WHY ARE POST-BARIATRIC PATIENTS IN SUBSTANCE ABUSE TREATMENT?
PATIENTS’ PERCEPTIONS OF ETIOLOGY AND FUTURE RECOMMENDATIONS
“I didn’t see this
coming…”
Valentina Ivezaj¹, M.S., Karen K. Saules¹, Ph.D., Ashley Wiedemann¹, B.S., Daniel Wood¹, B.S.,
John A. Hopper2, M.D., Joyce Foster-Hartsfield3, M.D, & Anne Eshelman4, Ph.D.
Eastern Michigan University¹, St. Joseph Mercy Hospital2, Brighton Hospital3, Henry Ford Hospital4
Contact: vivezaj@emich.edu
Representative Sample (n = 14) of Trajectories of Substance Abuse Development Relative to Bariatric Surgery
Introduction
Recent evidence suggests that post-bariatric surgery
patients are overrepresented in substance abuse
treatment programs (Saules et al., in press). Little is
known, however, about why this phenomenon is
occurring. The goal of the present study was to gain a
better understanding of the onset of substance abuse
relative to the timing of bariatric surgery through the
perceptions of post-bariatric patients struggling with this
issue.
Method
Twenty patients in Brighton Hospital’s comprehensive
substance abuse treatment program participated in the
present study. Participants were asked to complete two
phases, namely a semi-structured interview and a
questionnaire packet. Qualitative interview data were
used to evaluate participants’ perceptions of the etiology
of their substance abuse problems and
their
recommendations for treatment providers working with
bariatric patients.
AGE
10
15
20
F
25
30
M
A
45
50
X
X
P
X
P
A
D
F
55
P
A
X A
A
P X A
A
D
X
F
X
A
D
P
F
X P
F
X P A P
F
X
P
M
X
F
F
60
A
A
F
F
40
P X P
F
F
35
A
X
A
A
A P
A
X A
A = Alcohol D = Drugs P = Pain Medications
X = Bariatric Surgery
Red = Problematic Use
THEMES REGARDING ETIOLOGY OF SUBSTANCE
ABUSE DEVELOPMENT
THEMES REGARDING FUTURE RECOMMENDATIONS
Counseling Pre-Post Surgery (55%)
“People need to have therapy while they are losing weight
because it is such a big transition. Just getting on a scale is
stressful, whether you lose weight or not.”
Unresolved Psychological Problems (75%)
“After losing weight, I was still left with issues. It was a roller-coaster
Increasing Knowledge Regarding Associated Risks
The sample consisted primarily of Caucasian (88.2%)
of emotions…I was a fat person in a skinny person’s body.”
of Substance Abuse Post-Surgery (70%)
women (77.8%) with a mean age (± SD) of 43.83 (±
“There should be required readings, or readings
10.50), mean BMI (± SD) of 31.85 (± 7.20), mean number
Addiction Substitution (85%)
on education related to addiction.”
“I gave up love for food, and compensated that with going out and
of years since surgery (± SD) of 5.06 (± 2.58) years, and
drinking.”
mean post-surgical weight loss (± SD) of 120.83 (± 56.25)
“Honesty” of Patients and Bariatric Staff (35%)
pounds. Based on interview data, four themes emerged
“Get honest without fear of not getting surgery.”
Faster Substance Metabolism/Increased Effects (55%)
regarding substance abuse etiology and three themes
“A slam of wine felt just like a shot of heroin”
emerged
regarding
future
recommendations.
Discussion
Representative quotes of each theme are presented to
Increased Availability of Pain Medications (40%)
Implications include increased psychological treatment prethe right. In addition, representative trajectories of
“Pain pills seemed safe and innocent…I began to act the part of a and post-surgery , with a particular focus on navigating
substance abuse development relative to bariatric
patient who was in pain in order to get more pills.”
identity shifts, and increased education related to substance
surgery are depicted.
abuse risks post-bariatric surgery.
Results