O062
Postoperative evolution of the addictive pattern in patients with obesity undergoing bariatric surgery.
M. Menendez Munoz 1,*, M. B. POMAR 2, A. S. GARCÍA 1, C. F. PATO 1
1Psychiatry, 2Endocrinology and Nutrition, COMPLEJO ASISTENCIAL UNIVERSITARIO DE LEÓN, LEÓN, Spain
Introduction: Bariatric surgery is effective for morbid obesity, though it may be associated with mental health changes and increased substance use. This study analyzes changes in the use of addictive substances and medications before and after surgery, considering age, sex, and psychiatric history.
Objectives: To assess the progression of addictive behaviors in patients undergoing bariatric surgery.
- To determine whether patients consume more abuse-prone prescription drugs (opioids, benzodiazepines, or others) before or after the intervention.
Methods: A retrospective study was conducted on 126 patients who underwent surgery between 2014 and 2022. Data on demographics and the use of abuse-prone prescription drugs (such as opioids, benzodiazepines, and others) were collected before and after the intervention. Statistical analyses included chi² and McNemar tests. Measures of risk were calculated. Statistical analysis and figures were performed using Julius.ai. A p-value < 0.05 was considered statistically significant.
Results: Before surgery, 62.7% of patients (79) did not use prescription drugs with abuse potential. Benzodiazepine use was 14.29% (18), opioids 7.14% (9), and combined use 7.14% (9). Data were missing for 11 patients. After surgery, only 44.44% (56) remained non-users. Benzodiazepine use decreased to 4.76% (6), opioid use rose to 33.33% (42), and combined use increased to 12.7% (16). Data were missing for 6 patients. In 114 valid pre-post pairs, the shift from non-use to use was significant (p = 0.000388), with 43.04% of pre-op non-users starting use post-op. Overall substance use rose from 30.7% to 51.75% (Figure 1). The NNH was 4.75; RR was 1.68; OR for initiation vs cessation was ~3.40.
By drug type:
Benzodiazepines dropped from 14.91% to 4.39% (70.59% reduction, p = 0.007).
Opioids rose from 7.89% to 33.33% (322.22% increase, p < 0.00001).
Combined use increased from 7.89% to 14.04% (not significant, p = 0.18).
In summary, opioid use increased significantly post-surgery while benzodiazepine use declined (Figure 2).
Image 1:
Image 2:
Conclusions: Based on the data presented, it appears that patients exhibit an addictive phenotype that migrates from food to other substances. This highlights the importance of addressing addiction not merely in its individual forms, but as a broader behavioral pattern. Given that many addictions share a common neurobiological pathway—particularly involving reward, impulse control, and reinforcement mechanisms—it is essential to focus interventions on the underlying addictive process itself. A comprehensive, integrative approach to addiction may help prevent the substitution of one pathological behavior for another.
Disclosure of Interest: None Declared