The correct answer is B. Overall, 18 observational studies with sample sizes ranging from 50 patients to >4000 patients, indicate that bariatric surgery is associated with an increased risk of alcohol and substance use disorders compared with usual care. Some proposed mechanisms include: pharmacokinetic studies showing higher peak blood alcohol concentrations after RYGB compared with controls, changes in reward sensitivity, changes to the ghrelin system, and altered genetic expression in some regions of the brain.

Publication reference : Courcoulas A et al. Long term outcomes of metabolic/bariatric surgery in adults. BMJ 2023 Dec 18:383:e071027
Reference URL: https://pubmed.ncbi.nlm.nih.gov/38110235/