S722 Alcohol-Related Outcomes in Patients With Obesity Underwent Bariatric Surgery: A Systematic Review and Meta-Analysis

Introduction: Obese patients undergoing bariatric surgery (BS) may experience an increase in alcohol consumption. However, evidence regarding alcohol-related outcomes following BS remains limited. This study aims to assess alcohol-related outcomes in the obese population who have undergone BS. Methods: Electronic searches were performed up to November 2024 focusing on studies reporting alcohol-related outcomes after BS. The control group was obese patients not receiving BS. Primary endpoint was the incidence of alcohol use disorder (AUD) before and at 1-year and 2-year after BS. Secondary endpoints were the alcohol use disorder identification test (AUDIT) score change and the amount of alcohol intake in grams per day. We performed subgroup analyses according to the type of BS including Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Data were analyzed using both random and common-effects models based on heterogeneity. Results: We analyzed data from 19 studies including 12 prospective cohort, 5 retrospective cohort and 2 cross-sectional studies totaled 225,008 bariatric patients. AUD incidence is significantly increased in BS group compared to the non-BS group with an hazard ratio of 2.81 (95% confidence interval [CI] 1.39-5.67, I2 = 88%, P < 0.01). At 1-year post-BS, AUD incidence was at 5% (95% CI 3-11%, I2 = 98%, P < 0.01). Subgroup analysis showed AUD incidence for RYGB and SG group were at 8% (95% CI 3-17%, I2 = 96%, P < 0.01) and 4% (95% CI 1-18%, I2 = 99%, P < 0.01), respectively. At 2-year post-BS, AUD incidence was at 7% (95% CI 2-19%, I2 = 98%, P < 0.01). Subgroup analysis showed AUD incidence for RYGB and SG group were at 7% (95% CI 1-30%, I2 = 95%, P < 0.01) and 4% (95% CI 0-29%, I2 = 99%, P < 0.01), respectively. The AUDIT score did not significantly change between pre- and post-BS with mean differences of 0.23 (95% CI -1.37, 1.83, I2 = 95%, P < 0.01). The mean amount of 2-year post-BS alcohol intake was 29.58 grams per day (95% CI 1.08-812.18, I2 = 100%, P < 0.01). Conclusion: The incidence of AUD has continuously risen following BS. It is crucial to enhance alcohol reduction strategies for the post-BS obese population in future guidelines.