DR MAX PEMBERTON: Why so many women are binge drinkers without even knowing it
What image springs to mind when I say the words 'binge drinker'? Young people knocking back shots and staggering out of bars barely able to stand, perhaps?
What if I told you that three standard glasses of wine consumed in one sitting is considered a binge?
You may be shocked by that information but six or more units of alcohol for women (eight for men) is all it takes, meaning that many people who would be aghast at the very suggestion they are a binge drinker, may well be. Therefore, with Christmas party season now upon us, you're going to have to forgive me for donning my party pooper hat for a few minutes.
While I want everyone to enjoy themselves, my concern lies with the fact that I know a large numbers of people are going to end up consuming far more alcohol than is safe and are likely to be completely ignorant of the damage they are doing.
Some may already be reading this and thinking, 'Where's the harm? It's once a year!' Perhaps you've decided you'll make amends by doing dry January? Well I'm sorry to say that a month of excessive boozing can't be magically cancelled out by a month of sobriety.
Last week's Panorama shone a light on the devastating health impact of alcohol in women. It was presented by BBC journalist Hazel Martin who, in her early 30s, was diagnosed with alcohol-related liver fibrosis because of her drinking habits.
This is a form of severe scarring of the liver and if she had continued drinking, it would have developed into cirrhosis.
Yet Hazel wasn't dependent on alcohol and didn't drink every day. When she drank it was to be sociable and because she liked it. But her pattern of alcohol consumption, like so many others, definitely classed her as a binge drinker.
More women under the age of 45 are dying due to alcohol-related liver disease (ARLD) than ever before, according to Office for National Statistics (ONS) figures from 2001-22
Her compelling investigation showed that while the problem is undoubtedly bigger in men, more women under the age of 45 are dying due to alcohol-related liver disease (ARLD) than ever before, according to Office for National Statistics (ONS) figures from 2001-22.
From my experience working in a liver unit, and later alcohol services, many patients with liver problems had convinced themselves that their drinking was fine because they had days off and therefore gave their body a 'rest'. It's an attitude that is sadly misguided.
There is now mounting evidence that bingeing alcohol is uniquely damaging to the body compared to drinking the same amount spread out over time. In other words, a binge on a night out followed by six non-drinking days is actually worse than if you drank the same amount over the course of the entire week.
Bingeing is up to four times as damaging to the liver. According to the latest ONS data, liver disease is consistently in the top three causes of death each year for women aged 39-45.
The toll of alcohol bingeing doesn't stop with liver damage either. There's also evidence that even one session can compromise functioning of the immune system and lead to acute pancreatitis as well as increasing the risk of traumatic injuries and suicidal behaviour.
For many years I worked in A&E and saw countless women who had been out, got blind drunk and then suddenly felt suicidal or developed heart arrythmias (irregular heart beat that can be brought on by alcohol).
When binge drinking becomes chronic it increases the likelihood of developing cancer and coronary heart disease.
And while the problem of bingeing is growing in younger women, the highest rates are still in adults between 55 and 64, according to research conducted by DrinkAware. Their data suggests that around one in five people in this age range binge drink. Yet this age range is also one of the most vulnerable to the toxic effects of alcohol.
An interesting study was published recently that showed how increased alcohol consumption raises the risk of dementia. It's now becoming clear that even moderate drinking can cause brain damage.
Figures show that two people are hospitalised every day because of alcohol-related dementia. As doctors, we have a duty to tell our patients more about the chronic, disabling conditions linked to excessive alcohol consumption.
We tend to over-emphasise how drinking (and smoking) will shorten their lives and all too often we'll get the jocular response: 'Well, doc, you've got to die of something!'
However, while bingeing on alcohol might not kill you outright, some of the consequences are, arguably, far worse than death; stroke, disability, dementia, cancer – conditions that you may have to live with for years.
It's not so easy to dismiss Christmas binge drinking as 'letting your hair down' once you're aware of the cold, hard facts.
So, have fun by all means but avoid bingeing – believe me your body will thank you.
I'm A Celeb's Oti Mabuse broke down recalling the premature birth of her daughter. As she said, it's terrifying to go home, leaving the baby in the care of others in hospital. A birth is meant to be joyful but having a premature baby can be traumatic... and impossible to prepare for.
Strictly Come Dancing judge Oti Mabuse on this year's I'm A Celebrity... Get Me Out Of Here!
Victoria's misery with acne
Victoria Beckham has revealed how she struggled with acne during the Spice Girls heyday, explaining that the lack of confidence it sparked stopped her from smiling in pictures.
People who haven't experienced the misery of acne might not fully understand the psychological impact it can have. I too had acne into my 20s. While I tried to never let it get to me too much, I remember speaking to a friend, who was a semi-professional boxer about how I felt about my acne and, to my astonishment, he confided in me that his acne made him frequently cancel plans and, shockingly, even feel suicidal at times.
He had suffered in silence for years because he thought no one would take it seriously. We decided to both make appointments at a dermatologist, had treatment and neither of us have been troubled with acne since. However, it left me with a profound knowledge that suffering from spots and acne can have a big impact.
Victoria Beckham has revealed how she struggled with acne during the Spice Girls heyday
About a quarter of the working age population - those aged 16 to 64 - do not currently have a job. That's about 11 million people. The numbers of people claiming benefits is soaring and a large proportion are claiming based on mental health grounds. While I think we should help those struggling, the system is at breaking point. A not insignificant proportion, while unwell in one way or another, could work but simply don't feel they should.
They seem to think that unless everything is perfect for them, with no stress or difficulty in their lives, they can simply sit back while others pay for them. They lack - and it's telling that it's almost become a dirty word - any sort of resilience. The difficulty is that quite rightly the 'pull your socks up' approach to mental illness is now frowned upon.
But, now, no one feels able to tell people that, yes, they might be a bit anxious, or stressed, or low, but they need to find ways to deal with it – and sitting at home watching TV and living off other people's hard-earned money is not an option.
Dr Max Prescribes: Inside Out 2
This sequel to the 2015 animation about the inner workings of a little girl's mind explores the emotions of the same girl, now she's an adolescent.
It perfectly captures the emotional turmoil of this age and gives a very useful insight into what's really going on with your teenager. Everyone should watch it.
Inside Out 2 perfectly captures the emotional turmoil of this age and gives a very useful insight into what's really going on with your teenager
