# Biobehavioral Mechanistic Model of Alcohol Use Following Bariatric Surgery: The BREW ME Model

> **NIH NIH R01** · SANFORD RESEARCH NORTH · 2024 · $784,687

## Abstract

Biobehavioral Mechanistic Model of Alcohol Use Following Bariatric Surgery: The BREW ME Model
Abstract
Metabolic and bariatric surgery (MBS) is currently the most efficacious and durable intervention for Class III
obesity. While weight loss and metabolic outcomes after surgery are very good, unfortunately one deleterious
complication is a markedly increased risk of hazardous alcohol use after MBS (i.e., almost 1 in 5 patients
develop Alcohol Use Disorder). The understanding of mechanisms of hazardous alcohol use following MBS
are developmentally young, but there is growing evidence of the unique role of the microbial environment. Our
transdisciplinary research team has been at the forefront of advancing understanding of how the microbiome
and the rewarding effects of alcohol change following MBS. Although the mechanisms through which changes
in the microbiome influence post-surgical outcome remains unclear, the gut microbiome is increasingly
recognized for its bi-directional communication with the brain and the Microbiome-Gut-Brain Axis may explain
the complex relationships between the gut microbiome, subsequent changes in the rewarding effects of
alcohol, and resulting risk for hazardous alcohol use. For example, the microbiome has been shown to impact
neurobiological reward systems and alter reward processing. Further, patients who experience strong reward
value of alcohol engage in more drinking behavior. Therefore, the rewarding effects of alcohol may be
influenced through the gut microbiome, leading to significant impacts on the post-surgical alcohol consumption.
Unfortunately, the extant literature is methodologically limited due to traditional assessments further limiting
understanding of these relationships. Thus, we propose a novel, multi-method, longitudinal design to
investigate the Biome-Reward as Mechanisms for EtOH Use (BREW ME) Model to assess the mechanistic
role of post-surgical changes in reward in the relationship between the gut microbiome and hazardous alcohol
use. This study will address many of the methodological limitations in the literature (e.g., cross sectional
design, reliance on self-reported drinking behavior) and will be the first to combine a microbiome and
ecologically valid, real-time assessment of the reward value of alcohol in MBS patients. Understanding key
relationships between these variables will aid the development of interventions that can be tailored to individual
patients based upon their risk profile and can then be implemented early to optimize surgery-related outcomes.

## Key facts

- **NIH application ID:** 10774539
- **Project number:** 1R01AA031237-01
- **Recipient organization:** SANFORD RESEARCH NORTH
- **Principal Investigator:** SCOTT G ENGEL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $784,687
- **Award type:** 1
- **Project period:** 2024-09-15 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10774539

## Citation

> US National Institutes of Health, RePORTER application 10774539, Biobehavioral Mechanistic Model of Alcohol Use Following Bariatric Surgery: The BREW ME Model (1R01AA031237-01). Retrieved via AI Analytics 2026-07-25 from https://api.ai-analytics.org/grant/nih/10774539. Licensed CC0.

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