National Institutes of Health (NIH) | (.gov)https://pmc.ncbi.nlm.nih.gov › articles › PMC10752097by A Ahmed2023Cited by 2 — A deficiency of niacin and its precursor tryptophan leads to the development of pellagra - a nutritional deficiency disorder with multisystem involvement.
Pellagra is often called “the disease of four D’s” - dermatitis, diarrhea, dementia, and death. Niacin, also called pellagra preventing factor, acts as a precursor to the coenzymes nicotinamide adenine dinucleotide (NAD) and NAD phosphate (NADP).
in moderation, standard alcohol dehydrogenase is enough to get it out of your system quick enough to make your body happy. But with excess alcohol, your body starts to panic a little. It's got so much of this poison in it that if it doesn't get it out quick enough, there'll be some pretty poor consequences (i.e. vomitting, loss of consciousness, death...).........
When binge drinking alcohol, the body treats the substance as a drug and metabolizes it with a different pathway. Rather than using a reaction that creates NADH, the body uses a microsonal ethanol oxidizing system (MEOS), which uses up energy (takes NADPH and produces NADP).
And because energy in versus energy out is what determines weight loss and weight gain, an energy deficit would cause weight loss in a person. Since alcoholics are frequently metabolizing through MEOS, they have a net loss of energy.
Though I really don't want to encourage binge drinking, yes, you would lose weight - to a certain extent. It's common knowledge that binge drinking is bad for you... but many people don't understand the late stages of alcoholism and how exactly it affects your liver and body composition.
For example, long-term alcoholics can develop acites (NSFW), which are basically just massive amounts of fluid. This is generally at a point when they're already in poor enough health (due to malnourishment, particularly thiamin deficiency) that they'll wind up in the hospital.Unfortunately, many new doctors make some massive mistakes with alcoholics in terms of nourishment upon admittance. Meal plans are typically calculated using the patient's weight, but the acites in an alcoholic cause their scale weight to increase dramatically because of all the extra fluid. If a doctor doesn't consider their euvolemic weight (their body weight minus the acites), the patient can wind up being feed a caloric intake far beyond what their malnourished body can handle and many will go into cardiac arrest and die.
wow. Fascinating.
Another icky consequence deals with that thiamin deficiency. Thiamin is necessary for your body to produce pyruvate dehydrogenase, which is really important for central nervous system function. You can Google Wernicke-Korsokoff syndrome to learn more about that.
The symptoms of WKS can vary in severity and may include:
Confusion and disorientation
- Memory loss and difficulty learning
- Eye problems (e.g., double vision, eye movements)
- Gait disturbances (e.g., unsteadiness, wide-based stance)
- Muscle weakness
- Hallucinations
- Confabulation (making up memories that didn't happen)
Treatment involves immediate administration of high doses of thiamine.
those who are are most typically in the late stages of the disease due to consumption of solely alcohol (which has no real nutritive value apart from being calorie dense) or metabolic organ failures/disorders that have been caused by chronic excessive alcohol intake (like cirrhosis of the liver) that either impair hunger levels or interfere somehow with normal metabolic processes. Thus resulting in weight loss.
No, your metabolic pathways don't magically switch around if you're on a binge, and NO drinking excessively will not help you lose weight - an alcoholic being underweight is a symptom of the person being in the end stages of their disease.
wernicke korsakoff encephalopathy, which essentially develops because the person doesn't consume enough Thiamine/Vitamin B1 for their brain to work properly.
When admitting alcoholics to the ward we always have to clarify their bowel habits, "When was the last time you passed stool/pooped?", "Oh, yeah, that was like a week and a half ago", "Why do you think it's been so long?". They'll either say they don't know but their stomach has been killing them or they'll say it's because they haven't eaten anything for just as long, so we need to figure out it they have a GI problem on top of the alcohol consumption or if they just need lunch........
the alcoholic is "washing" away all of the life sustaining nutrients and vitamins and not replacing them. As mentioned above, alcohol inhibits the absorption of nutrients and fat. It is far more complex than that, but that's the easiest answer.
When we get alcoholics in the ER we used to give them a "banana bag" full of vitamins (Like Thiamin B1 and potassium). Now we just look at their blood work and treat their deficiencies. Also I give ativan and valium to treat their tremors (alcohol is one of the few drugs that can KILL you from withdrawals........
I was recently diagnosed with alcoholic hepatitis. I had lost a ton of weight, was always fatigued, dizzy and threw up daily. I thought I had diabetes actually. I couldn't eat at all. I was honest with my doctor about my consumption. He said the booze was taking the place of food. I had just been through a bad breakup and was self medicating. I think the low weight is more likely to be seen in extreme cases of alcoholism. I drank all day and night......
a lot of chronic alcoholics develop chronic pancreatitis - meaning their pancreas will calcify and be unable to produce digestive enzymes. The digestion of proteins and carbohydrates is somewhat compensated by bile and the intestines itself, but fats can't be digested without pancreatic enzymes. Because of this they develop steatorrhea - meaning a fatty, chronic diarrhea and lose even more weight when they reach this stadium.
However, lots of alcoholic beverage have plenty of sugar in them, including beer, wine, liqueurs, cocktails, and so forth. On the other hand, some alcoholics go with straight liquors, which are highly distilled and have very few carbs in them.
In other words, fat boozers are probably drinking beer or wine, whereas the thin ones are drinking rotgut whiskey.
......
An alcoholic who goes past functional will pay for alcohol before food and will start to get past the alcohol being extra calories and it will be their main source of calories. It is not healthy and they become malnourished. I have seen a guy go past the functional stage and get to where he forgets to eat and is not drinking beer anymore due to cost/content. It no longer had enough kick for his habit. So he switched to cheap vodka. The only meal he ate was lunch at work because everybody in office went to lunch together and it would be questioned if he did not eat. He lost about over 50-60 pounds in less than 4 months right before he went to rehab.
So to answer your question, actually frequently overweight is not always true for alcoholics. The obviously alcoholic people you see who are no longer functional/compensating and hiding it are underweight...
No comments:
Post a Comment