Why We Drink Too Much: The Impact of Alcohol on Our Bodies and Culture

by Charles Knowles

We drink it, celebrate with it, and barely question it—but what is alcohol really doing to us?

Drinking alcohol can be fun; its chemical effects on our brain are fundamentally pleasurable, and it can have social benefits. Alcohol may also help us forget the worries in our lives and temporarily overcome psychological barriers to human interaction.

But there are downsides. We now know that alcohol, even in quite modest amounts, is not good for our long-term health. So why do we, as humans, consume alcohol at all, and why does our tendency to drink “too much” vary from person to person?

Pairing scientific expertise with his personal experiences, Dr. Charles Knowles offers us an accessible window into what really happens in our brains and bodies when we drink, and why we do it. People vary greatly in the amount of reward they derive from alcohol, both physically and mentally. It’s in the genes that we were born with and the environment in which we grew up. For some of us, alcohol is greatly enhancing; for others, it is not much fun at all.

For the sober curious, those who may need help, and also readers just interested in a popular science book on what happens when we sip a glass of wine, Why We Drink Too Much teaches readers the science behind drinking and invites us to examine our relationship with alcohol.

Genres: Nonfiction, Science, Health, Self Help, Audiobook, Addiction, Psychology

304 pages, Hardcover

Published January 6, 2026

Reviews

[Sharon Orlopp · Rating 4 out of 5]

"Trust me, you can dance." Vodka

I rarely pre-order a book but when I saw Why We Drink Too Much: The Impact of Alcohol on Our Bodies and Culture I knew I wanted to read it as soon as it was available. I entered the Goodreads Giveaway for the book but still pre-ordered the book. I did not win the giveaway.

My primary reason for wanting to read the book was because of the contradictory information about alcohol and its impact on health. Many longevity books, including The Blue Zones: Lessons for Living Longer From the People Who've Lived the Longest, indicate that drinking in moderation with friends and family can help you live longer. The socialization aspect is the primary health benefit. At my recent annual physical exam, my primary care physician (PCP) recommended that I eliminate alcohol completely because it is a known carcinogen.

What I liked about the book was the detailed information about research studies with very large numbers of participants. Some of the results of medical research studies cited in the book include:

* There is an increased risk of cancer associated with alcohol consumption.

* World Heart Federation: there is no safe amount of alcohol consumption that does not affect health.

* Alcohol is a factor in 40% of all violent crimes, 30% of all US road fatalities involved drunk drivers, and tw0-thirds of police called to domestic incidents involve alcohol.

* There are 150 diseases for which chronic alcoholic consumption is a risk factor.

* 2018 study of 600,000 people showed that the risk of stroke was increased by any level of alcohol intake.

* Contrary to popular belief, no scientific evidence that red wine has any health benefits.

* Alcohol is classified as a group one carcinogen---the same category as asbestos, radiation, and tobacco.

* 2022 study with 19.4 million women showed a dramatic effect alcohol has on the risk of breast cancer.

* 2022 study with 37,000 generally healthy middle-aged and older adults showed that even a modest intake of alcohol is associated with reduced grey matter in the brain.

* Alcohol impacts REM (rapid eye movement) sleep which is when we dream and when the brain consolidates memories.

I learned a new phrase, grey area drinkers. These are people whose average weekly alcohol intake is excessive. It is problematic drinking, and people in this category wonder if they might have a problem with the amount of alcohol they are drinking.

Hazardous drinking is a pattern of alcohol intake that increases someone's risk of harm. The quote by F. Scott Fitzgerald in this chapter of the book sums it up well, "Man takes a drink; Drink takes a drink; Drink takes a man."

I also learned that there are podcasts for the "sober curious" and there are "quit-lit" authors.

What I didn't like as much about the book is that it is a memoir about the author's struggle with excessive alcohol consumption. I greatly appreciated his poignant transparency about his personal journey. Memoir is my favorite genre, but my main interest in this book was medical research findings.

Recently we had several friends over for wine tasting to help us select wines for a February Wine Club event. Some of our friends said they aren't doing Dry January, they are doing Damp January.

