eprintid: 28007 rev_number: 20 eprint_status: archive userid: 1684 dir: disk0/00/02/80/07 datestamp: 2017-10-17 11:36:21 lastmod: 2017-10-17 12:45:07 status_changed: 2017-10-17 11:36:21 type: article metadata_visibility: show creators_name: Yoder, Ruth creators_name: MacNeela, Padraig creators_name: Conway, Ronan creators_name: Heary, Caroline browse_creators: Yoder:Ruth:: title: How do individuals develop alcohol use disorder after bariatric surgery? A grounded theory exploration. ispublished: pub subjects: BB subjects: FE10-4-6 subjects: FN subjects: FP subjects: FR subjects: GA2-2 subjects: GC16 subjects: JM subjects: JQ6-4 subjects: JQ6-8 subjects: VH4-2 full_text_status: none abstract: BACKGROUND: Bariatric surgery is the most effective treatment for severe obesity. However, following Roux-en-Y gastric bypass (RYGB) surgery, a small minority of patients develop new-onset alcohol use disorder (AUD), the aetiology of which is poorly understood. AIM: The aim is to construct a theory to explain the development of AUD among a sample of individuals who reported problematic drinking following RYGB. METHOD: Semi-structured interviews were conducted with eight RYGB patients diagnosed with AUD attending a multi-disciplinary outpatient weight management service at a public hospital in the Republic of Ireland. A constructivist grounded theory methodology was used to analyse interview transcripts. RESULTS: Participants' main concern was identified as 'unresolved psychological issues' which were managed by 'external coping mechanisms', namely, 'eating to cope'. After RYGB, comfort eating was no longer possible to the same extent. Following a 'honeymoon period', participants' need for an external coping mechanism resurfaced. 'Filling the void' provides a framework to explain how participants managed the symptoms of their unresolved psychological issues through 'behavioural substitution', that is, drinking alcohol instead of eating. CONCLUSION: The theoretical framework of 'filling the void' adds to contemporary research that conceptualises AUD behavioural substitution as 'addiction transfer' by describing the process by which the phenomenon occurs as well as the characteristics of participants. The clinical implication of this research is to advocate for a reshaping of treatment of RYGB patients, with increased psychological input following surgery. date: 2017-10-14 date_type: published browse_by: Yoder Ruth publication: Obesity Surgery volume: Early online publisher: Springer refereed: TRUE issn: 1708-0428 related_url_url: https://link.springer.com/article/10.1007%2Fs11695-017-2936-7 related_url_type: pub request_form: display_in_all_cases doc_order_by: 1 jv_volume: Early online jv_pub: Obesity Surgery vol_subject_list: BB , FE10-4-6 , FN , FP , FR , GA2-2 , GC16 , JM , JQ6-4 , JQ6-8 , VH4-2 vol_subject_list_words: B Drugs and alcohol substances > Alcohol -- F Concepts in psychology > Skills > Coping skills -- F Concepts in psychology > Motivation -- F Concepts in psychology > Emotion -- F Concepts in psychology > Attitude and behaviour -- G Health and disease > State of health > Physical health -- G Health and disease > Drugs and alcohol disorder > Alcohol use -- J Health care, prevention and rehabilitation > Patient care management -- J Health care, prevention and rehabilitation > Care by type of problem > Medical care -- J Health care, prevention and rehabilitation > Care by type of problem > Mental health care vol_subject_list_geo_words: VA Geographic area > Europe > Ireland vol_subject_list_words_last: Alcohol -- Skills - Coping skills -- Motivation -- Emotion -- Attitude and behaviour -- State of health - Physical health -- Drugs and alcohol disorder - Alcohol use -- Patient care management -- Care by type of problem - Medical care -- Care by type of problem - Mental health care vol_subject_list_geo_words_last: Europe - Ireland ace_words: Yoder Ruth , MacNeela Padraig , Conway Ronan , Heary Caroline sticky: 0 home_hide: yes citation: Yoder, Ruth and MacNeela, Padraig and Conway, Ronan and Heary, Caroline (2017) How do individuals develop alcohol use disorder after bariatric surgery? A grounded theory exploration. Obesity Surgery , Early online .