“Women are drinking more, and they’re being diagnosed with liver disease more,” says lead study author Brian P. Lee, MD, a hepatologist and liver transplant specialist with Keck Medicine of USC in Los Angeles.
Dr. Lee says the reasons for this troubling shift are complex. Here’s what his research found, plus how you can protect your liver if you drink.
What Is Considered Heavy Drinking? Less Than You Might Think
The current study defined heavy drinking as having 15 drinks or more a week for men and 10 drinks or more for women — a little more than two a day for men, and less than two a day for women.
“This is one of the most predominant themes when I see patients,” Lee says. “We talk about what heavy drinking is, and it’s much lower than what they think.”
“This says a lot about current society,” he says. “Heavy drinking is so pervasive that it doesn’t seem heavy anymore, even though it’s causing liver failure and a host of other diseases.”
Liver Disease More Than Doubled Among Heavy Drinkers
Study participants who met the criteria for heavy drinking developed alcohol-related liver disease at more than double the rate they did two decades ago, the analysis found.
The risk of significant liver damage, which is a stage of liver disease when the liver forms scar tissue that impairs liver function, also more than doubled, going from nearly 2 percent between 1999 and 2004, to more than 4 percent between 2013 and 2020.
Metabolic syndrome diagnoses also increased during the study period, jumping from 26 percent to nearly 38 percent among heavy drinkers.
Four groups of people made up a larger share of heavy drinkers than they did 20 years ago:
- Women
- Adults 45 and older
- People living in poverty
- People with metabolic syndrome
“This is certainly something we’ve been seeing in terms of trends for years,” Lee says.
Why Are Women Drinking More?
The study didn’t determine why women are drinking more. “This is something that has been observed, and I’m not sure we have the exact answer,” Lee says. Still, doctors have several theories.
One possibility is changing norms in society that make drinking more acceptable among women, says Andrew Talal, MD, MPH, a hepatologist and professor at the Jacobs School of Medicine and Biomedical Sciences at SUNY University at Buffalo. Dr. Talal was not involved in the study.
“There’s been this normalization of drinking. We talk about ‘mommy wine hour’ or ‘wine o’clock,’” Lee says. “This idea of drinking and drinking heavily is normal for women.”
But there also seems to be a rise in drink options that are tailored to women, says Sammy Saab, MD, MPH, medical director of the UCLA Adult Liver Transplant Program. “Today, we have a lot of sweet cocktails, canned seltzers … Perhaps the type of alcohol available is more appealing to women than ever before,” Dr. Saab says.
Women Are More Susceptible to Liver Disease Than Men
Women who drink the same quantity of alcohol as men will develop liver disease faster and at a higher frequency, Lee says. There are several reasons for this.
Women typically have less water weight and a higher percentage of body fat than men. “At the same quantity of alcohol that they consume, you will see higher concentrations of alcohol in the blood,” Lee says.
Women also have lower levels of an enzyme known as alcohol dehydrogenase, which helps the body metabolize alcohol, Saab says. That can also lead to higher concentrations of alcohol in the blood. Together, those factors tax the liver, which has to process alcohol, he says, which ultimately raises the risk of developing liver disease.
Don’t Take Your Liver for Granted
“The liver has tremendous regenerative capacity,” Talal says — but there is a point of no return. In Saab’s practice, he says, “We see women in their late twenties, early thirties who have been drinking more than usual that develop permanent damage.”
The easiest way to reduce the risk of developing liver disease from alcohol is to stop drinking alcohol or dramatically cut back, Lee says. “If you’re drinking because you think it’s good for your health, that all has been debunked,” Lee says. “Alcohol is not healthy.”
If drinking is a stress reliever for you, he suggests replacing your glass of wine, cocktail, or beer with a special nonalcoholic drink. “The reality is, you don’t have to drink if you don’t want to,” Lee says. “Figuring out what those options are and if they will work for you is the first step.”
You can even just make a point to simply take time for yourself, Rustgi says. “Slow down when arriving home, breathe, and enjoy the quiet,” he says.
Take Control of Your Liver Health
Not drinking alcohol or cutting back is a big step, Saab says. “But there is emerging data that suggests that common 2025 health issues — type 2 diabetes, hypertension, obesity — can make someone more susceptible to alcohol,” he says. “If you want to keep your liver healthy, look at the big picture and try to manage those health conditions.”
Lee recommends trying to live a healthier lifestyle overall. “If you have diabetes or hypertension, you can have lifestyle modifications — diet and exercise, or medications — to treat these conditions,” he says.
It’s important for people to be aware of the potential health risks of drinking, Lee says. “People enjoy drinking and, if you’re able to do this in moderation and understand what your health risks are, that is a decision you can make for yourself,” he says. “No one is trying to take that away. But know that cutting back is helpful, and stopping completely is the best thing for your health.”
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