I don't think I will completely stop drinking alcohol, but I will focus on drinking water or club soda during times when I would otherwise be enjoying alcohol.

[Mai H.]

a dirty filthy martini hates to see me coming

RTC

tw: alcoholism, drinking culture

📱 Thank you to Goodreads and Celadon Books

[Stiffra Armamento · Rating 3 out of 5]

Thank you Celadon for the ARC!

As a clinical nurse specialist in neurology, I found it a very apt read for me as a clinician and for my patients. It’s quite science heavy so I don’t know about its reach for the general public and I feel that it wouldn’t resonate as well with the lay person but for other clinicians and those who work in addictions medicine, it’s a good read that uncovers motivations for both consuming alcohol and sobriety.

[Tanja Berg · Rating 4 out of 5]

I thought this book would be a good start to what I intend to be a sober year. I have a tradition for dry January and for nearly a decade this has further extended to a dry first quarter and sometimes six months. Particularly as perimenopause has destroyed my ability to process alcohol and every occasion for alcohol has to be carefully evaluated.

Well, damn if this book didn’t make me crave a drink! However, it passed.

The book covers grey zone drinking, full alcoholism, the sober curios movement and the damage alcohol does to the body. It’s not a guide to stop drinking, but it’s informative. The author, a surgeon, is a sober alcoholic and gives insight into his road to rock bottom and recovery.

He also name dropped other authors and books, so I will probably read more on the topic.

[Ren · Rating 4 out of 5]

i never wanna drink again

[Kelley - rva_reader · Rating 4 out of 5]

I thought this was an interesting read. It combined the author’s own experience with alcohol with scientific data and lots of research. It was a quick read and I found myself taking a look at my drinking habits and reflecting. I have actually been trying to not drink for about the last 3 months. I have been letting myself have one night where I drink if it’s socially out with friends but otherwise I’ve been abstaining. I do feel a lot better, have less anxiety and sleep better without it. Sometimes my drinking felt like just a habit. Like oh it’s Friday, I guess I’ll have a glass of wine. This book was educational and definitely makes me feel better about trying to cut back.

Thank you to the publisher for an advanced copy. This will be out in January.

[Ellen Lowe · Rating 5 out of 5]

This is very interesting and informative…I especially liked the excerpts the author’s wife added with regards to her own drinking habits and how she was somewhere in that gray area that many of us exist in…she discussed the gradual pulling away from that culture and eventually stopping altogether…Knowles also discusses how there are Facebook groups and other groups of “sober curious” people to join in these discussions and get support from…I would place myself in that gray area where I’m looking at a gradual disconnect as well for health reasons mainly…this is a good resource for both those who are daily drinkers/alcoholics and those who are more in the gray to gain better understanding for our drinking habits…scientifically and behaviorally…I do recommend it!

[Kat V · Rating 3 out of 5]

This is sort of two books meshed together. It’s part memoir and part scientific book. I kind of wish they had been separate books. It wasn’t bad but I didn’t learn that much and it wasn’t really that enlightening. 3.2 stars

[Dez Roberts · Rating 3 out of 5]

The book opens with a blunt and striking preface and quickly establishes its mix of memoir, science and self help. Charles Knowles honesty and humour work well, and the personal sections are the strongest.

He looks at how we learn drinking behaviours and the cultural and scientific factors that shape them. Some of the ideas are fascinating, though the scientific detail can become quite dense and may not be accessible to every reader.

The memoir elements deepen as the book progresses, and the sections written by his wife are a real standout. Her perspective adds sincerity and gives a fuller picture of who he was during this period of his life, making the book feel more grounded and personal.

Overall, I enjoyed the blend of personal insight and research, but I think it will resonate most with readers who are comfortable engaging with more complex science around alcohol and biology.

[Dev (lit.lark)]

Thank you Macmillan Audio for this gifted audio!

