Ethanol interferes with carbohydrate energy metabolism. Liver and muscle glycogen are depleted. As cellular toxin, ethanol is catabolic and promotes structural tissue loss. The catabolic effect causes a greater loss of weight than caloric input can replace in the form of fat stores. Typically, fat distribution shifts to the belly and trunk, leaving the extremities skinny and weak.
Men often grow female breasts, as estrogen accumulates in their system.
Their psyches follow their body degeneration. This discussion of alcohol abuse is continued in the Book of Alcohol .