Even occasional binge drinking may significantly raise the risk of a serious liver condition, according to new research.
Researchers from the University of Southern California found that even one episode of heavy drinking per month was linked to a threefold increase in advanced liver fibrosis in people with underlying liver disease.
The findings, based on data from more than 8,000 U.S. adults, were published in the journal Clinical Gastroenterology and Hepatology.
Advanced liver fibrosis is a late-stage condition in chronic liver disease. It is marked by significant scarring of the liver caused by long-term inflammation. Over time, this damage can impair liver function and lead to more severe complications.
The study focused on people with metabolic dysfunction-associated steatotic liver disease, or MASLD. This condition, commonly tied to obesity and metabolic issues such as Type 2 diabetes, high blood pressure, and high cholesterol, is estimated to affect roughly 25% to 30% of U.S. adults.
Researchers analyzed six years of data from more than 8,000 adults who participated in the National Health and Nutrition Examination Survey. They found that more than half of participants reported some level of episodic heavy drinking. Nearly 16% of those with MASLD fell into that category.
Heavy drinking in the study was defined as consuming four or more drinks in a day for women and five or more drinks for men, at least once per month. Those who followed this pattern were significantly more likely to develop advanced liver scarring compared to people who drank the same total amount spread out over time.
Lead investigator Dr. Brian P. Lee, a hepatologist and liver transplant specialist with Keck Medicine of USC, said the findings challenge a common assumption about alcohol use.
“Patients often ask how much they can drink,” Lee said. “In the liver world, we’re used to thinking about this as an average.”
He said the research shows that the pattern of drinking may be just as important as the total amount consumed.
“Many patients ask if they don’t drink on weekdays, whether they can drink more on weekends — like a weekly ‘quota’ — and our study is showing that the answer is no,” Lee said.
The study also found that younger adults and men were more likely to engage in occasional binge drinking. It noted that the more drinks consumed in a single session, the greater the level of liver scarring observed.
Health experts have long warned that consuming large amounts of alcohol in a short period can trigger inflammation and damage in the liver. This study adds to growing evidence that even infrequent episodes of heavy drinking may carry serious long-term risks.
At the same time, researchers cautioned that the study was observational. That means it cannot prove that binge drinking directly causes advanced liver fibrosis. The findings were also based on self-reported alcohol use, which may not always be accurate.
In addition, the results were primarily tied to individuals with MASLD and may not apply to all populations.
Experts say the findings highlight an important point for both patients and physicians.
Julian Braithwaite, CEO of the International Alliance for Responsible Drinking, said the research reinforces that not all drinking habits carry the same level of risk.
“How you drink matters,” he said. “Binge drinking is high-risk, even occasionally, but that’s not the same as moderate consumption.”
Dr. Amanda Berger of the Distilled Spirits Council of the United States also emphasized that alcohol abuse, including binge drinking, is linked to serious health problems. She encouraged individuals to consult with their healthcare providers and consider personal risk factors when making decisions about alcohol use.
Current Dietary Guidelines for Americans define moderate drinking as up to one drink per day for women and up to two drinks per day for men.
Researchers say more long-term studies are needed to better understand how different drinking patterns affect liver health over time. However, they noted that with more than half of adults reporting some level of episodic heavy drinking, the issue deserves closer attention.
The findings add to growing evidence that even occasional binge drinking may carry serious risks for liver health.