Bariatric Realities – Medical Professionals’ Guidelines about Alcohol Use & WLS

[Connie Stapleton PhD 342]

@@SweetPeas

Glad to hear that mayo is giving a consistent message. And glad that it's not overbearing. My point is not about being absolute or overbearing... it's specifically related to the bariatric professionals who are the "leaders of the pack." My position is that this governing body needs to have a more definite RECOMMENDATION, based on the fact that alcohol is a toxin that can have deleterious effects on the absorption of essential nutrients, in addition to other possible negative effects.

A recommendation is different than a "thou shalt not."

Now that pizza... that's another issue all together! Take care and thank you.

[OKCPirate 5,323]

@@Connie Stapleton PhD - Thanks for the clarification. I understand the warnings and advice to abstain to maximize success. The tone just comes across like this scene from Mean Girls:

The term toxin is loaded, pejorative and a bit misleading. Tylenol is toxic. Vitamin D is too. Both can be hard on the liver and fatal in high doses. But these are acceptable risks in moderation. Alcohol is rough on the liver in high doses. It can be fatal in the most extreme cases. There are risks in sex, driving, and even walking on a treadmill, so I heed the cautions.

And to be clear, when I discuss this subject with fellow WLS people, I do share my cautions based upon my experience, research and warn of possible red flags and dangers signs to watch for. It is a danger area. Alcohol may have put me in a stall, but that's why I am abstaining for a season to test this out.

In short, I don't disagree with your message, just the words (rhetoric in the classic sense of the word). Thanks for what you do, and I do have a great deal of respect for those of you who work with people in recovery from substance abuse. It is a tough job, where you know most are not going to succeed and it is often heart breaking work, so take care of yourself too (this is a major part of my sister's work, and I always remind her "there is a reason why the airline tells you to put on your own oxygen mask before you put one on those around you, and don't forget it.").

[Babbs 14,681]

Speaking only for myself, I'd prefer an occasional glass of wine to an occasional four Cookies, hands down.I'm an adult. I'm educated and capable of educating myself about the pros and cons of alcohol intake now that I'm sleeved.I neither want or need anything beyond education on the matter from my bariatric team. Like every bite I put in my mouth and every step I take toward improved fitness, these are my responsibilities for my life, and my lifetime. I neither want nor need draconian edicts in an attempt to scare me into adherence into what anyone thinks I "must" do, or not. It's paternalistic, patronizing, and unwelcome.

I like the cut of your jib

[slvarltx 332]

Wow a mature discussion without anyone getting nasty! I concur with @@OKCPirate says about the term "toxin". At certain doses virtually anything can be termed a "toxin". In fact, there is a vast database supporting the fact that there is a therapeutic dosage of alcohol between 1-2 drinks per day that significantly extend lifespan.

Being honest, I don't normally stop at 1-2 drinks, nor do I want to drink everyday. Weirdly enough, post surgery, I enjoy stout and porter beers that are bubbly due to nitrogen rather than carbon dioxide.

Yesterday being a beautiful sunny day, and I had already been to the gym, and done all of my outdoor chores, I drank 4 guiness nitro cans in my hot tub while reading a magazine and soaking up the sun. Enjoyed the heck out of it.

[OKCPirate 5,323]

Wow a mature discussion without anyone getting nasty! I concur with @@OKCPirate says about the term "toxin". At certain doses virtually anything can be termed a "toxin". In fact, there is a vast database supporting the fact that there is a therapeutic dosage of alcohol between 1-2 drinks per day that significantly extend lifespan.

Being honest, I don't normally stop at 1-2 drinks, nor do I want to drink everyday. Weirdly enough, post surgery, I enjoy stout and porter beers that are bubbly due to nitrogen rather than carbon dioxide.

Yesterday being a beautiful sunny day, and I had already been to the gym, and done all of my outdoor chores, I drank 4 guiness nitro cans in my hot tub while reading a magazine and soaking up the sun. Enjoyed the heck out of it.

I'm glad everyone has been respectful too. Be careful with the claims in the popular press on health benefits of wine. It's actually much more complicated than "the flavonoids protects you from cancer."

Here is an interesting presentation summarizing some of the major studies: http://kisefront02.ki.se/sites/default/files/alcohol_women.pdf

The health benefit might be from one glass for women...but that ends with more than one. There is a very slight increase in morbidity as you drink more. But so little that British health officials said to effect "nothing alarming, just warn people to be careful."

The most interesting question some researchers are asking is "wine drinkers seem to be more social, and having friends seems to be more important than the wine itself."

Wine has been a medicine for 5000 years. Paul in the bible told his protege Timothy to take a little wine for his stomach. But I'm under no illusion that having a glass is going to make me healthier. Hanging around with friends and enjoying laughter might be great medicine, but that is not my motivation ...my motivation is I really enjoy it.

