Meta-analysisindependent cross-checkabstract checked I-BAR-130 standard review

Meta-analysis: new alcohol problems after surgery

Rates of de novo alcohol use disorder and de novo high-risk alcohol use after bariatric surgery: a systematic review and meta-analysis.

Overview

Cheloff et al.. Surg Obes Relat Dis 2026 · PMID 42191444 · DOI 10.1016/j.soard.2026.03.030

About 2.5 in 100 developed new alcohol problems; the increase was clear after bypass but uncertain after sleeve.

Does the study support the specific claim? Partly · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: De novo AUD after MBS
How was the study done?: Meta-analysis
How many people, animals or samples were studied?: 934,824
What was actually found?: 2.49% overall
How large was the observed effect?: RYGB OR 1.81
What do the results mean in everyday life?: Alcohol risk mainly after bypass
What are the study's limitations?: Heterogeneous
What does it say about Elawady's specific claim?: Partly supports
Do the results apply to Germany and Europe?: Applicable
What can explicitly not be concluded from this study?: Sleeve-specific risk

What are the rates of de novo alcohol use disorder or high-risk alcohol use after bariatric surgery, and do they differ between RYGB and SG?

Exposure / intervention: MBS (RYGB, SG, others)
Comparator: Pre-surgery; between procedures
Endpoints: De novo AUD / high-risk alcohol use
Statistical methods: Pooled event rates; meta-regression; GRADE and Newcastle-Ottawa

Results: De novo AUD/high-risk use 2.49% (2.34-2.65) after any MBS; RYGB 1.48% vs SG 0.77% (differences not significant in direct comparisons). Odds increased post-surgery for RYGB (OR 1.81, 1.06-3.08) but not for SG (OR 0.67, 0.14-3.08) or other surgery.
Absolute risks: About 2.5 in 100 developed de novo AUD/high-risk alcohol use.
Authors' conclusion: De novo AUD and high-risk use appear to increase after both RYGB and SG, with no clear difference; interpretation limited.

SG pre-post OR 0.67 with very wide CI - inconclusive, not evidence of no effect.

Confirms alcohol problems after surgery but shows the evidence for sleeve specifically is weaker than for bypass.

International.

Mixed: supports general claim, uncertain for sleeve.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	low
Directness	direct
Reproducibility	partly replicated
Consistency with the overall evidence	mixed
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable

Sleeve-specific AUD risk.