Key result
Roux-en-Y bypass is linked to a ~69% higher risk of new alcohol-related diagnoses versus sleeve gastrectomy.
Why the study?
Bariatric surgery may increase the risk of alcohol use disorder, but whether Roux-en-Y gastric bypass confers higher rates than sleeve gastrectomy was unclear.
Does Roux-en-Y gastric bypass increase the risk of alcohol use disorder compared to sleeve gastrectomy in patients undergoing bariatric surgery?
Cohort (n=17,800)
Yes
Does Roux-en-Y gastric bypass increase the risk of alcohol use disorder compared to sleeve gastrectomy in patients undergoing bariatric surgery?
Roux-en-Y gastric bypass is associated with a significantly higher risk of developing alcohol use disorders compared to sleeve gastrectomy, which in turn is linked to increased morbidity and mortality.
May support enhanced alcohol surveillance after RYGB vs SG; leaves open whether this alters bariatric procedure choice.
Background Bariatric surgery provides notable weight loss and metabolic benefits but may also increase the risk of alcohol use disorder (AUD). We investigated whether Roux-en-Y gastric bypass (RYGB) confers higher rates of AUD and related disorders than sleeve gastrectomy (SG) and examined associated morbidity and mortality. Methods We conducted a retrospective, population-based cohort study using data from the Norwegian Patient Registry and the Norwegian Prescription Database. A total of 17,800 patients underwent RYGB ( n = 12,244) or SG ( n = 5556) between 2008 and 2018. Patients with prior diagnoses related to alcohol or use of medications for AUD were excluded. Incidence rates (IR) for alcohol-related diagnoses were calculated per 1000 person-years; hazard ratios (HR) were derived comparing RYGB to SG. Morbidity was measured as number of specialized healthcare contacts, but also as number of prescriptions/defined daily doses in an exploratory model. Results Mean postoperative follow-up was 5.7 years (RYGB) and 3.8 years (SG). By 31 December 2018, 576 patients (3.2%) had developed a new alcohol-related diagnosis – an incidence rate of 6.34 per 1000 person-years. The adjusted HR for such diagnoses was 1.69 (95% CI 1.33–2.13, p < 0.001) for patients undergoing RYGB compared to SG. Because mortality did not differ significantly between RYGB and SG, mortality was assessed for the cohort as a whole: patients with alcohol-related diagnoses had an adjusted HR for death of 2.08 (95% CI 1.40–3.08) relative to those without. They also recorded, on average, 5.5 additional contacts in specialist care. Conclusions Compared with SG, RYGB was associated with a 69% higher risk of alcohol-related diagnoses. Further, given the elevated morbidity and mortality linked to these disorders, enhanced preoperative screening and long-term postoperative monitoring are warranted in modern bariatric practice.
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Strømmen et al. (2026) conducted a cohort in Obesity (post-bariatric surgery) (n=17,800). Roux-en-Y gastric bypass (RYGB) vs. Sleeve gastrectomy (SG) was evaluated on New onset alcohol-related diagnosis (incidence rate per 1000 person-years) (HR 1.69, 95% CI 1.33-2.13, p=<0.001). Compared with sleeve gastrectomy, Roux-en-Y gastric bypass was associated with a 69% higher risk of new onset alcohol-related diagnoses (HR 1.69).
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