Problematic intake of high-sugar/low-fat and high glycemic index foods by bariatric patients is associated with development of post-surgical new onset substance use disorders

• New Onset Substance Use Disorder (SUD) can emerge after weight-loss surgery (WLS).
• New Onset SUD is predicted by pre-WLS problems with high-sugar/low-fat foods.
• New Onset SUD is predicted by pre-WLS problems with high glycemic index foods.
• Results support the possibility of “addiction transfer” after WLS.

Bariatric or weight loss surgery (WLS) patients are overrepresented in substance abuse treatment, constituting about 3% of admissions; about 2/3 of such patients deny problematic substance use prior to WLS. It is important to advance our understanding of the emergence of substance use disorders (SUDs) – particularly the New Onset variant – after WLS. Burgeoning research with both animal models and humans suggests that “food addiction” may play a role in certain forms of obesity, with particular risk conferred by foods high in sugar but low in fat. Therefore, we hypothesized that WLS patients who reported pre-WLS problems with High-Sugar/Low-Fat foods and those high on the glycemic index (GI) would be those most likely to evidence New Onset SUDs after surgery. Secondary data analyses were conducted using a de-identified database from 154 bariatric surgery patients (88% female, Mage = 48.7 yrs, SD = 10.8, Mtime since surgery = 2.7 yrs, SD = 2.2 yrs). Participants who endorsed pre-surgical problems with High-Sugar/Low-Fat foods and High GI foods were at greater risk for New Onset SUD in the post-surgical period. These findings remained significant after controlling for other predictors of post-surgical SUD. Our findings provide evidence for the possibility of addiction transfer among certain bariatric patients.