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The aim of this study was to examine the association between MBS and the risk of AUD and alcohol-related mortality over up to 35\u2005years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Swedish Obese Subjects (SOS) study enrolled 2007 participants with severe obesity who underwent MBS and 2040 matched controls (median follow-up 25.2\u2005years). Patients in the surgery group underwent gastric bypass (GBP; 266 patients), gastric banding (376 patients), or vertical banded gastroplasty (VBG; 1365 patients). The matched controls received the customary treatment for severe obesity at their primary healthcare centres. Data on AUD diagnoses and alcohol-related mortality were captured from the Swedish National Patient Register and the Swedish Cause of Death Register respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During long-term follow-up, a significant difference in the incidence of AUD was found across surgery groups (log rank P &amp;lt; 0.001). Patients who underwent GBP exhibited the highest AUD risk (adjusted HR (HRadj) 5.07 (95% c.i. 3.11 to 8.25); P &amp;lt; 0.001), followed by patients who underwent VBG (HRadj 2.28 (95% c.i. 1.56 to 3.34); P &amp;lt; 0.001) and patients who underwent gastric banding (HRadj 2.34 (95% c.i. 1.37 to 4.01); P = 0.002), compared with usual obesity care. Alcohol-related mortality was significantly elevated after GBP (adjusted sub-HR (sub-HRadj) 6.18 (95% c.i. 2.48 to 15.40); P &amp;lt; 0.001) and VBG (sub-HRadj 3.56 (95% c.i. 1.79 to 7.08); P &amp;lt; 0.001) compared with usual obesity care. Mortality after gastric banding was also elevated, but did not reach statistical significance (sub-HRadj 2.52 (95% c.i. 0.89 to 7.15); P = 0.082).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Effective management of alcohol-related complications in MBS patients requires preoperative risk assessment, postoperative monitoring, and access to targeted interventions for AUD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znaf211","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T11:26:48Z","timestamp":1757935608000},"source":"Crossref","is-referenced-by-count":7,"title":["Alcohol use disorder and alcohol-related mortality after metabolic bariatric surgery: prospective controlled cohort study"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0146-8193","authenticated-orcid":false,"given":"Kajsa","family":"Sj\u00f6holm","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3767-4223","authenticated-orcid":false,"given":"Markku","family":"Peltonen","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna C","family":"Andersson-Assarsson","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0619-2683","authenticated-orcid":false,"given":"Sofie","family":"Ahlin","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg ,","place":["Sweden"]},{"name":"Department of Clinical Physiology, Region V\u00e4stra G\u00f6taland, NU Hospital Group , Trollh\u00e4ttan ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Adm\u00e9us","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Arnetorp","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"My","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Surgery, Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital , Gothenburg ,","place":["Sweden"]},{"name":"Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Taube","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical 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