Does drinking alcohol always get in the way of weight loss? It can — but the impact depends on your individual health and weight loss plan.

Let’s look at what research shows about alcohol’s effects on obesity, weight loss, and overall health. We’ll also cover how alcohol might affect obesity treatments and when you should talk with your doctor.

How Alcohol Affects Weight and Obesity

Research reveals a complicated relationship between alcohol and weight. Alcohol can contribute to weight gain, but for some people, drinking in moderation may not affect their goals.

Alcohol use may cause weight gain in four main ways:

• Adding empty calories — Alcohol has about 7 calories per gram, and many standard drinks have at least 150 calories. These calories usually don’t make you feel full and tend to be added on top of what you already eat.
• Increasing hunger — Drinking alcohol can make you crave food and eat more, which may work against weight loss efforts.
• Leading to unhealthy food choices — People often make poor food choices, such as eating more high-fat items, while drinking.
• Slowing metabolism — Your body burns fat less efficiently while it’s processing ethanol (the specific type of alcohol in drinks).

Not all research indicates that alcohol always causes weight gain. Light to moderate drinking (up to one drink a day for women or two for men, according to the Dietary Guidelines for Americans) isn’t always linked to weight gain and may be part of an overall healthy lifestyle. However, heavy drinking (at least four drinks a day for women, five or more for men) and binge drinking (four or more drinks in two hours for women and five or more for men) are consistently tied to weight gain.

The Effects of Alcohol on Conditions Related to Obesity

Drinking alcohol doesn’t just influence body fat. It can also worsen certain comorbidities (health conditions that often occur with obesity), like type 2 diabetes, cardiovascular disease (heart and blood vessel issues), and liver disease.

Type 2 Diabetes

Any alcohol intake can make it harder to manage type 2 diabetes. If you take insulin or certain diabetes medications, alcohol can cause your blood sugar to drop, especially if you drink on an empty stomach. This is because your liver is too busy processing the alcohol to help maintain your blood sugar. If you drink, try to have alcohol with a meal to help maintain healthy blood sugar levels.

Some studies have found a connection between moderate drinking and a lower risk of type 2 diabetes. However, drinking larger amounts of alcohol can interfere with how your body releases insulin, which increases the risk of diabetes over time.

Cardiovascular Issues

The effects of light to moderate alcohol intake on heart health, including coronary artery disease, stroke, and heart failure, aren’t very clear. However, heavy drinking is a risk factor for many cardiovascular conditions, including:

• Hypertension — Heavy alcohol use raises blood pressure.
• Cardiomyopathy — Long-term alcohol misuse weakens the heart muscle.
• Arrhythmia — Too much alcohol can lead to an irregular heartbeat.
• Ischemic heart disease — Heavy drinking can damage arteries (blood vessels) and raise the risk of a heart attack.

Liver Damage

Obesity increases the risk of liver disease. When fat builds up in the liver, it’s called metabolic dysfunction-associated steatotic liver disease (MASLD). Over time, MASLD can lead to swelling, inflammation, and cirrhosis (permanent liver damage).

Similar damage happens with heavy alcohol use. The liver can handle some alcohol intake, but higher amounts cause fat to accumulate, leading to inflammation or alcohol-related cirrhosis.

Alcohol and Obesity Treatment

If you’re working on managing obesity, it’s important to consider how alcohol might help or hurt your efforts. Here’s how alcohol can affect lifestyle changes such as diet and exercise, as well as weight loss medications.

Lifestyle Changes

Alcohol contains calories, so if you’re watching your intake, you’ll need to factor those in. Most alcoholic drinks range from 100 to 380 calories or more. If you choose to enjoy a glass, have a plan, such as:

• Setting a limit ahead of time
• Eating first or pairing alcohol with healthy snacks to slow down its absorption
• Staying mindful of your food choices while drinking

Physical activity can help offset some of the extra calories, but drinking can affect your performance when exercising. Even a small amount before exercise may lower energy, reduce endurance, and affect balance and coordination. Your workout might feel harder or less effective.

Cutting back on alcohol isn’t always easy, especially if you’ve used it to manage stress or emotions. “I ran to alcohol during every stressful situation,” one MyObesityTeam member shared. “Alcohol has a lot of calories that I don’t need, so now I’m trying to find other ways to cope.” If lowering your alcohol intake is difficult, your weight loss team can connect you with someone who can help.

Weight Loss Medications

More studies are needed to fully understand how alcohol impacts people on glucagon-like peptide 1 (GLP-1) agonists such as semaglutide (Ozempic, Rybelsus, Wegovy), but researchers have identified some effects.

For example, mixing alcohol with a GLP-1 drug may influence how the liver manages blood sugar. In many cases, blood sugar may drop, sometimes unpredictably, which can be risky if you have type 2 diabetes. Alcohol may also affect how well these medications work, or your alcohol tolerance may change over time.

Talk With Your Healthcare Provider

Current guidelines state that drinking less is better than drinking more, but what’s right for you depends on your health history and goals. For some people, like those recovering from alcohol use disorder, avoiding alcohol completely is the safest choice.

Talk with your healthcare team about how alcohol may affect your weight loss journey. Be sure to ask if it’s safe to drink based on your health conditions and medications. Your team can help you decide if alcohol is OK to include in your diet and show you how to fit it into your weight loss strategy.

Join the Conversation

On MyObesityTeam, people share their experiences with obesity, get advice, and find support from others who understand.

Have you adjusted your alcohol intake since beginning your weight loss journey? What strategies have worked for you? Let others know in the comments below.