This was a very informative read. It has a lot of science (like, a lot) but also some really great personal stories from the author about his own drinking and journey. So while science heavy I do think there was a decent balance. Since he is both a physician and recovering alcoholic, I definitely felt his knowledge on the subject throughout.

As someone who has been sober for about 2 years (while I did not have real issues with drinking, I just chose to stop prior to getting pregnant and chose to not resume after having my daughter) I enjoyed this because it left me feeling pretty validated in my decision to do so.

He (the author) narrates this book himself and since this has a lot of his personal journey, I found it fitting and thought he narrated well. His expertise on the science as a doctor definitely came through because he had an ease in how he spoke.

Definitely recommend for anyone interested in this sort of topic or considering quitting drinking!

[Raven Preisinger · Rating 3 out of 5]

There was a lot of interesting information in this book about the science behind alcohol and what it does to your body. Other parts of it weren’t quite as relevant for me, as I don’t have a problem with alcohol/not trying to quit, so those chapters kind of drug on for me. Overall though, a really insightful book that anyone who even occasionally has a drink would find intriguing as to the mechanics of it all on one’s physical and mental health.

[Caro]

thank you Netgalley for the digital ARC!
I enjoyed Charles perspective on alcoholism, sobriety and the journey in between. I think this is a great book for everyone who is questioning their own drinking or knows people who are. The mix of scientific parts and from his own life make it a great book.

[Sarah Cervantes · Rating 4 out of 5]

I was thankful to get an ALC (advanced listening copy) of this book, especially during round the holidays when alcohol consumption can be at it’s peak, and prior to the “New Year” goal setting that many of us partake in.

Before you read/listen to this book, I do want to provide a few warnings, there are topics such as: alcoholism, addiction, depression, and suicide discussed which may be triggering to some.

This book takes a unique take on alcoholism making a strong connection to sciences, evolutionary changes, and environmental factors such as where and how we were raised. I was familiar with many of these concepts but I gained a much deeper understanding of addiction and many of the factors that are out of the control of the individual struggling.

I really enjoyed hearing this book narrated by the author himself, which some excerpts narrated by his wife. Although this book has a focus on the science and development of alcohol dependence, it incorporates very real personal anecdotes that give the book more credibility and helps the reader develop more empathy. Likely, most of us can think of someone suffering from alcohol dependence or addiction that we can be easily slipped into this narrative. As someone who has a family with a history of alcoholism, this book was equal parts hard to listen and refreshing by learning more about how much alcohol has been engrained in our lives and is apart of our cultural.

At times, I did feel like the book got a little bit too science heavy for me and I wanted a little bit more of the personal story from both the author and his wife. I LOVED how some of her journey was woven into the book and that we got to hear from her personally about her own experience with alcohol as well as dealing with the effects of alcoholism on their family and marriage.

Sober cultural has been rapidly growing in many of the circles that I find myself in and I have often found myself curious about completely cutting alcohol out of my life completely, although I am already an infrequent drinker. If you are sober curious OR have friends/family that deal with alcohol dependence, I highly recommend this book for you. I believe you will get so many valuable insights that may help you in your journey.

[Brynx · Rating 5 out of 5]

I know, non-fiction. Weird, right? I don’t usually read non-fiction, but this felt like the perfect time of year for me to see if this book could shake the cobwebs loose in my brain. I’ve been in a bit of an emotional rut for the past few years and really needed something to rewire my brain, much like “Forks Over Knives” did for me 10 years ago (I was vegan for 2 years after watching that), and this book absolutely did it for me.

As a child of alcoholics and as someone who has had a weird relationship with alcohol for my entire adult life, I was unsure if this book would tell me something I didn’t already know or would actually impact my mental and physical state for the better. Yes, I know alcohol is bad for the body, and that it is a slippery slope for me personally when drinking starts. But, I was pleasantly surprised with the blend of scientific information, life experiences from both husband and wife (two different relationships with alcohol), and the guiding principles to help anyone reduce or quit drinking altogether. This book covers information not just for heavy drinkers, but also for social or occasional drinkers.

