A new study has found that even one heavy drinking session a month could triple the risk of severe liver damage.
The occasional alcohol binge might seem like a safer choice than regularly drinking less, but that assumption may be dangerously misplaced – particularly for people with metabolic dysfunction–associated steatotic liver disease (MASLD).
MASLD – which was formerly called non-alcoholic fatty liver disease – affects an estimated one in three British adults, making it the most common liver condition in the UK. It develops when fat builds up in the liver and is often symptomless.
Those most at risk include people who are overweight – particularly with excess fat around the waist – as well as individuals with poor diets or low levels of exercise. It is not linked to alcohol intake, unlike other forms of liver disease.
The condition is also more common in individuals with type 2 diabetes, polycystic ovary syndrome, high blood pressure, high cholesterol and adults over 50.
Now, new findings suggest that even occasional binge drinking may push those with MASLD into dangerous territory.
The study, conducted in the US and published in the journal Clinical Gastroenterology and Hepatology, found that people who binge drank at least once a month were around three times more likely to develop advanced liver fibrosis than those who consumed the same amount of alcohol more evenly over time.
This kind of scarring can lead to cirrhosis – a serious and irreversible condition that can lead to fatal complications.
Dr Brian P. Lee, a hepatologist and liver transplant specialist with Keck Medicine and leader of the investigation, described the findings as a ‘huge wake-up call’.
New research suggests that people with MASLD could triple their risk of severe liver damage by indulging in just one binge drinking session per month
He said: ‘Traditionally, physicians have tended to look at the total amount of alcohol consumed, not how it is consumed, when determining the risk to the liver.
‘Our research suggests that the public needs to be much more aware of the danger of occasional heavy drinking and should avoid it even if they drink moderately the rest of the time.’
The research analysed data from more than 8,000 adults between 2017 and 2023 and uncovered that younger adults and men were more likely to report binge drinking.
In the study, binge drinking was defined as four or more drinks in a day for women, and five or more for men, at least once a month.
The researchers focused on MASLD because it is prevalent in the USA as well as Britain and is not related to alcohol consumption.
More than half of participants reported occasional binge drinking, and nearly 16 per cent of those with MASLD fell into this category.
When comparing individuals of similar age, sex, and average weekly alcohol intake, those who engaged in occasional binge drinking had nearly three times the odds of developing advanced liver fibrosis.
Dr Lee noted that while the findings focus on people with MASLD, they may apply more broadly.
He added: ‘With more than half of adults reporting some episodic heavy drinking, this issue deserves further attention from both physicians and researchers to help better understand, prevent and treat liver disease.’
While MASLD is largely symptomless, some people may experience fatigue, a general feeling of being unwell, or discomfort and pain on the right side of the abdomen, just beneath the ribs.
The NHS advises seeing a GP if you think you may have MASLD because although most people are in the earliest stage of the disease – known as steatosis, where fat builds up in the liver without causing damage – it can progress to more serious conditions.
In the second stage, the excess fat begins to trigger inflammation in the liver. At this point significant damage has not usually occurred, but the disease can advance further.
The next stage is fibrosis, where scar tissue starts to form. It is crucial to prevent further liver damage when this happens, as it can progress to cirrhosis – linked to life-threatening complications, including internal bleeding, liver failure, liver cancer, and sepsis.