Why Do Alcoholics Eat So Little? (Alcohol Ketoacidosis)

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Alcoholics eat so little because alcohol messes up your normal psychological and metabolic process, including your cravings, tricks your body’s feeling of fullness, triggers bloating, engenders hangover, and causes Alcohol Ketoacidosis.

Alcoholism, diagnostically known as Alcohol Use Disorder (AUD), negatively impacts the GI tract because it gets frontline exposure to alcohol. It irritates, inflames, and affects normal digestion and metabolism.

It sends the body to go overboard and bypass its normal processes, which affect the body’s overall health. Abbeycare is here to help you combat the harmful effects of alcoholism. 

Alcohol is known as a risk factor for obesity. But chronic long-term alcoholics keep drinking alcohol and not eating, losing weight instead of gaining some pounds.

They eat less, appear lean and skinny, and don’t gain weight. Wondering how they maintain their slim body despite constantly shoving tons of alcohol-derived calories into their system?

Reasons Why Alcoholics Eat Less

1. Alcohol Makes You Crave, Not for Food but For More Liquor

This is the simplest explanation of why alcoholics eat so little or, in worse cases, don’t eat at all. Their mindset and priority are set on alcohol.

They care less about getting enough nutrients to feed the body but eager to drink only alcohol and not eat, taking the next opportunity to get that drunken feeling.

In some cases, alcoholics intentionally skip meals to avoid stuffing their stomach with food. They save every space of their stomach for liquor.

2. Alcohol Makes You Feel Full

Even if alcohol brings in empty calories, it still brings in many calories and fills the tummy, which makes you feel full and sends signals to the brain to stop craving for actual food.

When drinking too much alcohol and not eating, the volume of liquor intake is relatively higher than when consuming food.

Too much alcohol in the digestive system sends the normal metabolic process into overdrive, thus prolonging the person’s ability to feel hunger

3. Alcohol is an Inflammatory Substance

Have you ever noticed feeling puffy, gassy, and bloated after drinking too much alcohol?

Bloating is characterized by swelling on the face, lower extremities, stomach, and the frequent passing of gas. This is one of the adverse effects of drinking too much alcohol beyond the acceptable limit.

Alcohol, being an inflammatory substance, causes swelling in the body and irritates the GI tract. The irritation causes bloating, which makes a person feel full and heavy, even without eating food.

The effect is worse for people who consume alcohol mixed with sugary carbonated substances because it leads to gassiness, more bloating, and stomach discomfort.

Alcohol also causes dehydration. When the body does not receive proper hydration, the vital organs are forced to hold more water for them to be able to continue their normal body functions.

The water accumulated in the organs leads to puffiness and more bloating.

Bloating and gassiness both bring discomfort; thus, the urge to eat food is set aside to focus more on dealing with the discomfort rather than sufficing the body’s basic need to address hunger. 

This explains why alcoholics eat so little.

4. Hangovers From Hell Disrupts Hunger

Most chronic alcoholics are blackout drinkers and won’t stop until they drop. This leads to unmitigated hangovers once the effects of alcohol wear off.

So, the next day, instead of enjoying your breakfast, you’re left to deal with your hangover.

Hangover also triggers vomiting secondary to nausea and vertigo. It stirs up and messes with your gastric acid, which causes the acidic aftertaste that affects your appetite.

 Lastly, alcoholism messes up with your body clock and window of hunger. You often sleep throughout the day and, once sober, deals with an unmanageable hangover which leads you to skip meals.

This explains the reason why alcoholics tend to eat less when hangover.

5. Alcoholic Ketoacidosis

Ketoacidosis, also known as metabolic acidosis, is a life-threatening condition that requires immediate treatment and intervention.

When the body burns fat as an energy source, byproducts called ketone bodies are produced.

When the body constantly burns fat, ketone bodies accumulate in the bloodstream; this condition is called ketoacidosis.

Alcohol Ketoacidosis occurs when the body is deprived of enough glucose supply, and the pancreas produces low to zero insulin.

Cells need glucose to function correctly, while insulin allows cells to process glucose for energy.

The negative impact of alcoholism on your appetite and eating habits affects the body’s glucose supply. And alcohol’s effect on the pancreas limits, if not hinders, the production of insulin. 

This leaves the body with no choice but to break down fats as an energy supply, and this is where alcoholic ketoacidosis occurs.

One of the many symptoms of Alcohol Ketoacidosis is lack of appetite. This explains the reason why people with AUD who developed Alcoholic Ketoacidosis eat so little.

Do alcoholics lose their appetite?

Yes. Alcoholics lose their appetite for food because alcohol temporarily suppresses their appetite, which makes them feel full.

Despite bringing in empty calories in the body, alcohol still provides tons of calories that fill your stomach, making your brain believe that you’re not hungry.