If you’re looking to reduce or cut alcohol out of your life as a New Year's Resolution, this is the book for you. Or if you know someone who struggles with alcohol (you probably do), it offers insights to better understand the physical, psychological, and genetic need to drink that many people in the world experience. Alcoholism is so heavily stigmatized in our society, despite affecting so many. While this issue is very personal to me, I wanted to open up and let you know that you are not alone in the world. Many people, including myself, struggle with addiction, and if there is even a flicker of hope in recovery, we should grasp it. If you or someone you know struggles with drinking, I suggest picking up this book when it is published. You have nothing to lose and everything to gain.


As this is a review, I will say that this book is well-paced, formatted, and kept me interested till the end. I will be purchasing this book when it is published, as I would like to revisit it when my burden weighs too heavily.

Thank you, @Macmillan.Audio and @netgalley for the ARC audiobook.

Pub Date: Jan 06 2026

⭐⭐⭐⭐⭐

[Bargain Sleuth Book Reviews · Rating 4 out of 5]

Thanks to NetGalley, Celadon Books, and Macmillan Audio for the digital copy of this book; I am leaving this review voluntarily.

I live in the drunkest state in the country. Several years ago, a report came out and seven of the top ten drunkest cities in the United States were in Wisconsin. So proud of my state (I’m dripping with sarcasm.) As someone who used to drink socially but stopped drinking alcohol for a variety of reasons, I have complicated feelings about this legal drug that can also ruin lives. Why We Drink Too Much attempts to break down the reasons for this phenomenon.

The book has an emphasis on biology and personal drinking habits; the science-focused yet culturally aware approach made this book a bit of a slog to get through. The author narrates his own book, and while he has a pleasing voice, I actually thought that this book could use a different sounding narrator. While I am rating this book pretty high, I feel I would have had a better experience physically reading the information because of that.

Yes, we all know that alcohol is bad for us if we overconsume on a regular basis. I did appreciate Dr. Knowles’ mix of life experience of he and his wife interspersed with all the scientific information provided. This style made the material more palatable.

My favorite part of Why We Drink Too Much is the guidance on how to reduce or stop drinking altogether. The information provided is for everyone, from social drinkers to heavy drinkers. This is the perfect book to explore at the beginning of a new year, where many people make resolutions.

[Alex Shrugged · Rating 5 out of 5]

The author is a medical doctor who suffers from alcoholism and as of the writing of this book has been sober 10 years. He covers the problem with alcoholism in as objective a way as possible given his own experience. He is very open to all sorts of ideas in fighting alcoholism and, as I recall, avoids dumping on anyone, and frankly, he is very positive about a number of ideas on how to fight alcoholism.

I recommended this book to a number of friends.

Something he pointed out that I hadn't thought about much is that one cannot solve the alcohol problem (in the long run) by avoiding situations where alcohol is available or making it illegal in the hope that eventually the world supply of alcohol will run out. Alcohol will always be around. What is required is a change in the individual's mindset. (FYI, the book "Alcoholics Anonymous" calls this a "psychic change".) After this change, alcohol is no longer important to the alcoholic.

Another important point he made was that he did not know of anyone who was made a moderate drinker once they passed the point of becoming alcoholic. (He didn't way it that way, but that is how I heard it.) After that point the only thing they could do was to abstain from drinking alcohol entirely. No pill or treatment or therapy has been able to do that reliably. I agree with that observation.

I'd love to read this book again some time.

[Allison · Rating 4 out of 5]

This was a very interesting and extremely informative read. It’s written for anyone who is sober curious all the way to the full blown alcoholic.
It was very scientific and lost me quite a few times, it was a little hard to follow. But on the other hand, it had so much good information. There was definitely a balance.
Personally, I wish there was more info on how much drinking would need to occur to have all of these things happen in the body. I know it touched on serving sizes and heavy drinking definitions but mostly it sounded like this was geared towards heavy drinking with a lot of the examples being extreme.
I was interested in this book because as I age, I notice I don’t handle the occasional glass or two of wine as well as I used to. I just feel like it has so many negative effects on my body and wanted to learn more about that. I think I would have liked a comparison of what happens to the body when drinking different quantities. Although he did say there is no minimum amount for some of this stuff so maybe that’s just it.
I think anyone who struggles with alcohol should read this book and hopefully it will be the thing to get them to seek help and realize they need to make a change.

