Intermittent fasting is a hugely popular health and wellness trend that involves abstaining from eating for up to 20 hours in a 24 hour period. Is it right for you? A HAES informed Integrative Health and Wellness Coach (me!) pipes in.
As a health coach, I have been asked the question, “does intermittent fasting work for weight loss?”
My first step in answering this question is to offer the reminder that,
“thinness and health are not the same, and fatness does not necessarily equate to being unhealthy.”
Next, I inquire as to why they want to lose weight and reassure them that the data shows that adopting healthy lifestyle behaviors – such as regular physical movement/exercise, improved sleep, stress management, and increasing dietary nutrition – result in significant and measurable health improvements regardless of weight.
In the conversation about intermittent fasting, it’s important to recognize that, barring chronic stress, inflammation, and other health problems such as thyroid and hormonal issues, any significant calorie restriction can lead to weight loss. So it stands to reason that if the practice of intermittent fasting results in a significant calorie deficit and a person doesn’t have physical or mental health issues that impair or impede it, weight loss can result. However, if asked, I would not recommend intermittent fasting for weight reduction purposes for several reasons.
Intermittent fasting is a health, wellness, and diet industry trend right now. Much like the widely touted low-fat craze of my childhood which led me to read labels and conclude that I had “permission” to eat a whole loaf of French bread and a package of Red Vines because they were both “fat-free,” many health trends are fads that perpetuate and push diet culture on the masses. Is it true there are people who have adopted intermittent fasting and been happy with the results? Sure! You could pick any health and diet trend and find people who like it so much they proselytize for it – from Keto to low-fat, from vegan to carnivore, from macro to raw foods you’ll be able to find people who feel like their life was changed for the better due to their adopted way of eating. While it’s important to validate and create space for people’s lived experiences, it’s also important to note that most people who adopt diets for the purpose of losing weight do not keep the weight off longer than a year or so.
It’s estimated that a whopping 80-90% of all people who set out to intentionally lose weight, many of whom may choose a trendy health and wellness diet, regain the weight they lost. This statistic makes it staggeringly clear that diets don’t work long term for weight loss! And it’s not because people aren’t strong, disciplined, or committed! It’s also not because they just haven’t found the right diet yet, like the billion dollar diet industry wants you to believe; people are amazingly tenacious and proactive when it comes to making these changes! Our biology, however, has other plans. Our bodies evolved to fight tooth and nail to hold onto weight, with studies showing that decreasing caloric intake results in systemic hormonal reactions that increase our hunger and affect our metabolism long term, which can and does result in weight regain for the vast majority of people. If you’d like to learn more about this, check out the research page on my website: https://www.spunkysprout.org/research
As a disordered eating informed Health and Wellness Coach, a major concern I have with intermittent fasting is that those who may want to participate in it for weight reduction purposes could be people who have a disordered relationship with food and their body and may tend to hop on diet trends to satiate it. This can commonly lead to weight cycling, also known as “yo-yo dieting,” which can have a negative impact on a person’s mental and physical health. Some negative consequences of weight cycling can include increased incidence of binge eating, loss of muscle, gallbladder attacks, higher mortality, negative effects to metabolism, and can contribute to and worsen disordered eating and body dysmorphia. It’s also important to keep in mind that even the allopathic and holistic medical systems can both get caught up in dietary trends such as intermittent fasting, so always do your own research for true informed consent.
Another concern I have with intermittent fasting is the research about the efficacy and safety of intermittent fasting has largely relied on animal (mostly rodent) studies. Very few human studies have been done, and even fewer human studies with randomized control groups have been completed. Also, most of the research information and conclusions use words such as “may” or “could” or utilize hypotheses about how intermittent fasting has the “possibility” to x, y, or z. Not only is such language inconclusive, but it can also be highly misleading.
When discussing the topic of restricting energy intake (calories) for the purpose of weight loss utilizing diets such as intermittent fasting, it’s important to note that intentional weight loss results in an extremely low long-term efficacy rate, and is not something I would recommend because of the potential negative effects it can have on long term physical health, including weight cycling. It can also have detrimental effects on a person’s relationship with food, their body, and their perception of “health.” When we restrict energy intake, our bodies have powerful biological responses that enact chemical and hormonal reactions to counteract the restriction. These biological responses can result in our bodies fighting tooth and nail to hold onto energy and energy stores. These responses also strengthen biological pathways that encourage our bodies to return to or exceed the fat storage levels the body had before engaging in restriction. This is one of the main reasons why yo-yo dieting can be so harmful.
