How Alcohol Affects Your Health, Hormones, and Fat Loss

By Dr. Brooke Kalanick

For many of us, alcohol goes hand in hand with fun and relaxation. It is called "happy” hour, after all.


So it’s no wonder why many women want to know how much booze they can get away with drinking and still achieve their health, fitness, and fat-loss goals. As a wine lover myself, I really, really want to tell you that this article will end with the kind of advice I’d like to hear: “Go ahead! Drink as much wine as you want and enjoy effortless weight loss!” Unfortunately, it’s just not that simple. And as fun and delicious as a glass of wine can be, it may not support your current goals. I’m sorry. Really, I am.

The Chemistry Of Cocktails

It’s likely that you’ve heard from a fitness expert or read in a magazine that alcohol turns instantly to fat. That’s not exactly true, but it’s become a go-to sound byte.

Here’s what really happens: Once alcohol (a.k.a. ethanol) passes your lips and gets absorbed into your system, your body converts it to acetaldehyde, then to acetate, and finally to acetyl-coA.

So, luckily, your body doesn’t convert ethanol or its metabolites directly into fat. In fact, your body can use both acetate and acetyl-coA as fuel. However, as far as fuel sources go, they are both pretty inefficient. That means that it takes more calories to convert them into energy than it does to convert glucose, AKA sugar, into energy.

Well, that sounds good, right? You would think. However, since your body doesn’t like inefficiencies, it doesn’t like to burn acetate or acetyl-coA for fuel. But because our bodies can’t store the metabolites, we still have to burn them off. ASAP. So, while your body’s cells work on burning through that acetate and acetyl-coA build up first, other fuel sources, like sugar and fat, just hang around.

In other words, when we drink, fat and sugar burning come to a halt.

So while that glass of chardonnay won’t pass your lips and make itself at home on your hips, when we drink (i.e. when there is acetate and acetyl-coA around), your metabolism as a whole is in fat-storing mode.

alcohol-cant-sleep-450x338At the same time, after you drink, your liver and muscles don’t do a great job of storing sugar as glycogen for later. This is evident when, after a few glasses of wine, you fall asleep and find yourself wide awake around 3am with low blood sugar. Fitful sleep or outright waking up during the night is typically the result of low blood sugar. While this can happen to anyone after drinking, it’s going to be worse if you already deal with low blood sugar issues, in particular waking unable to go back to sleep, waking anxious, waking hungry, etc.

And of course, blood sugar swings beget more blood sugar swings. That’ll be especially true for you if you already have insulin or cortisol issues. As these two hormones battle it out, you’ll feel the effects in terms of sleep issues, cravings, and irregular appetite.

In short, alcohol primes you for storing fat and then makes a mess of your blood sugar and energy levels, which can easily increase appetite and cravings, resulting in eating more and setting fat storing further in motion.

Beyond Blood Sugar: Alcohol’s Other Effects on Cravings and Appetite

Beyond blood sugar fluctuations when you drink, changes in brain chemistry can also drive you to eat more.

The feel-good neurotransmitter dopamine immediately increases when you drink alcohol. Unfortunately, dopamine fires up the reward-seeking pathways in your brain, making you want more alcohol along with those fatty, starchy foods so often on the menu right next to the wine. Again, this effect is usually more pronounced in those of us who already run low on dopamine. Symptoms of low dopamine levels include a short fuse for stress (i.e. “snapping”), depression that comes and goes, disorganized attention, lack of focus, and low libido.

Alcohol also affects levels of the stress-related hormones adrenaline and cortisol. First, when we drink, the booze quickly ramps up our levels of the fight-or-flight hormone adrenaline, which causes our bodies to release sugar into our bloodstream. And, when we don’t use that influx of energy to say, outrun a lion, that glucose can easily be stored as fat. Then, in time, the alcohol also raises our levels the stress hormone cortisol, which can further increase appetite and cravings for those fatty, carby, high calorie foods.
alcohol-cocktails-327x300When you hit up happy hour before a meal, it can have a direct effect on your appetite. This seems to be worse with a cocktail or mixed drink compared to wine. My best advice here is to not drink too much before dinner or you’re likely to eat more when mealtime comes around.

What’s more, if you’re drinking booze at night, it’s important to remember that alcohol lowers your body's levels of the sleepy-time hormone melatonin. This hormonal drop in conjunction with the low blood sugar levels we already talked about make troubled sleep almost inevitable. As we all know, lack of sleep will do nothing favorable for hormone balance, weight loss, and next-day cravings and energy.

Alcohol and Your Health

By wreaking havoc on our hormones, alcohol does much more than spike our hunger. Blood sugar swings can create chronically high cortisol levels, increase inflammation, and surges in insulin can worsen estrogen dominance.

What’s more, when we gals drink, our growth hormone levels drop. This isn’t great for achieving or maintaining a lean body composition and doesn’t help with signs of aging much, either. Women can also see a rise in testosterone related to alcohol intake. And while testosterone is largely considered a “lean hormone” like growth hormone, in women it can worsen insulin resistance, hinder ovulation, make us break out, lead to facial hair growth, and increase our risk of both diabetes and cardiovascular disease. And as you may have guessed, if you lean toward any of those things already (hello, PCOS!) then these effects can be even worse.

