Substance Use and Bariatric Surgery: Alcohol, Tobacco and Drugs

Five clear drinks and fruit in wine glasses on a bar

Bariatric surgery is not a quick fix, but requires long-term changes for long-term success.

A new, healthier lifestyle combines improved nutrition and exercise and may require you to reduce or eliminate your use of alcohol or other substances to prevent weight regain and other health issues.

But don’t worry, the Penn Medicine Bariatric and Weight Loss Surgery Program is here to help no matter where you are along your weight loss surgery journey. 

Here’s what you need to know about alcohol, tobacco, marijuana and other substance use before and after bariatric surgery.

Alcohol Use and Weight Loss Surgery

If you’re considering bariatric surgery, you may have questions about whether you can consume alcohol before and after weight loss surgery. While it’s possible to drink alcohol safely with modifications, there are risks.

Alcohol use after bariatric surgery can lead to liver damage, dehydration, malnutrition, ulcers, and weight regain.

Most people are more sensitive to the effects of alcohol after weight loss surgery.

"Alcohol is absorbed quickly and takes longer to break down for many people who have had surgery," said Samantha Warner-Grimsley, registered nurse with Penn Bariatrics. "This may put you at increased risk of developing a problem with your drinking."

If you regularly drink alcohol, you will be asked to begin to reduce your alcohol intake when you begin Medical Weight Management. Your bariatric surgery team will ask you to quit drinking alcohol at least two weeks before your surgery to minimize risk of the operation, including drug interactions. Certain insurances may require longer.

You should not drink any alcohol for at least six months after having bariatric surgery to allow time for healing and adjusting to your smaller stomach. Many drinks with alcohol are high in calories and can lead to reduced inhibition and eating more than intended. So, we strongly recommend that you not drink alcohol long-term after surgery.

Smoking and Tobacco Use and Weight Loss Surgery

Tobacco and other inhaled substance use in the months before surgery increases the risk of death during bariatric surgery. It also makes it more likely that ulcers or infection will develop during surgical recovery.

If you smoke cigarettes or use any tobacco products — including e-cigarettes or hookah — you will be asked to quit at least two months before the surgery and pass a urine test. Your team will connect you with programs and tools to help you work toward reducing and abstaining from smoking.

We strongly recommend that you not restart tobacco use after the surgery because of the increased risk of developing cancer or cardiovascular disease.

Marijuana and Other Substance Use and Weight Loss Surgery

Substance abuse — the use of recreational drugs or abuse of prescription drugs — may also increase the risk of experiencing complications after weight loss surgery, including heart attack and stroke. If you have used recreational drugs or abused prescription medication at least twice per month, you will be asked to stop all misuse of these substances for at least six months before your surgery. We will connect you with programs and tools to help. You also will be required to pass a drug screening before your surgery.

If you have used recreational drugs or abused prescription medications one time per month or less within the past year, you will be required to pass a drug screening before your surgery.

If you are currently prescribed opioids or cannabis (marijuana) for a medical purpose, the bariatric surgery team recommends using a non-inhaled form. We will require a copy of your prescription from your doctor.

We strongly recommend that you not restart substance abuse after surgery.

Your Safety is Most Important

Our policies are designed to help us provide you the safest possible care. We ask that all patients participate in this goal of safety by being honest with us.

Please discuss any questions or concerns that you may have regarding our recommendations for alcohol, tobacco, and substance use with your bariatric surgery team.

About this Blog

Learn about bariatric surgery and get the support you need to continue on your weight-loss journey. We offer workouts, recipes and tips from Bariatric Surgery program team members, and stories from patients like you.

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