Gastric bypass surgery may help you lose weight, but it may also increase your risk for addictive behavior, like alcohol and drug abuse, that’s the upshot of a study in the Archives of Surgery.

Researchers followed 200 gastric bypass patients for 2 years. They compared everyone’s pre-surgery history to a behavioral survey given at each post-procedure visit. The result: Most of the group showed an increase in drug and alcohol use. 

Lead researcher Dr. Alexis Conason says the results highlight the way that - for some people - food is a coping mechanism. And when they can no longer comfort themselves by over-eating, they’re tempted to turn to something else to get them through. 

Still, Dr. Erik Dutson, who’s the director of bariatric surgery for the UCLA Health System, says that gastric bypass patients who develop serious substance abuse problems are the exception rather than the rule. But he emphasizes that anyone who’s considering weight loss surgery must answer questions about their habits honestly. So their doctor can make sure they’re mentally prepared for the surgery, and the restricted diet afterwards. And Dr. Conason says that it’s important for gastric bypass patients to stay in close contact with their healthcare team for at least 2 years after the procedure. 

Because the 24-month mark is the point where patients had the highest risk of substituting another addictive behavior for food.