It’s also important to acknowledge that the desire to change our bodies to fit a societally produced “ideal” based on ever-changing, judgmental, narrow standards of “health” and “beauty” is a result of constant media and culture exposure; this desire is natural and totally understandable. The health and wellness, diet, and medical industries are huge purveyors of the highly coercive propaganda related to weight and health – it’s no wonder the pressure to participate in health and weight-loss trends is so strong; we’re lambasted by it 360, 24/7 since we take our very first breaths on this planet! Every person they can convince to change their bodies to try and fit this idealized mold is a dollar sign.
The global weight-loss market is an over $224 BILLION dollar industry as of 2021, and is exponentially growing with expectations for it to DOUBLE by the year 2030! Every year, Americans spend over $30 BILLION dollars on diet and weight loss products! It’s extremely telling that none of these things – from the hugely gigantic amounts of money spent to the good intentions people have – has led to better health outcomes for our population. In fact, the general health of Americans (and most industrialized nations) continues to decline in spite of the heavy-handed “health” propaganda and colossal amounts of money spent. This decline in health has resulted in decreases in wellbeing, satisfaction, and overall quality of life. For these reasons and more is why it’s so important to seek out, research, and hear reputable information that can counteract the propaganda and poorly executed research data they utilize to back it up.
For example, research shows that intentional and concentrated weight loss is not necessary for improved health and wellness outcomes. Studies demonstrate facts such as:
-physical activity is the greatest indicator of health and mortality, irrespective of weight
-obese individuals who adopted lifestyle habits had the lowest risk of mortality compared with every other weight strata and lifestyle combination
-obese individuals who engage in moderate intensity physical activity for 150 minutes per week have half the death rates and lower rates of cardiovascular disease than their unfit, normal-weight counterparts
-physically active overweight or obese individuals can have greater cardiovascular fitness than inactive individuals, regardless of weight status
I would not recommend intermittent fasting for weight loss. Instead, I would suggest a person research, learn about, and adopt Intuitive Eating as a sustainable way to support their bodies and inform their choices. Intuitive Eating is a philosophy and relationship with eating that involves rejecting diet mentality (a hard thing to do!) while embracing your own innate wisdom and unique needs. The Original Intuitive Eating Pros at intuitiveeating.org have compiled a list outlining the basics of Intuitive Eating:
10 Principles of Intuitive Eating
- Reject Diet Mentality
- Honor Your Hunger
- Make Peace With Food
- Challenge the Food Police
- Discover the Satisfaction Factor
- Feel Your Fullness
- Cope with Your Emotions with Kindness
- Respect Your Body
- Movement – Feel the Difference
- Honor Your Health – Gentle Nutrition
In addition to recommending Intuitive Eating, I would also encourage someone to work toward adding health-promoting lifestyle habits and behavior choices to support their body and mind in long-term health and wellbeing. The data backing these types of changes, such as regular physical activity, adequate and quality sleep, stress reduction, and social connection, is immense, reputable, and ever-growing.
It is true that those who practice Intuitive Eating and pay attention to their body’s cues, signals, and symptoms in relation to consuming food may find that their body feels better when with greater amounts of time between eating. This type of pattern could be observed as intermittent fasting. However, someone listening to and following the needs of their body and physiological cues would not include a dogmatic following of dietary rules like are found when adhering to dietary principles like intermittent fasting. It is also true that when adopting healthy lifestyle behaviors such as exercise, nutrient dense eating, stress management, and improved sleep, a natural consequence can be slow and sustainable weight loss that lasts, however this is not the goal.
The bottom line is that trendy styles of eating like intermittent fasting are not the magical answer to weight loss or health, and can potentially cause more problems than they solve – especially when adopted and adhered to with a diet mentality. The good news is Intuitive Eating could be the supportive framework you didn’t even know you were looking for to help you get off the health, wellness, and diet bandwagons and onto a life where the least important thing about you is your weight and clothing size.
If you are interested in working to let go of diet mentally and heal your relationship with food and your body by learning more about Intuitive Eating principles and how to apply them realistically in your life, a HAES (Health At Every Size) and Intuitive Eating informed Health and Wellness coach (like me!) can help guide and support you in this goal.
*Intermittent fasting is not recommended for those for which it is contraindicated such as Type 1 Diabetics, children under the age of 18, and women who are pregnant and/or breastfeeding.
**Intuitive Eating, however, can be recommended to virtually everyone in virtually all circumstances.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132299
https://christyharrison.com/what-is-weight-cycling
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516560
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663
https://www.cedars-sinai.org/blog/what-is-intuitive-eating.html
Spunky Sprout Wellness 
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