Thank you to the author, NetGalley and MacMillan Audio for the audio ARC of this book in exchange for my honest review. All opinions are my own.

[Maddie · Rating 4 out of 5]

I’ve been sober my whole life- aside from that one sip I had of an accidental non-virgin Mojito (which I hated). My reasons for being sober started out purely religious. Both of my parents were dry, my grandparents, extended family, almost every one around me.

As I grew up my reasons morphed from religious to personal. I learned about my great grandparents (one on each side) and how they were rager alcoholics and died from its complications. Alcoholism runs further back, and even trickled down into some extended family. It freaked me out so much that I knew I’d never touch it. The book touches on genetic predispositions, and more or less disproves the “addictive personality” theory - which I slightly disagree with when it comes to myself. Ultimately I don’t miss what I don’t know.

Based on my family history, I’ve always been curious about what it would be like to be an alcoholic. And to peek behind the curtain through the authors story was so eye opening. To look at alcoholism as a mental disorder gave me so much more empathy towards my family members. It’s such a devastating addiction to go through. And I’m so glad I was able to learn more about it through this book! It was super dense science wise, and I didn’t quite understand everything. But it was a great condensed lesson on how alcohol affects us all.

[Aura · Rating 5 out of 5]

Listening to Why We Drink Too Much felt uncomfortably familiar in the best way. Always being surrounded by alcoholics, I didn’t need convincing that alcohol changes people. What this audiobook gave me was language and context for things I’ve witnessed my entire life but never fully understood. Dr. Charles Knowles connects the science of addiction with the cultural normalization of drinking in a way that made so many moments from my past click into place. The mood swings, the denial, the “it’s not that bad,” the way alcohol becomes both the problem and the coping mechanism. None of it felt exaggerated. If anything, it felt validating.

What I appreciated most was that the tone isn’t preachy or shame-driven. It acknowledges how deeply woven alcohol is into our social fabric and how that makes it harder for people, and families, to recognize when drinking crosses into harm. As someone who has lived with the ripple effects of alcoholism, this audiobook felt grounding and clarifying rather than triggering. It helped separate the people I love from the substance that hurt them, while still holding alcohol accountable for the damage it causes. This is an eye-opening listen for anyone who has grown up around addiction and wants understanding instead of excuses.

[Stacey · Rating 4 out of 5]

A timely read as we make our way on to the new year a head. Alcohol consumption is something some people struggle with in their lives and others taking a closer look at their relationship with the substance, especially after coming down after the holidays.

I really loved Dr. Charles Knowles approach to this book. It’s scientific, but in an approachable, interesting way that doesn’t make your eyes glaze over. It’s not preachy in why you shouldn’t be drinking, but rather gives insight on where an individual is based on their drinking habits. It’s fantastic reflection without shaming.

Yes, it’s science based, but it’s personal, too. Very humbling as he recounts his experiences and history with alcohol. His wife has sections where she gives her thoughts on sobriety and support and it’s powerful from her stance.

I highly recommend for informative reading on why we drink too much. The audio is read by Dr. Knowles and is a listening pleasure.

Thanks to NetGalley and McMillan audio for an early copy.

[Shannon · Rating 4 out of 5]

Based on the doctor's own struggles with alcohol addiction and later ten year sobriety, this personal account of alcoholism and the scientific reasons behind why some people are more inclined to addiction than others as well as some of the damaging effects of overindulgence was equally moving and eye-opening.

Hopefully this book will help convince those who might need to hear it why choosing sobriety can be so important and life changing and how harmful relapsing over and over actually ends up being. I especially liked that his wife shared her opinions and experiences as a partner having to watch her husband spiral and work his way out of addiction as well as her experiences with overindulging and eventually choosing sobriety.

