A large body of studies indicate an increase in alcohol use disorder (AUD) rates after bariatric surgery. However, little information exists on the evolution of other drinking patterns after surgery and the psychological predictors of problematic drinking postoperatively. The identification of these factors is necessary for the implementation of prevention strategies regarding postoperative problematic alcohol use. The aim of this research is to examine the evolution of various drinking patterns after bariatric surgery as well as the psychological factors associated with AUD and an increase in postoperative alcohol consumption.
Obesity affects 15.9% of the Belgian population and remains a difficult disease to treat with traditional weight loss interventions. Its high prevalence and the negative consequences it entails make it a public health concern. Bariatric surgery is associated with long-term weight loss and an improvement in obesity-related comorbidities. However, despite its success in achieving significant and lasting weight loss, numerous studies raise the emergence of unpleasant psychosocial problems after the operation, including an increase of regular alcohol consumption and prevalence of AUD. Some of these studies are longitudinal and include large samples. For example, in a prospective multicenter study, King et al., (2017) found that more than 20% of patients with a bariatric surgery present symptoms of AUD within five years after surgery. Moreover, some studies suggest that, among patients with postoperative AUD, some had never suffered from alcohol problems before surgery. Given the severe negative consequences of AUD for the individuals who suffer from it, their family and the society, better understanding the factors involved in postoperative alcohol use problems is necessary. However, little is known about predictors of post-bariatric surgery AUD. Known risk factors are: male gender, smoking, regular alcohol consumption before surgery, younger age, recreational drug use, lower sense of belonging and ADHD symptoms. Information is lacking about the psychological risk factors for postoperative AUD and regarding the evolution of problematic drinking patterns other than AUD after surgery. Given the previously cited gaps in the scientific literature, the present research's aims are to study the evolution of different drinking patterns after bariatric surgery as well as the psychological factors associated with AUD and increased alcohol consumption postoperatively.
Study Type
OBSERVATIONAL
Enrollment
350
Participants whose application for bariatric surgery was accepted, regardless of the type of surgical intervention (e.g., sleeve gastrectomy, Roux-en-Y Gastric Bypass). This longitudinal study includes five measurement times: before surgery and then, 6 months, one year, one and a half years and two years after surgery. At each measurement time, participants are asked to respond to a set of online questionnaires. Responses are anonymous.
Centre Hospitalier Interrégional Edith Cavell - site Delta
Auderghem, Belgium
RECRUITINGGrand Hôpital de Charleroi
Charleroi, Belgium
RECRUITINGCentre Hospitalier Universitaire de Liège
Liège, Belgium
RECRUITINGCentre Hospitalier Universitaire CHU UCL Namur - site Sainte-Elisabeth
Namur, Belgium
RECRUITINGAlcohol consumption and alcohol use disorder
Alcohol consumption and presence of alcohol use disorder assessed using the Alcohol Use Disorders Identification Test (AUDIT). Scores on the AUDIT range from 0 to 40, with higher scores indicating more problematic alcohol use.
Time frame: Before bariatric surgery and 6 months, one year, one and a half years and two years after surgery.
Binge drinking
Frequency of binge drinking as evaluated by a three item questionnaire.
Time frame: Before bariatric surgery and 6 months, one year, one and a half years and two years after surgery.
Alcohol Intoxication
Frequency of alcohol intoxication assessed by a single item.
Time frame: Before bariatric surgery and 6 months, one year, one and a half years and two years after surgery.
Antecedents of alcohol use problems
Assessment of the lifetime presence of alcohol problems using the CAGE questionnaire (CAGE as an acronym for "Cut down drinking", "Annoyed by criticism", "Guilty feelings" and "Eye-opener").This questionnaire is made up of 4 items to which participants can respond on a binary scale ("yes" or "no"). Two or more "yes" answers indicate an alcohol abuse problem.
Time frame: Before surgery only.
Drinking Motives
Assessment of reasons for consuming alcohol using the Drinking Motives Questionnaire - Revised Short Form. This questionnaire is composed of 12 items and 4 subscales assessing four types of motivation to drink. Scores on each of the subscales range from 3 to 9, with higher scores indicating more motivations to drink.
Time frame: Before bariatric surgery and 6 months, one year, one and a half years and two years after surgery.
Sensitivity to alcohol
Single-question assessment of the extent to which participants perceive a change in their response to alcohol following bariatric surgery.
Time frame: At 6 months and one year after surgery.
Binge eating
Assessment of binge eating behaviors using the Binge Eating Scale. Scores on this scale range from 0 to 46, with a higher score indicating a higher levels of binge eating. A score greater than or equal to 18 on this scale indicates binge eating disorder.
Time frame: Before bariatric surgery and one and two years post-surgery.
Emotional eating
Assessment of emotional eating through the "emotional eating" subscale of the Dutch Eating Behavior Questionnaire. Scores on this subscale range from 13 to 65, with higher scores indicating a greater tendency toward emotional eating.
Time frame: Before bariatric surgery and one and two years post-surgery.
Grazing
Assessment of grazing behaviors through a single question.
Time frame: Before bariatric surgery and one and two years post-surgery.
Emotion regulation
Assessment of emotional regulation using the Difficulties in Emotion Regulation Scale. It includes 6 subscales (i.e., nonacceptance of emotional responses, difficulty engaging in goal-directed behavior, impulse control difficulties, lack of emotional awareness, limited access to emotion regulation strategies and lack of emotional clarity). A total score is calculated as well as scores for each subscale. Higher scores suggest higher levels of emotional regulation deficits.
Time frame: Before bariatric surgery and one and two years post-surgery.
Experiential Avoidance
Assessment of experiential avoidance using the Brief Experiential Avoidance Questionnaire. Scores on this scale range from 15 to 90, with higher scores indicating higher levels of experiential avoidance.
Time frame: Before bariatric surgery and one and two years post-surgery.
Impulsivity
Assessment of impulsivity through a short version of the UPPS-P Impulsive Behavior Scale. This scale includes 5 subscales: negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking. Higher scores on these subscales indicate higher levels of impulsivity.
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Time frame: Before bariatric surgery and one year post-surgery.
Anxiety
Assessment of anxiety using the "Anxiety" subscale of the Hospital Anxiety and Depression Scale.This subscale has 7 items. Scores vary between 0 and 21. A score greater than or equal to 8 is an indicator of anxiety.
Time frame: Before bariatric surgery and 6 months, one year, one and a half years and two years after surgery.
Depression
Assessment of depressive symptoms using the "Depression" subscale of the Hospital Anxiety and Depression Scale.This subscale has 7 items. Scores vary between 0 and 21. A score greater than or equal to 8 is an indicator of depressive symptoms.
Time frame: Before bariatric surgery and 6 months, one year, one and a half years and two years after surgery.