How come all alcoholics are not extremely overweight?

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Alcoholic drinks have a shit ton of calories, but I personally know many skinny people who drink an insane amount of beer & liquor. Even if they didn’t eat anything, the calories from the drinking alone should be enough for them to put on weight. How come they don’t? Does the body lose it’s ability to take in the energy properly if it’s mostly coming from alcohol?

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Anonymous 0 Comments

Addiction doctor here: a lot of valid points have been raised such as poor overal nutrient intake in alcoholics, alcohol damaging cells in the body which need energy intensive repairs and decreased nutrient absorption. However, a very important point has been missed in previous comments. In a non- alcohol addicted human alcohol is mainly broken down by alcohol dehydrogenase enzymes in the liver. The resulting chemical, acetyl aldehyde is then broken down further, this process is net energy positive. However, in an alcohol addicted individual a collateral process is upregulated to ensure the high amount of alcohol in the body is broken down. This process uses the so called microsomal ethanol oxidizing system (MEOS) which when up regulated can become the main way of processing alcohol in the body. This process is a net negative in terms of energy meaning the ingestion of alcohol can become an outlet as opposed to source of energy for these individuals. This is supposedly a big reason end-stage alcoholics are so thin, especially those who drink alcohol types without high carbohydrate contents.

For more info see:

[https://en.wikipedia.org/wiki/Microsomal_ethanol_oxidizing_system](https://en.wikipedia.org/wiki/Microsomal_ethanol_oxidizing_system)

[https://en.wikipedia.org/wiki/Alcohol_dehydrogenase](https://en.wikipedia.org/wiki/Alcohol_dehydrogenase)

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