The effects of binge drinking followed by abstinence: A real-world observational study in healthy adults

Binge drinking is a common pattern of alcohol intake often considered particularly harmful. However, its immediate effects on the development of hepatic steatosis and early alcohol-related liver injury are not well established. This study investigated the acute effects of binge drinking on the liver and their reversibility in healthy individuals.
Healthy adults were studied in a real-world setting before, the day after, and 10 days after attending a 3-day festival. Participants were alcohol abstinent 1 week before the first visit and between the last two visits. Each visit included liver MRI proton-density fat fraction and elastography, and blood tests. Alcohol and food intake were self-reported during the festival, and blood alcohol concentration was measured once daily.
Fifteen participants (9 male, 6 female), aged 36 ± 5 years, with a BMI of 23.2 ± 2.7 kg/m2, completed the study. They consumed 186 ± 56 g of alcohol per day, resulting in a 2.5-fold increase in hepatic fat fraction from 1.9% to 4.6%. Six participants developed steatosis. Compared with those without steatosis, they had higher baseline BMI, triglycerides, and glucagon, and lower free fatty acids, while there was no difference in alcohol or energy consumption. Binge drinking also increased liver stiffness and triglycerides, while LDL-cholesterol decreased. After 10 days of abstinence, all outcome measures were normalised.
Three days of recreational binge drinking increased liver fat content and stiffness in most participants. This early consequence of excessive alcohol intake resolved after 10 days of abstinence, suggesting that the acute hepatic effects of binge drinking are readily reversible if followed by short-term abstinence.
These findings offer timely insight into the health risks of recreational binge drinking and contribute knowledge with potential implications for public health messaging and recommendations, clinical guidance, and alcohol policies.
Source: Kjærgaard, K., Yeoman, J.M., Eriksen, P.L., Mikkelsen, A.C.D., Møller, E.E., Wietz, A.F., de Zawadzki, A., Gormsen, L.C., Heebøll, S., Vilstrup, H., & Thomsen, K.L. (2025) Binge drinking acutely induces hepatic steatosis which is readily reversible: A real-world observational study in healthy adults. JHEP Reports, 8(1):101623. doi.org/10.1016/j.jhepr.2025.101623.