THURSDAY, July 24, 2025 (HealthDay News) — Heavy-drinking Americans are more than twice as likely to develop alcohol-related liver disease compared to two decades ago, even though folks generally imbibe the same amount as before, a new study says.

This is likely because heavy alcohol use has increased among groups with a higher risk for developing liver scarring from hard drinking, researchers write in the journal Clinical Gastroenterology and Hepatology.

“Our results show that the makeup of the American public with heavy alcohol consumption has changed compared to 20 years ago,” senior researcher Dr. Brian Lee said in a news release. Lee is a hepatologist and liver transplant specialist at Keck Medicine of University of Southern California in Los Angeles.

Specifically, heavy drinking has increased among women, adults 45 and older, people living in poverty and folks with metabolic syndrome.

Metabolic syndrome, in particular, increases the risk of liver scarring from hard drinking, researchers noted. It’s a cluster of health-threatening conditions that include abdominal obesity, high blood pressure, elevated blood sugar, high levels of dangerous blood fats known as triglycerides, and low levels of “good” HDL cholesterol.

“We found that the increase of metabolic syndrome was over 40% during our study period among increased alcohol consumers, which is similar to the general population,” the study says.

Heavy drinking is considered eight drinks a week for women and 15 for men, researchers said in background notes.

For the study, researchers analyzed data gathered between 1999 and 2020 for more than 44,600 people as part of the National Health and Nutrition Examination Survey.

Results showed that the average drinking rate in America hadn’t changed in the 20 years before the COVID-19 pandemic.

Nonetheless, a greater number of heavy drinkers showed signs of liver scarring that can impair the organ’s function. Specifically, more than 4% of heavy drinkers had severe liver scarring between 2013 and 2020, up from less than 2% in 1999 to 2004, results show.

Lee thinks the study can help doctors identify people at risk for alcohol-related liver disease. 

“These findings — the first comprehensive look at the demographics of heavy drinking and their relation to liver disease since the 1990s — provide important new information about which population groups may need more intervention to curb alcohol use and may also explain the rise in liver disease over the years,” Lee said.

The findings were published July 23.

More information

Johns Hopkins Medicine has more on alcohol-related liver disease.

SOURCES: Keck School of Medicine of USC, news release, July 23, 2025; Clinical Gastroenterology and Hepatology, July 23, 2025