Impact of Alcoholism on the Indication for Bariatric Surgery and Pharmacological Clinical Treatments for Obesity

Introduction: Obesity and alcoholism are major public health problems with complex interactions in clinical management. Alcohol use disorder may influence eligibility for bariatric surgery and adherence to pharmacological treatments for obesity. Objective: To systematically review the impact of alcoholism on the indication for bariatric surgery and on the outcomes of pharmacological clinical treatments for obesity. Secondary objectives included assessing perioperative risks, long-term metabolic outcomes, and implications for clinical decision-making. Methods: Searches were conducted in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP. Studies published in the last 5 years were included, with extension up to 10 years if fewer than 10 were eligible. PRISMA methodology was applied, and risk of bias was assessed with RoB 2, ROBINS-I, and GRADE. Results and Discussion: From 1,245 records, 27 studies were included. Alcoholism was found to increase postoperative complications, impair weight loss sustainability, and reduce adherence to pharmacological regimens. Evidence suggested that preoperative assessment of alcohol use is critical, and integrated management strategies improve outcomes. Conclusion: Alcoholism negatively impacts the safety and efficacy of bariatric surgery and pharmacological obesity treatments. Screening and integrated multidisciplinary care are essential in optimizing outcomes for this high-risk population.