From the Research
Alcohol use disorder is a relative contraindication for a bariatric operation in this patient. The patient's daily consumption of a full bottle of wine and description of periods of craving and withdrawal suggest an alcohol use disorder, which is a concern for bariatric surgery due to the potential for increased risk of alcohol abuse post-operatively 1, 2. Studies have shown that bariatric surgery can be associated with an increased prevalence of alcohol use disorder, particularly in patients who undergo gastric bypass procedures 1. Additionally, the patient's history of childhood physical abuse and current symptoms of depression may also contribute to the risk of alcohol use disorder and should be addressed through appropriate treatment and support before proceeding with surgery 3, 4, 5. A comprehensive pre-surgical psychological evaluation and medical assessment would help determine if these relative contraindications can be adequately managed to allow for safe and effective bariatric intervention.
Some key points to consider in this patient's case include:
- The patient's alcohol use disorder should be treated and managed before proceeding with bariatric surgery
- The patient's history of childhood physical abuse and current symptoms of depression should be addressed through appropriate treatment and support
- A comprehensive pre-surgical psychological evaluation and medical assessment is necessary to determine if the patient's relative contraindications can be adequately managed
- Bariatric surgery can be an effective treatment for obesity, but it is essential to carefully evaluate the patient's overall health and well-being before proceeding with surgery 1, 2.
It is crucial to prioritize the patient's morbidity, mortality, and quality of life when making decisions about bariatric surgery, and to carefully weigh the potential benefits and risks of the procedure in this patient's case.