Cannabis use before and after metabolic and bariatric surgery and its association with alcohol use

Document Type

Article

Publication Date

4-1-2026

Publication Title

Surg Obes Relat Dis

Keywords

Humans, Female, Male, Bariatric Surgery, Adult, Middle Aged, Alcohol Drinking, Marijuana Use, Prevalence, Michigan, Postoperative Period

Abstract

BACKGROUND: Research on changes in cannabis use prevalence from pre- to postmetabolic and bariatric surgery (MBS) is limited.

OBJECTIVES: To assess the change in legal cannabis use prevalence from pre-to post-MBS and the association between postoperative alcohol and cannabis use.

SETTING: Single Michigan health system.

METHODS: Patients who received MBS between 2018 and 2021 were invited to participate. The analytic sample included 612 participants who completed online surveys regarding cannabis, alcohol, and other substance use, psychiatric symptoms, and demographic information.

RESULTS: Patients who received MBS between 2018 and 2021 were invited to participate. The analytic sample included 612 participants who completed online surveys regarding cannabis, alcohol, and other substance use, psychiatric symptoms, and demographic information. RESULTS: Findings indicate a 52.4% relative increase in cannabis use prevalence from pre-to post-MBS (P = .0001). Specifically, 16% of participants reported postoperative cannabis use of which 45.9% were new initiates. Among initiates, 11.8% screened positive for hazardous cannabis use while 19.2% who used cannabis pre- and post-MBS screened positive for hazardous cannabis use. Of 61.9% participants who reported past year alcohol use, 41.4% screened positive for hazardous alcohol use. Those who screened positive were more likely to initiate cannabis use post-MBS (odds ratio [OR](adj) = 2.8; 95% CI: 1.4, 5.4) and more likely to persist cannabis use post-operatively (OR(adj) = 3.0; 95% CI: 1.6, 5.8).

CONCLUSIONS: Cannabis use initiation post-MBS is not uncommon. The increase in cannabis use prevalence might be explained by its use as a coping mechanism and cannabis legalization, though most participants underwent MBS after legalization. Results suggest a significant association between past year hazardous alcohol use and higher odds of persistent and new initiate post-MBS cannabis use. MBS programs might consider monitoring patients for cannabis use, particularly among patients using alcohol.

Medical Subject Headings

Humans; Female; Male; Bariatric Surgery; Adult; Middle Aged; Alcohol Drinking; Marijuana Use; Prevalence; Michigan; Postoperative Period

PubMed ID

41651721

ePublication

ePub ahead of print

Volume

22

Issue

4

First Page

427

Last Page

433

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