If you’re trying to build or keep your lean mass strong, alcohol isn’t doing you any favors.

alcohol-lean-mass-strength-alli-squat-450x338Finally, when it comes to preserving lean mass and recovering from workouts, a couple of important events are affected by alcohol consumption: There is a decrease in glycogen synthesis (you’ll have less in the tank for your next workout after you drink), your muscles don’t rehydrate as well, and cytokine signals that trigger post-workout muscle repair are altered, and not for the better.

I think most of us can report that our workouts after a night of drinking are not as good—and research backs that up. No surprise there, right?

Drink the Right Way

So while there isn’t clear-cut research proclaiming that if you drink exactly three glasses of cabernet per night you will miss out on specifically losing two pounds, here’s what you can do to make sure alcohol doesn’t interfere with your goals, ranging from strength gains to fat-loss:

1. Don’t overdo it.

Research does show that most of the downsides we’ve talked about happen after we’ve had 0.5g/kg of alcohol (that’s not very much). So the number of glass you down certainly does count. Not overdoing it does count.

2. Reach for protein.

Since you’re likely to store fat and sugar rather than burn it after drinking, eat protein and veggies instead of a meal or snack that’s high in carbs or fat alongside your drinks.

3.Remember, every woman is different.

Always take your individual chemistry into account. For example, even though it gets the research thumbs up, red wine contains histamine. If you’re already dealing with a heavy allergy burden or are under some stress (histamine raises cortisol and bogs down your liver), red wine is gonna be tougher on you.

4. Consider Vitamin B.

If you’re taking estrogen medications or have a hormone-secreting IUD like Mirena, have a low B vitamin intake, or have a methylation defect like many women with the MTHFR gene mutation, you will likely have greater issues with alcohol. If any of these apply to you be sure you take at least a B complex containing only the natural form of folic acid and consider 200mg of B6 daily.

5. Know your hormones.

If you have PCOS, are on the other side of menopause, or have estrogen dominance issues like fibroids, then you’ll likely have worse estrogenic effects and more difficulty losing weight when you drink. Similarly, if you’re hypothyroid, remember that thyroid hormones are crucial keeping your liver humming along and efficiently processing that acetate and acetyl-CoA.

6. Support Glutathione.

Glutathione is a very important antioxidant that exists in every cell in your body and can neutralize free radicals before they build up and cause damage. If you have autoimmunity like Hashimoto’s, in addition to an increased inflammatory burden, you are compromised in your levels and function of glutathione, which is an important part of alcohol metabolism. This is why many women with Hashimoto’s find their alcohol tolerance to be really unpredictable. One night they are fine with a couple drinks, and another night they have one glass of wine and wake up feeling like a wreck. Glutathione can be supported by taking a nutrient called NAC (n-acetyl-cysteine), but with Hashimoto’s, often other support for the entire glutathione process is necessary, not only for being able to tolerate alcohol, but for calming the immune over-activity as a whole. Compromised glutathione is also why many women with Hashimoto’s struggle with workout recovery. Couple this with the effects of alcohol on recovery, and it’s that much harder for you ladies.

7. Reduce inflammation.

Anything that decreases inflammation and oxidative stress will be helpful, like turmeric and resveratrol. The classic herb silymarin (also know as milk thistle) is known to specifically be protective to oxidative stress on liver cells.

8. Keep your goals in mind.

It can seem particularly unfair when we see that our fittest faves are able to drink more than us while maintaining their lean physiques. Keep in mind (and I believe they would all back me up on this) that they didn’t lose weight while drinking, but they’ve been able to maintain or not gain while gradually incorporating wine into their lives.


Check out what three of our wine-loving fit friends have to say about incorporating alcohol into their healthy lifestyle:

Jen Comas

If I could have one nutritional freebie—something that wouldn't negatively affect my physique—it would be wine.  

Not ice cream, or cookies, or chips, but one or two glasses of wine every night. Unfortunately, I discovered a long time ago that my body simply will not drop body fat if I consistently have alcohol. As a matter of fact, I learned through trial and a whole lot of error that anything more than two cocktails per week will bring my fat loss efforts to a screeching halt, regardless of how tightly dialed in I am with my nutrition and training. Wah-wahhh.

Upon realizing this, I completely recalibrated my nightly wind-down routine. One or two glasses of wine is how I relaxed! I knew that if I wanted to reach my goals, I was going to have to find other ways to unwind instead of sipping vino. I started to beef up my book collection, and I bought magazines about motorcycles and business. I bought aromatherapy bath salts, and I would lounge in the tub and read. I got different kinds of tea to try since I was used to sipping on something at nighttime. While I missed drinking my nightly wine, I had to make a choice, and at the time, my fat loss goals were more important than my mindlessly drinking wine while I watched reruns of Grey's Anatomy.

Unfortunately, alcohol can be a big barrier for fat loss, and this is something that I see many clients struggle with, time and time again. They feel like they deserve a glass or two of wine because they've had a hard day or week, as a way to unwind, or as a reward because they've been eating well and exercising.

