postsurgical nocturnal eating, subjective hunger, and environmental responsiveness to food cues were also associated with a probable postoperative SUD. These findings have clinical utility in that family history of substance misuse can be easily assessed, and at-risk patients can be advised accordingly. In addition, those who endorse post-RYGB substance misuse appear to have stronger cognitive and behavioral responses to food, providing some support for the theory of behavioral substitution (or “addiction transfer”).