Resumen
Objetivo: Verificar la relación entre el alcoholismo en pacientes post-bariátricos, sus implicaciones y factores de riesgo. Métodos: Se realizó una revisión integrativa de la literatura mediante búsquedas en las bases de datos LILACS, PUBMED y LIVIVO, utilizando los descriptores “alcoholism” y “bariatric surgery”, en artículos publicados entre 2014 y 2024, en portugués e inglés. Se seleccionaron trece artículos que analizaron los cambios en el patrón de consumo de alcohol después de la cirugía bariátrica. Resultados: El análisis reveló que el 61,53% de los estudios reportaron un aumento en el consumo de alcohol en el postoperatorio, el 46,15% señalaron un aumento en la sensibilidad al alcohol, el 15,38% observaron una disminución en el consumo y el 7,69% presentaron datos inconclusos. La técnica de Bypass Gástrico en Y de Roux (BGYR) fue la más asociada con el aumento en el consumo de alcohol. Los principales factores de riesgo identificados fueron: antecedentes de consumo de alcohol, trastornos mentales, sexo masculino y factores familiares. Consideraciones finales: La relación entre la cirugía bariátrica y el alcoholismo es compleja y multifactorial, requiriendo un seguimiento psicológico y médico a largo plazo. Se refuerza la necesidad de realizar estudios adicionales a largo plazo, con metodologías variadas, para una mejor comprensión del fenómeno y el desarrollo de estrategias de prevención e intervención.
Referencias
ALVARADO-TAPIAS E, et al. Bariatric surgery is associated with alcohol-related liver disease and psychiatric disorders associated with AUD. Obesity surgery, 2023; 33: 1494-1505.
ASMBS. AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY. Estimate of Bariatric Surgery Numbers. ASMBS.ORG, 2024. Disponível em: https ://asmbs.org/resources/estimateof-bariatric-surgery-numbers/. Acesso em 20 set. 2024.
BRIEGLEB M e HANAK C. Gastric bypass and alcohol use: a literature review. Psychiatria Danubina, 2020; 32: 176-179.
EISENBERG D, et al. American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) indications for metabolic and bariatric surgery, 2022.
ENGEL SG, et al. The rewarding effects of alcohol after bariatric surgery: do they change and are they associated with pharmacokinetic changes?. Surgery for Obesity and Related Diseases, 2022; 18: 190-195.
GREGÓRIO F, et al. O padrão de consumo de álcool é alterado após a cirurgia bariátrica? Uma revisão integrativa. Revista ABCD: Arquivos Brasileiros de Cirurgia Digestiva, 2018; 31(4): 1404.
IVEZAJ V, et al. Changes in Alcohol Use after Metabolic and Bariatric Surgery: Predictors and Mechanisms. Curr Psychiatry Reports, 2019; 21: 1-9.
KENKRE JS, et al. Alcohol misuse post metabolic and bariatric surgery: a systematic review of longer-term studies with focus on new onset alcohol use disorder and differences between surgery types. Current obesity reports, 2024; 13: 596-616.
KING WC, et al. Alcohol and other substance use after bariatric surgery: prospective evidence from a US multicenter cohort study. Surgery for Obesity and Related Diseases, 2017; 13: 1392-1402.
LUPPINO FS. et al. Overweight, obesity, and depression: a systematic review and metaanalysis of longitudinal studies. Archives of general psychiatry, 2010; 67(3): 220-229.
MELLINGER JL, et al. Bariatric surgery and the risk of alcohol‐related cirrhosis and alcohol misuse. Liver International, 2021; 41: 1012-1019.
MURRAY CJL, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The lancet, 2020; 396(10258): 1223-1249.
RIEDEL O, et al. Alcohol use disorders after bariatric surgery: a study using linked health claims and survey data. International Journal of Obesity, 2024; 48: 1656-1663.
SCHAUER PR. et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. New England Journal of Medicine, 2014; 370(21): 2002-2013.
SMITH KE, et al. Problematic alcohol use and associated characteristics following bariatric surgery. Obesity surgery, 2018; 28: 1248-1254.
SBCBM. SOCIEDADE BRASILEIRA DE CIRURGIA BARIÁTRICA E METABÓLICA. Doenças associadas. Sbcbm.Org, 2017. Disponível em: https ://www.sbcbm.org.br/doencas-associadas/. Acesso em set. 2024.
SBCBM. SOCIEDADE BRASILEIRA DE CIRURGIA BARIÁTRICA E METABÓLICA (SBCBM). SBCBM divulgadados sobre cirurgia bariátrica no Dia Nacional de Combate à Obesidade. SBCBM.ORG, 2023. Disponível em :https ://www.sbcbm.org.br/sbcbm-divulga-dados-sobre-cirurgia-bariatrica-no-dianacional-de- combate-obesidade/. Acesso em 20 set. 2024.
SOUSA MNA e SANTOS EVL. Medicina e Pesquisa: um Elo Possível. Curitiba: Editora Prismas, 2016.
SPADOLA CE, et al. Alcohol and drug use among postoperative bariatric patients: a systematic review of the emerging research and its implications. Alcoholism: Clinical and Experimental Research, 2015; 39: 1582-1601.
TAE B, et al. O impacto da cirurgia bariátrica nos sintomas depressivos e ansiosos, comportamento bulímico e na qualidade de vida. Revista do Colégio Brasileiro de Cirurgiões, 2014; 41: 155-160.
WHITE GE, et al. A prospective cohort of alcohol use and alcohol-related problems before and after metabolic and bariatric surgery in adolescents. Annals of surgery, 2023; 278: 519-525.
WHO. WORLD HEALTH ORGANIZATION. Global status report on alcohol and health 2018. WHO, 2018. Disponível em: https ://iris.who.int/bitstream/handle/10665/274603/9789241565639-eng.pdf?ua=1. Acess o em 20 set. 2024.
WHO. WORLD HEALTH ORGANIZATION. Obesity and Overweight. WHO, 2024. Disponível em: https ://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Acesso em 20 set.2024.
