Keto, Weight Loss, and Alcohol

There is a lot of interest in the interaction between alcohol and weight loss — and just as much confusion. Keto is one of the few diets that does not forbid alcohol, but that doesn’t mean it has no impact on weight loss. For some, an occasional glass of dry wine or distilled spirit isn’t enough to affect their ketosis; but the carbs and calories in alcohol aren’t the only things to consider.

Alcohol and Keto

When on a keto diet, you may experience a lowered tolerance for alcohol. This has a couple of potential causes. First, a gastrointestinal tract full of carbs typically slows down alcohol absorption. This is because alcohol competes with sugar (broken down from carbs) for the limited surface area of the small intestine; without the competition, alcohol is absorbed much faster. Next, when you restrict carbs, most of the glucose your body needs is produced from non-carbs in a process called gluconeogenesis. When alcohol enters the system, it is possible that gluconeogenesis is put on hold as the liver prioritizes alcohol metabolism above all else — resulting in decreased glucose and increased acetone, likely making the alcohol hit you harder.

You may also experience worsened hangovers, which are most likely the result of dehydration and electrolyte loss. As always with a keto diet, you need to make sure you are consuming enough water and salt.

A keto diet can also result in higher levels of acetone in your breath, which can cause higher-than-normal readings (and even false positives) on alcohol breathalyzers. Please drink responsibly and never drink and drive.

Alcohol and Calories

Alcohol (ethanol in its pure form) does indeed have calories — about 10 calories per gram — and will contribute towards your total daily intake. Not counting calories from alcohol is the same as not counting calories from any other source: you will shrink the energy deficit built into your macros and your body will use the alcohol for energy in place of your body fat.

Things get confusing quickly with alcohol as there are many kinds and ways to drink it: light and dark beers, sweet and dry wines, distilled spirits, and an endless array of mixed drinks, often with plenty of sugar added.

  • A 12oz beer can range anywhere from 60 calories all the way to 300 calories, depending on the brew. However, beer is not keto-friendly because of its high carb content — read more below.

  • The average glass of distilled spirit contains about 1.5oz of alcohol. The calorie content varies with the strength of the alcohol: around 130 calories at 80 proof to 160 calories at 100 proof. Avoid sweet mixers — a cosmopolitan has 12g of sugar (48 calories), a gin and tonic has 16g of sugar (64 calories), and margarita mix has as much as 24g of sugar (100 calories).

  • The average glass of dry wine (red or white) is about 5oz, containing 120 calories. Most dry wines have less than half a gram of sugar as well as some complex carbs left over from fermentation. Avoid sweet wines, especially dessert wines. They contain much more sugar: the same 5 ounce glass of sweet wine has about 235 calories.

  • Wine coolers are not keto-friendly. The added soda contributes between 30–40g of sugar per bottle!

Alcohol and Insulin Response

Spikes in blood sugar and the resulting insulin responses are direct results of your carbohydrate intake. Beer, for instance, is typically carb-rich and is quickly digested, resulting in large spikes of blood sugar and the accumulation of fat — what we’ve come to call “beer bellies.” Low carb beers do exist, but still result in sharp spikes and should only be drunk on occasion. A 5oz glass of dry wine, on the other hand, typically contains about 2g of net carbs. Distilled alcohol — when drunk by itself — has no carbs.

However, drinking alcohol will slow down weight loss for many people as their liver prioritizes cleaning it from your blood over burning body fat. While the exact reasons for this are still unclear, fat burning can be reduced in some people by as much as 70% after only a couple of low carb alcoholic drinks.

To lose weight, you should limit your alcohol consumption to a maximum of one glass of dry wine or one glass of distilled spirits (with no added carbs or sugars from mixers) a couple times a week — not per day.

If you’d like to test the impact of alcohol on your specific body, you can eliminate it completely for a couple weeks and then add 2–3 drinks a week back in and take note of any changes you experience. This requires strict and consistent adherence to your macros, however; otherwise, the changes you experience could be related to other changes in your diet.

Alcohol and Self Control

Aside from the calories, carbs, and sugars in alcohol, it impacts the judgement and self-control centers of the brain. Even a light buzz can affect your ability to manage cravings at the sight of a brownie or warm, crusty bread — as well as the ability to stop once you’ve started. You are more likely to make excuses for your actions, blame others, and pass up opportunities for self-reflection in the face of cravings. The same neurology and brain chemistry at play in managing these cravings can also make it difficult to limit the number of drinks.

For those with a history of strong sugar cravings, removing sugar from their diets results in a change in their dopamine systems — a chemical in the brain involved in reward motivated behavior. Sugar and alcohol molecules are very closely related, physically and chemically. Consequently, the brain may turn to alcohol to fuel the dopamine response that was previously driven by sugar. Your apparent inability to deal with cravings and limit your drinking is not about your willpower and self-control but rather about a change in the chemistry of your brain.

Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) refers to a range of conditions affecting the livers of people who rarely or never drink alcohol. It is a growing epidemic in western countries: there are approximately 65 million people in the U.S. who suffer from NAFLD. It is linked to obesity, insulin resistance, polycystic ovarian syndrome, diabetes, high blood sugar, and high levels of triglycerides in your blood.

If you suffer from NAFLD, do not drink alcohol. You should also avoid sugar and carbs. Chemically, fructose is closely related to alcohol and both can cause fatty liver diseases to progress to cirrhosis, liver failure, and liver cancer.