Can You Drink Alcohol With Obesity and High Blood Pressure?

While research on alcohol is evolving, the Centers for Disease Control and Prevention says drinking less or not at all is better for your health.

If you have obesity and high blood pressure, you may wonder whether it’s safe to drink alcohol. The answer is no.

Alcohol amplifies the negative effects of excess weight and hypertension on metabolic health, increasing your risk of health complications.

“Adding alcohol use to obesity and high blood pressure is like adding gas to a fire,” says Meghan Garcia-Webb, MD, a Wellesley, Massachusetts–based obesity medicine physician in private practice.

“Being overweight, especially around the belly, is one of the strongest risk factors for high blood pressure,” says Raghuveer Vedala, MD, a family and obesity medicine specialist with Norman Regional Hospital System in Oklahoma City and member of the Obesity Medicine Association.

Alcohol and Obesity

Alcohol exacerbates obesity by adding empty calories that promote fat storage, increasing hunger and cravings, and disrupting sleep quality.

Alcohol is toxic to the liver, which plays a critical role in metabolic health. Even low and moderate alcohol intake is associated with sharply increased risks of the liver diseases MASLD and MASH. These conditions are defined by a dangerous accumulation of fat in the liver. They are common in people with obesity.

And for many people, alcohol promotes weight gain simply because it’s a high-calorie beverage.

Alcohol and High Blood Pressure

When you drink alcohol, the sympathetic nervous system, which triggers your “fight-or-flight” response to stress, ramps up. This prompts the kidneys to tighten control of blood pressure signaling and causes inflammation that interferes with how the blood vessels naturally relax, says Dr. Garcia-Webb. Your blood pressure spikes as a result.

“While one drink might cause a short-term spike, regular use activates stress hormones and leads to sustained increases in blood pressure,” Vedala says.

Beyond creating further complications for the health conditions you’re trying to treat, alcohol may also have an unhealthy interaction with the medications you take for hypertension, obesity, and other common conditions:

• Alpha-Blockers (Doxazosin, Prazosin) Drinking alcohol can magnify alpha-blockers’ effects of lowering blood pressure, leading you to feel dizzy and lightheaded.

  [12]

• Beta-Blockers (Metoprolol, Atenolol, Propranolol) Alcohol may increase the concentration of beta-blockers in the blood. This boosts the medication’s blood pressure–lowering effects, which can cause dizziness, lightheadedness, fainting, and heart rate changes.

  [13]

• Calcium Channel Blockers (Amlodipine, Nifedipine) Calcium channel blockers are a class of medication that treat high blood pressure. They may slow the metabolism of alcohol, causing it to linger in the bloodstream. Prolonged elevations of alcohol mean you’ll continue feeling the effects longer than usual.

  [13]

• ACE Inhibitors (Lisinopril, Enalapril) Alcohol can increase the blood pressure–lowering effect of angiotensin-converting enzyme (ACE) inhibitors, a class of medication used for high blood pressure. Pairing the two may cause dizziness or lightheadedness.

  [14]

• Diuretics (Hydrochlorothiazide, Furosemide) Both alcohol and diuretics (water pills) increase urine excretion. Together, they can lower blood pressure, leading to headache, dizziness, lightheadedness, and fainting.

  [15]

• Phentermine Pairing alcohol with phentermine, a weight loss medication, can increase the risk of cardiovascular side effects, including rapid heart rate, chest pain, and blood pressure changes. It may also cause dizziness, drowsiness, and difficulty concentrating.

  [16]

• GLP-1 Agonists (Semaglutide, Ozempic, Liraglutide) Glucagon-like peptide-1 (GLP-1) agonists are a class of medication prescribed for weight loss and type 2 diabetes management. While some evidence suggests GLP-1 agonists may reduce your motivation to drink alcohol and offer protective effects for the liver, they may also slow alcohol metabolism. This can lead alcohol to stay elevated in the bloodstream for a prolonged period.

  [17]

Minimizing or eliminating alcohol is important if you have obesity or high blood pressure.

Before you drink, first consider trying a nonalcoholic beverage. Nonalcoholic beverages can be a helpful option for those who want to socialize without risking the negative effects of alcohol on obesity and high blood pressure.

If you do decide to drink, these tips could help reduce your risks:

• Limit intake. There are no official guidelines for safe alcohol limits for people with obesity or high blood pressure. “So, if you’re going to drink alcohol, it’s important to know this, and keep it to just a few drinks per week, maximum,” Garcia-Webb says. “Definitely not more than one drink per day for women or two drinks per day for men.”
• Stay hydrated. Experts generally recommend drinking a glass of water in between alcoholic beverages to give your body time to process the alcohol you just consumed. This helps the liver process alcohol at a more manageable pace, which can keep blood pressure stable and reduce impulsive eating.

  [19]

• Eat first. Eating a meal or snack with protein, fats, and carbohydrates before drinking slows the absorption of alcohol into the small intestine.

  [19]

  It also increases the rate of alcohol elimination from the bloodstream by 25 to 45 percent.

  [20]

   These combined effects can help minimize blood pressure spikes and prevent alcohol from impairing food judgment.
• Monitor yourself for any reactions. Stop drinking if you experience symptoms of medication interactions, including dizziness, rapid heart rate, and feeling faint. Severe dizziness, chest pain, difficulty breathing, and fainting warrant medical attention.

  [21]

Remember, there is no safe level of alcohol; not drinking is the safest approach. Discuss alcohol use with your healthcare provider, especially if you take medications.

• Obesity and high blood pressure result from impaired metabolic health. Drinking alcohol can worsen both conditions.
• Alcohol consumption is especially risky when taking medications for obesity and high blood pressure, as dangerous interactions may occur.
• There is no safe alcohol limit for people with obesity and hypertension. Drinking less, or not drinking any alcohol at all, is always the safest choice.