I understand that having a couple of cocktails can be part of a social event, and once in awhile, that is to be expected! But I'm seeing a rising trend in the number of women drinking wine almost every night!

I have found that the threshold for most women to lose body fat and still imbibe seems to be no more than two standard-serving sizes of alcohol per week (that’s two four- to five-ounce servings). Anything more than that for most women is much more conducive to maintaining your current body composition. There will always be exceptions to this rule, but you are probably not the exception; you are most likely the rule.

If you’re having a hard time losing body fat, and you’re eating well, moving a lot, and getting plenty of sleep, I encourage you to temporarily remove alcohol completely for two to three weeks—don't change anything else—and see what you notice. I'm willing to bet that you'll be pleasantly surprised.

Jill Coleman

In terms of health, yes, polyphenols and all that, but honestly, calling alcohol a “health food” is, to me, a reach.

I think you can think of alcohol in three ways:

  1. Physique implications
  2. Health implications
  3. Quality of Life (QOL) or what I call #SatisfactionFactor implications

alcohol-jill-327x341I mainly use it in the third way. I think we can all agree that no particular way of eating will be sustainable if there is not some level of enjoyment and even automation. For me, a glass of wine is actually an adherence tool. I know that sounds counterintuitive, but it’s what I consider a “preemptive cheat” food that I use as nutritional relief during the week so that I don’t go off the rails with eating at night or on the weekend. I use wine, among other foods that are not traditionally seen as “clean” to take the edge off and “preempt” overindulging on other foods, such as bacon, cheese, chocolate or healthier baked goods. The idea is that you never reach the point of deprivation, so the chance of overindulgence is limited.

In terms of physique implications, wine is a maintenance tool. I think it’s a mistake to think that drinking wine can help you lose weight at the physiological level. If it helps with weight loss, it’s probably due more to the preventative effect (above) than anything else. But this always comes back to the individual knowing herself. For a lot of people, drinking leads to compensatory eating and lowered inhibitions (duh) with food, so for someone like that, alcohol is more likely to take them further away from their physique goals. If you are the type of person who can have a single drink, or even two, and feel satisfied and satiated, then it might work as a maintenance tool.

In terms of health, yes, polyphenols and all that, but honestly, calling alcohol a “health food” is, to me, a reach. As a health and fitness professional, touting alcohol as a healthy choice is irresponsible in my opinion. There are plenty of other foods that are a million times healthier. Doesn’t mean it doesn’t have its place for enjoyment and satisfaction (which is how I use it, and I love it)...but let’s be real!

Neghar Fonooni

Today, I don't stress out about drinking a few glasses of wine, but I've learned that wine, for me, is a ritual.

I post a lot about wine on my social media channels, the reason being I absolutely love it. But the truth is, there are periods of time in my life when I don't drink at all, and others when I drink a glass of wine every night. I used to be extremely strict when it came to my wine consumption (cheat days only!), but I realized that by placing that restriction on something I loved so much, I was actually giving it a lot of power.

alcohol-Neg-327x341Today, I don't stress out about drinking a few glasses of wine, but I've learned that wine, for me, is a ritual. I drink when I'm doing really involved writing (a la Hemingway) or when I'm with my wine-loving friends. I use the first bite/sip rule in order to truly enjoy every drop, and I stop drinking when it's not adding to my ritual. If I have a glass of wine at dinner, I'll sometimes avoid excess edible carbs—not to mention I lift four to five times per week and engage in some sort of physical movement every day, so my activity levels are pretty high.

If I ever feel like I want to change my physique, I know that reducing my wine consumption will help. The thing is, I'm totally in love with my body. As is. If that ever changes, or if I notice my wine rituals are messing with my performance, I'll adjust. But I have no attachment to any of it—no shame or stress around it—so I'm really just going with the flow.

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About the author:  Dr. Brooke Kalanick

Dr. Brooke Kalanick earned her Doctorate in Naturopathic Medicine from Bastyr University. Known as “The Hormone Whisperer,” Brooke's balanced approach to health, using both conventional and alternative therapies, allows her to successfully treat patients with Hashimoto’s Hypothyroidism and PCOS as well as other female hormone imbalances. Learn more about Dr. Brooke on her website and connect with her on Facebook and Twitter.


  1. Raben, et al. Meals with similar energy densities but rich in protein, fat, carbohydrate or alcohol have different effects on energy expenditure and substrate metabolism but not on appetite and energy intake. American Journal of Clinical Nutrition. January 2003;77(1):91-100.
  2. YeomansMR. Short term effects of alcohol on appetite in humans. Effects of context and restrained eating. Appetite. December 2010;55(3):565-573.
  3. Kokavec, A., Lindner, A., Ryan, J.E., & Crowe, S.F. (2009). Ingesting alcohol prior to food can alter the hypothalamic-pituitary-adrenal axis. Pharmacology, Biochemistry & Behavior, 93, 170-176.
  4. Heikkonen, et al. The combined effect of alcohol and physical exercise on serum testosterone, leutininzing hormone and cortisol in males. Alcoholism, Clinical and Experimental Research. June 1996;20(4):711-716.

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