SAN FRANCISCO -- People who had obesity surgery got drunk after just one glass of wine, researchers reported in a small study that was inspired by an episode on "The Oprah Winfrey Show." For those who have had the operation, one drink may be too many, the lead researcher warned.
While some experts took issue with the study's size and methodology, they said it basically confirmed what they had suspected for some time: People who have gastric bypass surgery have a heightened sensitivity to alcohol.
"A lot of people think they can have one glass of wine and be OK," said Dr. John Morton, assistant professor of surgery at Stanford University Medical Center, who is the study's lead author. "The concern here is they really can't."
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The findings, presented Thursday at a meeting of bariatric surgeons in San Diego, highlight an important warning for gastric bypass patients: "Never have more than a couple of glasses in a single sitting, and don't drive afterward," Morton said.
Gastric bypass, or stomach stapling surgery, involves reducing the size of the stomach and bypassing part of the small intestine. People eat less and absorb fewer calories after surgery.
About 177,600 people underwent the procedure in the United States last year, making it the most common obesity operation performed in the country.
Morton, who has performed more than
1,000 gastric bypass surgeries, said he routinely warned his patients about alcohol, but it wasn't until Winfrey discussed the issue on an episode about the procedure that patients really took notice.
Questions poured in after the episode, but Morton couldn't find all the answers.
"I didn't find a whole lot in the literature, so that prompted the study," he said.
Morton and his research team gave 36 men and women -- 19 who had gastric bypass surgery and 17 control patients -- five ounces of red wine each to consume in 15 minutes. Using a breathalyzer, they had their alcohol level measured every five minutes until it returned to zero.
More than 70 percent of the gastric bypass patients reached a blood-alcohol level of 0.08 percent, which qualifies as legally intoxicated in California. Two gastric bypass patients had levels above 0.15, Morton said.
By contrast, most of the control group had levels below 0.05 percent, the study reported.
Researchers also found that gastric bypass patients took longer to sober up. After matching both groups for age, gender and weight, they found the patients took 108 minutes on average to return to a blood-alcohol level of zero, based on the breathalyzer test, versus 72 minutes for control subjects.
Morton said gastric bypass patients don't produce as much of an enzyme that breaks down alcohol because their stomachs are smaller. The alcohol also passes to their small intestine faster, speeding up absorption, he said.
Meg Semrau, a nurse coordinator of Stanford's bariatric program who had gastric bypass surgery herself more than three years ago, said she noticed her tolerance for alcohol had decreased after surgery.
"I literally feel it within a couple of sips now," she said. "Flushing in the face, a kind of disequilibrium."
Morton said his results are consistent with a similar study involving 11 patients five years ago that measured alcohol tolerance in gastric bypass patients using blood tests.
"It's a nice documentation by breathalyzer of what we've known for years by blood alcohol tests," said Dr. Neil Hutcher, past president of the American Society for Bariatric Surgery.
Dr. Madelyn Fernstrom, director of the weight management center at the University of Pittsburgh Medical Center, said Morton's results support alcohol warnings normally given to gastric bypass patients, but she called the consumption of five ounces of red wine in 15 minutes an "artificial" test. No one -- let alone bariatric surgery patients -- would be advised to drink that amount of alcohol so quickly, she said.
Still, patients are discouraged from drinking alcohol because it is a "waste of calories," Fernstrom said.
"Alcohol is not part of a healthful diet for gastric bypass surgery patients," she said. "If this is a pleasant part of life to certain people on special occasions, it must be monitored and discussed with their surgeon."
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