Many thanks to NetGalley and the publisher for an early audio copy in exchange for my honest review. I liked that this book wasn't too preachy but laid out fact based arguments for choosing a path of sobriety. Recommended for fans of books like Living naked AF or The sober shift.

[David · Rating 4 out of 5]

Thanks to Netgalley for the review.
The audio version is primo both for quality sound and narrator. BTW - I easily listened to this one on 3x speed.
I regularly review all the new addiction books as able because of my work. Knowles doesn't waste a lot of time with drunk-alogs, which I appreciate. Additionally, He is very appropriate in mentioning his drinking to not be triggering for those in early recovery. Amidst the sharing of his experience, strength, and hope, he interweaves the current scientific data on drinking and impact of alcohol on the brain and body. Good narrative and easy listening.

[Sara Melugin · Rating 5 out of 5]

I received this as an audio ARC from NetGalley.
Why We Drink Too Much is a great book for those who are ready to reflect on their drinking habits. Even if the reader is not ready, reading this book is likely to get them to reflect on their drinking habits. It is a very thorough book regarding the effects alcohol has on one's social, emotional, health, relational, etc. wellbeing. I appreciate that Dr. Knowles is not an expert or doctor who would normally be exposed to drinking habits of a person, but rather he wrote this book from his own perspective and difficulties with alcohol through his life. I enjoyed the chapters included from his wife's perspective as well. This was a very interesting and informative read.

[Tori DeFazio · Rating 4 out of 5]

Written by a physician and recovering alcoholic, Why We Drink Too Much uncovers the physical, social, and psychological reasons that alcohol plays such a large part in our culture. Utilizing an interesting mix of personal experience and neuroscience, Dr Charles Knowles takes the reader through the very real health effects of drinking too much. This science-heavy book would be great for anyone who may want to examine their (and/or a loved one’s) relationship with alcohol. 4⭐️

Thanks to NetGalley for the opportunity to listen to the audiobook Why We Drink Too Much.

[Tori · Rating 4 out of 5]

I think this book offers many thoughtful and insightful perspectives on the factors that contribute to why people drink too much. I found the information fascinating. The author does a great job breaking up the educational content with personal stories, which made it more engaging. If you enjoy informative reads about alcohol use, this book is for you. I listened to the audiobook, and the narrator did an excellent job with the delivery.

Thank you, NetGalley, for providing me with this ARC!

[Laura · Rating 3 out of 5]

This book had some interesting insights as to why we as a society drink as much as we do. The idea of "grey area drinkers" was new to me. I think this would be a good book for someone who feels they could cut back, someone who's gotten so far they feel they need outside help, or a loved one of a person that matches one of the descriptions I just listed.

Thank you to Librofm for the advanced copy.

[Wendy · Rating 4 out of 5]

I received a pre-publication audio book of this title from Net Galley. The book was read by the author which made the anecdotal evidence more effective. Lots of information based on data but made easy to listen to because of the anecdotal evidence. Also, addresses all kinds of addictive behaviors, not just alcoholism. Since listening to this book I noticed the insidious encouragement of alcohol consumption everywhere!

[Michelle · Rating 4 out of 5]

*I received a free kindle edition in exchange for an honest review.*
This was a really interesting book. It is part memoir, part science and part self help. The memoir parts made the book easier for the layperson to read because some of the science is very complicated. I had also never heard of grey area drinking before and now I believe that this is where almost everyone who drinks alcohol on any regular basis probably falls.

[McKenna · Rating 3 out of 5]

Thanks Macmillan Audio and NetGalley for the ARC!

I wanted to like this book more than I did. It seemed like the author was going to talk about the idiosyncrasies of drinking and how it can affect you, even when it is not what many perceive as “heavy drinking” …but then would switch over to his personal story and he would talk about his over the top drinking habits.

[Kay’s Book Nook · Rating 4 out of 5]

For a nonfiction book this was really well written. The examples were easy to follow and I actually felt like I learned something and wasn’t overwhelmed with too much professional jargon. Great use of personal experiences, historical accounts and factual based evidence. Worth the read!