What’s worse is, drinking sessions and sprees last for a couple of hours which means that you keep on feeding your body with alcohol and prolonging the feeling of fullness and satiety.

Usually, for medium and occasional drinkers, alcohol is an appetite stimulant. But for chronic alcoholics who drink until they pass out, there’s barely enough time for the body to stimulate appetite. 

Because they usually drink right after they sober up to manage their hangover.

Although the above mentioned is the simplest explanation of why alcoholics lose their appetite, there are other reasons secondary to alcoholism that trigger the body to lose appetite.

Here’s a brief but detailed rundown of appetite-suppressing conditions triggered by alcoholism.

1. You’re Focused On More Alcohol, So You Eliminate Food From the Equation

You know you’re in deep trouble once you start planning how to handle your drinking habits.

For alcoholics, the urge is too much to resist to the point where they plan ways to manage how to condition their body to drink more.

So to do that, they eat less food, so their stomach doesn’t feel maxed out quickly, and that means they’ll be able to keep down more liquor.

2. Vomiting

One of the expected consequences of excessive drinking is vomiting. This messes your gastric juices that work in digesting the food you ingest.

Puking also leaves a bitter or tangy aftertaste that makes you lose your appetite even more.

3. Gastroesophageal Reflux Disease (GERD)

Alcohol is a significant contributor to GERD. It is known to be directly associated with the disease because alcohol can irritate, inflame, and eventually damages the lower esophageal sphincter.

This sphincter acts as a barrier that keeps the gastric contents down.

Alcohol also worsens GERD symptoms since the mucosal lining of the oesophagus and stomach are directly exposed to alcohol.

It often leads to distortion of the normal forward movement in the digestive processes.

GERD patients experience acid reflux, heartburn, and loss of appetite. The acidic aftertaste also spoils your cravings for food, thus limiting your interest in eating.

4. The Lousy Sick Feeling Hinders You From Feeling Hungry

Ever wonder why you feel sick and lousy after a night of excessive drinking? This is because of the increased aldehydes in the bloodstream.

The body immediately identifies alcohol as a toxin; thus, it tries to process and flush it out.

During this process, the liver secretes the alcohol dehydrogenase enzyme, which converts the ethanol in the bloodstream into aldehydes.

The aldehyde dehydrogenase then converts it into acetic acid. The aldehyde byproducts from these processes are toxic that it makes you feel sick.

Aside from these, alcohol and acids mess up your ph level and contribute to acidosis and other stomach discomforts, including diarrhoea.

This is your body doing its best to flush out the toxins you’ve ingested. With all these toxins and metabolic processes going on in your body, the last thing you’ll feel is hunger.

How does alcohol affect nutrition?

Alcohol affects nutrition because it interferes with the body’s normal digestion, metabolism, mineral absorption, and vitamin utilization.

These could lead to irreversible health conditions and organ dysfunction, including impaired fetal development among pregnant women.

As a result, chronic heavy drinkers often suffer from double negative impacts.

They don’t get sufficient amounts of nutrients for the body to function correctly, and the nutrients they consume are left unutilized due to alcohol-related symptoms and complications.

Either way, this leaves them malnourished and unhealthy.

One of the fundamental goals of recovery is to get your body into proper health and shape, thus eating nutritious and healthy food comes as a priority.

Here’s a list of how alcohol affects your nutrition as you go down the dark road of alcoholism.

1. Impaired Digestion

Alcohol inhibits the body’s normal digestive process.

  • The pancreas starts to diminish its supply of digestive enzymes.
  • Damages the cell lining in the GI tract that causes nutrient malabsorption.
  • Interferes with nutrient transport into the bloodstream.
  • Absorbed nutrients are left unutilized due to altercation in the storage, transport, and excretion process.
  • Kills and damages the body’s normal pH level and flora.
  •  Nutritional deficiencies damage the cells of the small intestines that leads to malabsorption of nutrients.

2. Abnormal Energy Supply

Food-derived calories contain vitamins, minerals, and beneficial nutrients that help maintain and develop the body.

Alcohol, on the other hand, brings in empty calories. And when it enters the system, it forces the body to resume its metabolic process using alcohol calories as an energy supply.

Furthermore, when alcohol is used as an energy supply for carbohydrates, this results in weight loss.

Over some time, this may lead to a rapid decrease in blood sugar or hypoglycemia.

3. Disrupts Vitamin Utilization

Vitamins play an essential role in sustaining normal body functions, regulating physiological processes, and maintaining our overall health.

Every organ in the body uses vitamins to deliver its optimum growth, development, and normal metabolism.

Alcohol influences food intake, which diminishes nutrient supply in the body and causes diverse effects which inhibit the body’s proper absorption, metabolism, and utilization of vitamins.