Enjoy life, but don't fool yourself over this, I can look at my own family and see the dangers of abuse of alcohol and drugs, but I also enjoy the relaxing properties of drinking. Just be a responsible adult and keep your eyes and mind open.

[Cape Crooner 589]

Prior to my VSG surgery, I thought alcohol might actually be the root cause of my weight problem. I now know that isn't the case.

Yes, alcohol does increase hunger and that puts me in a dangerous place, but as someone who only drinks vodka, whiskey, or red wine a few times a week, the empty 200-300 calories in a couple of drinks wasn't the problem.

My problem was misinformation about what was the right food to eat and what was causing me to gain weight. As a 40 year Atkins dieter, I would munch nuts, cheese, and dark chocolate with impunity when I drank. I would also consume these on days when I didn't.

I also think some people are fine with alcohol and some are not. From my experience, some people have a drink and want more, then more, then more. They wake up hung over and want another. For these people, abstinence is the best choice.

That's not me. When I retired, I acted like I was on vacation for 4 months. I drank every evening and by the end, I was no longer enjoying it.

I find that my level of enjoyment is a direct function of how long I abstain. I also find that the more I drink, the less I want another.

I have been back to drinking post opt for the last few months. I now drink less and more importantly, I plan what I'm going to eat when I drink and all the calories.

Finally, I'm not going to claim that alcohol is "good for me". The truth is that the vessels of clay that we call our bodies die a little every day. More likely than not, alcohol, a cigar, a marbled steak, Tylenol, and 15+ minutes of direct sunshine will all speed up our bodies clocks.

That said, I have news for everyone. "None of us are getting out of here alive".

If you had wls, you already made a huge deposit of extra lifetime in your bodies clock. Sure, abstinence might help you make it to 90 or 95 and if that's important to you, abstain.

Me, I'm happy knowing that I potentially added 15-20 years through my wls. It's all relative and I'll keep drinking socially because I believe the psychological benefits outweigh the physiological costs.

But that's just me!

Edited April 3, 2016 by Cape Crooner

[VSGAnn2014 12,992]

Here is an interesting presentation summarizing some of the major studies: http://kisefront02.ki.se/sites/default/files/alcohol_women.pdf

Fascinating meta-analysis, @@OKCPirate . Thank you.

[My Bariatric Life 764]

Well Connie, it looks like you disrupted the masses. It would be much easier to post an article telling people what they want to hear. Congrats on doing the right thing by telling us the Truth instead.

More than a decade ago when I had my gastric bypass surgery, patients were led to believe that they'd be normal weight, if not thin, after weight loss surgery. I guess that falls under the realm of education and awareness that you speak of in your article. We all know what a lie that is today.

As for me, I don't drink alcohol anymore. That includes beer and wine. I haven't for years. I also don't eat processed foods, smoke cigarettes (never have), or watch TV either. It is a lifestyle. You're either in or you're out. There's no dipping your toe in the Water. Choose health or choose anti-health.

More than a decade ago, I was a processed food junkie and couch potato on ~10 prescription medications for obesity-related illnesses. In 2003 I made a decision to chose health. Had I not done so, I would not be alive today. Today I choose health. Today I choose life. Today I choose me. Here is My Story of reclaiming my life.

Climbing down from my soap box now...

[VSGAnn2014 12,992]

So watching TV is a no-no, too?

Got to add that to the list of things I'm no longer allowed to do if I "choose health."

[CowgirlJane 14,259]

Oh good grief...I am either in or out?

Sent from my SAMSUNG-SGH-I337 using the BariatricPal App

[VSGAnn2014 12,992]

Oh good grief...I am either in or out?

LOL!

Actually, this is getting pretty funny.

[beinghappy2day 6]

What about transfer adiction? That could be the case in some people. I can't drink that much. I'm 5 1/2 years post op and keeping my weight off. I do occasionally have a drink though. Cheers!

Sent from my SM-G920V using the BariatricPal App

[Connie Stapleton PhD 342]

@@OKCPirate Thank you for the very kind message. Much appreciated.

[Connie Stapleton PhD 342]

@@Babbs

I definitely agree that the bariatric team need only give patients education and information. As I keep reminding people, my issue is about the governing body of the bariatric team not making a sound medical recommendation. My point is not about being absolute or overbearing... it's specifically related to the bariatric professionals who are the "leaders of the pack." My position is that this governing body needs to have a more definite RECOMMENDATION, based on the fact that alcohol is a toxin that can have deleterious effects on the absorption of essential nutrients, in addition to other possible negative effects.

Continue making the healthiest choices for you!

[Connie Stapleton PhD 342]

@@My Bariatric Life

Wow! You have made some incredible decisions for your health! Awesome! Thanks for sharing!