You’ve gotten a lot of good info here, especially from u/McKoijion.
However, to add to his answer, it’s not just that alcoholic beverages have calories. Also important to note is that alcohol is an endocrine disruptor.
Your endocrine system is a system of chemical messengers (hormones) secreted by endocrine glands that circulate through the blood and have various effects on the body, especially metabolic ones.
Alcohol has been demonstrated in studies to throw off the balance of certain hormones in the body:
1. Alcohol stimulates the generation of fat. It does this by forcing glucose (sugar) into the blood, which triggers the release of insulin, which stimulates the body to make fat and store it.
2. Alcohol stimulates your body to release cortisol, which over the long term can have metabolic effects, including weight gain.
3. Alcohol interrupts the release of testosterone (very simply put; it actually inhibits the release of luteinizing hormone, which inhibits testosterone production). Testosterone aids males in burning fat, so inhibiting it promotes weight gain.
4. In heavy drinkers, alcohol appears to interfere with the release of thyroid hormones, which slows down metabolism. However, this does not seem to affect moderate drinkers.
Many “beer bellies” are actually, in medical terms, ascites: fluid in between the visceral and parietal peritoneum, or the two layers of connective tissue that line your organs and your skin, respectively. These are men and women who look 9 months pregnant. The fluid builds up due to liver failure, and builds up so quickly that the skin doesn’t slowly grow like it does with fat, but rather stretches to capacity and becomes firm. Doctors often do a procedure called a thoracentesis to drain the fluid, as ascites is painful and can cause organ issues from conpression. I’ve seen someone in severe liver failure remove 5 liters in one go (with more to go, but the doctor stopped after 5 to prevent hypovolemic shock), and another who would routinely lose 2-3 liters every 3-4 days wgile waiting for liver transplants.
Ascites is a condition where the space in your abdomen between your organs fills with liquid. This can be caused by a damaged or cirrhotic liver. Alcoholism causes this liver condition. When you see someone that has a distended abdomen (similar in shape to that of a pregnant woman) it may be this condition. A beer belly is usually a very dangerous thing.
Heavy drinkers can damage their liver, which in turn can cause a condition called ascites where your [abdomen fills up with fluid](https://www.alfapump.com/wp-content/uploads/2017/07/ascites-illustration.jpg), and will eventually get round and hard like an overfilled water balloon. The treatment is literally to poke a needle into their belly and drain out the extra fluid, after which the round, hard look you are describing will be reduced.
This is different from a “beer belly” someone might get from drinking too many calories in beer.
If you stab your belly with a knife, first you will cut the skin, then subcutaneous fat, then your abdominal muscles, then visceral fat, then your organs.
That means if you press your belly and feel softness, you are pressing against your subcutaneous fat. Cutaneous means skin, and subcutaneous means below the skin. If you press against your belly and feel something hard, you are pushing against your muscles.
If you have a big belly, but it’s hard that means that you have a lot of visceral fat. Visceral means deep. It feels hard because you are pressing the muscle, but there’s a lot of fat behind the muscle which causes your gut to bulge.
This visceral fat is very dangerous. It’s right next to your organs, so it can “spill into them”. You can get non-alcoholic fatty liver disease, for example. Visceral fat is the thing most associated with heart attacks, stroke, diabetes, etc. In fact, measuring your waist size is probably even better than measuring your weight or BMI.
Drinking alcohol causes beer bellies. Taking in a lot of calories causes beer bellies. And most importantly, genetics causes beer bellies. Asian people tend to store their weight in their belly, which means they can get heart attacks at far lower BMIs than other races.
Fortunately, even though visceral fat is the most dangerous kind of fat, it’s the easiest to lose. Cardio like running, swimming, cycling can melt away visceral fat. It’s the first kind of fat to go.
As a last thing, sometimes people say that if you have a lot of visceral fat, you are apple shaped. Your gut is big and your arms and legs are small. If you have a lot of subcutaneous fat (especially in your thighs) you are pear shaped.
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