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When it comes to alcohol and how you approach weight care, consider this: It's not just about the calories. When your body is busy metabolizing alcohol, it doesn't have the capacity to metabolize other things. And this is particularly true for women.
Drinking alcohol is a huge part of our society and culture—that champagne toast on New Year’s Eve, warm Bailey's coffee at Christmas, small occasions like an after-work glass of wine or beer, or a Michelada at breakfast (a tasty Mexican beverage made with beer and tomato juice). We use it as a social lubricant, to celebrate events, and in our everyday lives.
Even though these rituals are ingrained, and so regularly done that we don’t think twice about reaching for or ordering a beverage, research has suggested for a long time that alcohol isn’t great for you. So what’s the deal and why is this important to our weight care journey and weight maintenance? Let’s dive in.
Alcohol is a depressant—it suppresses our central nervous system. This means that it’s a drug that slows down brain activity. It can change our mood, behavior, and inhibits our self-control. It can cause problems with memory and thinking clearly, and it can make us gain weight, especially women. When we have an alcoholic beverage, we are consuming more calories and this may contribute to weight gain.
Although there are conflicting studies—most swing from one side of the pendulum to the other on whether or not alcohol does make us gain weight—a 2017 study "further revealed that alcohol intake was associated with a higher waist circumference adjusted for BMI among women… showing that alcohol consumption was associated with an increase in body weight, body fat and BMI among Korean women."
And, during the height of the Covid-19 pandemic, alcohol sales soared and so did weight gain—it’s important to note here that other factors contributed to this, like lack of sleep and strained mental health as we were shut off from the world or working the front lines—but a survey published in The American Journal of Preventive Medicine of just over 3.5 million people (pre-pandemic and post-pandemic) found that “higher rates of alcohol consumption and lower smoking rates may have contributed to higher obesity prevalence rates.”
“As I have taken care of women over several years of their life and through different stages, I have noticed a profound difference in how many women tolerate alcohol over time and how it affects them. It is different for everyone but the way women process alcohol seems to change over time,” says Rekha Kumar, MD, MS, Found’s Chief Medical Officer, a globally recognized leader in obesity medicine and a practicing endocrinologist.
Dr. Kumar goes on to explain, “when our livers are busy breaking down alcohol, other jobs aren't being done like breaking down fats and estrogens which can increase the risk of obesity, heart disease, and cancer.” In turn, we gain weight because our bodies are focused on the alcohol breakdown and not on performing optimally.
We often drink when we’re eating—we’ll have a glass of wine with dinner or grab a margarita with an appetizer. It’s rare when we’re only drinking without having something to eat. Because we’re getting energy from the alcohol we’re drinking, but don’t experience the same sense of satiety that we would with food, we still tend to eat the same amount.
Surprisingly, alcohol may increase your desire to eat if you see food right in front of you, and it can possibly impair your brain’s ability to be in total control according to a 2010 study that experimented with the effects of alcohol and eating. This could contribute to not being able to lose body fat.
There’s even further evidence that “women who previously tolerated several drinks a week will report adverse effects related to sleep disturbance or mood disturbance often as early as the late 20s and early 30s. The complaint I hear from women in their 40s and 50s is that even small amounts of alcohol will lead to weight gain, and abstinence can lead to weight loss and better weight maintenance,” asserts Dr. Kumar.
In general, alcohol is metabolized at a different rate in women than it is in men—this is because men's and women’s body compositions are typically different. That’s why the number of drinks varies between men and women. Studies have also shown that women have fewer enzymes used to metabolize alcohol than men do (alcohol dehydrogenase and acetaldehyde dehydrogenase).
But give up alcohol? That’s a tough one. The recommendation by the Center for Disease Control (CDC) is different depending on age, alcohol, and gender (You can also get a better idea of how many servings you’re getting in ballpark cups, large bottles, and other containers—check here for drink calculators).
Skipping alcohol would certainly be ideal, but that can be difficult to do in social situations or when you want a relaxing treat for yourself. The important part is being mindful of how essential it is to a particular setting or if you really need to have one. “I like for patients to think about it more than they are used to. For example, do they really need to drink on weekdays and if not, it allows them to be a little more liberal on weekends,” says Dr. Kumar.
So try some simple swaps for your favorite alcoholic drink and learn more about how to manage peer pressure when you’re in a situation that typically prompts you to drink.
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