 This is the reason why alcoholics often suffer from vitamin A, B, C, D, E, and K deficiencies.

These deficiencies can pose serious health threats such as weakening of bones, delayed blood clotting, night blindness and impaired cell maintenance.

4. Inhibits Mineral Absorption

Although alcohol does not directly suppress the absorption of minerals, alcohol-related conditions contribute to or negatively impact mineral absorption.

For instance, decreased nutritious food intake may lead to calcium deficiency and zinc deficiency.

Magnesium deficiency may occur due to lack of food ingestion, frequent urination, vomiting, and diarrhoea.

Furthermore, GI bleeding due to alcoholism may lead to iron deficiency. Mineral deficiency, just like vitamin deficiency, can cause serious health complications that, if left untreated, may lead to irreversible damages.

5. Suppress Protein Nutrition

Amino acids function as building blocks of protein and play a role in synthesizing hormones and brain chemicals, building muscle mass, and maintaining cell health.

Cells are mostly made up of proteins. Animal and plant-based proteins are great sources of amino acids.

According to the National Institute on Alcohol Abuse and Alcoholism, alcohol negatively impacts protein nutrition by suppressing protein digestion to amino acids.

Further, it inhibits the processing of amino acids by the small intestines and liver, improper protein synthesis derived from the amino acid, and decreased protein secretion from the liver.

What are the dangers of drinking alcohol and not eating?

Drinking alcohol and not eating for days poses health dangers, including Spasmodic Diarrhea, elevated Blood Alcohol Concentration (BAC), Nausea and Vomiting, and Alcohol Ketoacidosis.

Drinking too much alcohol alone is dangerous to your health. But drinking alcohol and not eating brings the issue to a different level of danger.

Aside from the usual alcohol poisoning characterized by hangover symptoms, this can lead to more severe health conditions that require medical attention and intervention.

Dangers of Drinking Alcohol and Not Eating

Spasmodic Diarrhea

The GI tract, from mouth down to the intestines, gets direct exposure to alcohol every time you drink.

Alcohol, regardless of concoction and form, irritates the GI tract, specifically the lining of your stomach and gut.

The longer the contact, the higher the chance that you’ll develop stomach upset and spasmodic diarrhoea the next day after the happy drinking spree.

According to Tamara Freuman, eating food before drinking decreases the chance of developing stomach discomfort and loose stool.

The food you ate acts as a barrier that keeps alcohol from getting direct contact with your inner intestinal lining, thus minimizing the risk for irritation.

So eat some food instead of drinking your food if you don’t want to end up dehydrated and sicker than just a hangover.

A Rapid Increase in BAC Levels

The Blood Alcohol Level increases rapidly when drinking without eating a proper meal.

Without food that acts as a stomach coating, digestive motility is higher, which leads to quicker absorption of alcohol in the bloodstream. This results in a high BAC level.

Elevated BAC affects your judgment, coordination, and other brain function. This is where the danger comes in.

Due to minimal brain function, you are prone to accidents, self-inflicted injury,  and making illogical decisions that you’ll most likely regret the next day once you sober up.

Nausea and Vomiting

The presence of food contents in your digestive tract slows down the digestion process.

This minimizes the impact of alcohol in your intestines and allows your body to produce enzymes for proper digestion.

Drinking without eating allows the alcohol to create direct contact to the digestive walls and lining.

This also leads to quick emptying of the stomach, and the toxic alcohol metabolic byproducts tend to build up in the bloodstream more quickly.

Once this happens, the BAC shoots up, and the toxin-detecting function of the brain quickly notices these red flags.

This leads you to nausea and vomiting as the brain attempts to flush out the toxins from your body.

Alcohol Ketoacidosis

For chronic drinkers who adapted a habit of eating so little or skipping meals to drink more alcohol, they are at high risk of alcohol ketoacidosis.

This happens when the body doesn’t get enough glucose from food, and the pancreas doesn’t produce enough insulin.

To generate energy, the body uses fat instead of food-derived glucose to compensate for the absence of food supplied to the body.

Metabolic byproducts called ketone bodies are produced and eventually accumulate in the bloodstream over some time.

This condition requires hospital care and, if left untreated, can cause fatal effects.

Reach Out for Help

No matter how deep you are in the dark road of alcohol dependency, help is always available. Visit us at Abbeycare Scotland and Abbeycare Gloucester.

Our Addiction Treatment Plan is personally tailored to fit your case and needs. We believe that each case is unique and that each case requires a different approach.

Learn more about our different Addiction Treatment Plans and Clinically Managed Detox Plans that can help you recover and get back to life. 

Reach out to us at our free 24/7 Helpline on 01603 513 091 or fill out the form below to connect with our professional counsellor via live chat.

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.