099 Let’s Talk About Addiction with Dr James Mitchell

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In this episode we explore the topic of addiction. Much of the focus is on alcohol because as it pertains to bariatric surgery, that’s what been most significantly studied up to this point. However, as listeners will know, addiction comes in all forms and is certainly not limited to alcohol and drugs. To guide us along this discussion I called up Dr Jim Mitchell, psychiatrist turned researcher in the areas of obesity, bariatric surgery, and addiction.

But, in this episode I wanted more than clinical expertise to help us understand such a complex topic. So, I reached out to you, my listeners, to see if any of you would be willing to share your personal stories and lived experiences with addiction and you reached back. What you will hear woven throughout this conversation with Dr Mitchell are the stories you shared: tender stories, sad stories, wise stories, brave stories, human stories, of people showing up in your life every day, trying to be a healthier version of yourself. What more can any of us ask for, really?

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Discussed In This Episode:

Dr Mitchell describes his background.
What is the difference between a habit and an addiction.
Alcohol use disorder (AUD), Substance use disorder (SUD).
The false assumption that people who have bariatric surgery are addicted to food and will then switch addictions.
Is food addiction a real thing.
Margaret shares her story.
Screening tool: Yale Food Addiction Scale.
Dee Dee shares her story.
Are there healthy addictions.
Are people who are affected by obesity at increased risk for addiction compared to people not affected by obesity.
People with Binge Eating Disorder are at increased risk to gain weight.
Risk factors for developing addiction after bariatric surgery: The four big independent risk factors are male gender, younger age, smokers, and less interpersonal support.
Not drinking before bariatric surgery does not reduce your risk for drinking after surgery but if a person drank before surgery, especially heavily, they are at the highest risk for alcohol use disorder after surgery.
The issue of disclosure and that sometimes people don’t disclose their alcohol use before surgery for fear they will be denied surgery.
Jay shares her story.
The role of depression
The three independent risk factors related to bariatric surgery that increase a persons risk for SUD or AUD: Alcohol dehydrogenase, rapid absorption, neurohormonal changes in the brain that reinforce the reward of alcohol.
New Zealand Mom shares her story.
Is there an acceptable amount of alcohol after surgery.
Addiction transfer.
Anissa shares her story.
Screening tool: Alcohol Use Disorder Inventory Test (AUDIT)
Julie shares her story.
Does being clean and sober after AUD or SUD before surgery reduce a person risk of relapse after surgery.
The role of genetics.
Jane shares her story.
The risk for AUD seems to increase over the years after bariatric surgery.
Julia shares her story.
Treatment options: Alcoholics Anonymous, Cognitive Behavioral Therapy, and medication.
Leah shares her story.
One in five people, or 21%, by seven years will have gone through at least a period of AUD and 16% will have ongoing problems.
Dr Mitchell’s two-part call to action to bariatric surgery patients and their providers.
Dee shares her story.
Dr Mitchell reminds us that even though the number of AUD and SUD are higher than we would ever like to see, we must not lose site of the fact that overall bariatric surgery is an amazingly effective procedure that changes many peoples lives for the better.
Reeger’s concluding thoughts.
A special guest speaks up and shares a joke.