ROLE OF INTERMITTENT FASTING ON METABOLIC HEALTH IN OVERWEIGHT ADULTS A NARRATIVE REVIEW
DOI:
https://doi.org/10.71000/w0z4n925Keywords:
Intermittent Fasting, Metabolic Health, Obesity, Insulin Resistance, Dietary Intervention, Narrative ReviewAbstract
Background: Intermittent fasting (IF) has emerged as a widely practiced dietary strategy with growing scientific interest for its potential role in managing obesity and improving metabolic health. With global rates of overweight and obesity rising at an alarming pace, effective non-pharmacologic interventions are increasingly needed to address associated metabolic disorders such as insulin resistance, dyslipidemia, and impaired glucose regulation.
Objective: This narrative review aims to explore the metabolic effects of intermittent fasting in overweight and obese adults, highlighting its clinical benefits, potential limitations, and areas requiring further investigation.
Main Discussion Points: The review synthesizes findings from recent literature, revealing that IF is consistently associated with reductions in body weight, improved insulin sensitivity, better glycemic control, and favorable lipid profile changes. Various IF regimens, including time-restricted eating and alternate-day fasting, show similar metabolic benefits. However, the evidence is limited by short intervention durations, small sample sizes, and variability in outcome measures. Methodological issues such as selection bias, lack of blinding, and limited population diversity further constrain the generalizability of results. Despite these limitations, IF appears well-tolerated and effective for short- to medium-term metabolic improvements.
Conclusion: Intermittent fasting holds promise as an adjunct strategy for managing metabolic health in overweight populations. While current evidence supports its use in clinical practice, further high-quality, long-duration studies are needed to confirm long-term efficacy, safety, and sustainability.
References
Montefusco L, D'Addio F, Loretelli C, Ben Nasr M, Garziano M, Rossi A, et al. Anti-inflammatory effects of diet and caloric restriction in metabolic syndrome. J Endocrinol Invest. 2021;44(11):2407-15.
Martins C, Roekenes J, Hunter GR, Gower BA. Association between ketosis and metabolic adaptation at the level of resting metabolic rate. Clin Nutr. 2021;40(8):4824-9.
Lu D, Yuan Z, Yang L, Jiang Y, Li M, Wang Y, et al. Body Composition and Metabolic Improvement in Patients Followed Up by a Multidisciplinary Team for Obesity in China. J Diabetes Res. 2021;2021:8862217.
Beavers KM, Wolle BR, Ard JD, Beavers DP, Biehl O, Brubaker PH, et al. The Bone, Exercise, Alendronate, and Caloric Restriction (BEACON) trial design and methods. Contemp Clin Trials. 2024;146:107692.
Sayda MH, Abdul Aziz MH, Gharahdaghi N, Wilkinson DJ, Greenhaff PL, Phillips BE, et al. Caloric restriction improves glycaemic control without reducing plasma branched-chain amino acids or keto-acids in obese men. Sci Rep. 2022;12(1):19273.
Parr EB, Radford BE, Hall RC, Steventon-Lorenzen N, Flint SA, Siviour Z, et al. Comparing the effects of time-restricted eating on glycaemic control in people with type 2 diabetes with standard dietetic practice: A randomised controlled trial. Diabetes Res Clin Pract. 2024;217:111893.
Liu Y, Chen Y, Ma J, Lin J, Liu C, Li X, et al. Dapagliflozin plus calorie restriction for remission of type 2 diabetes: multicentre, double blind, randomised, placebo controlled trial. Bmj. 2025;388:e081820.
Beals JW, Kayser BD, Smith GI, Schweitzer GG, Kirbach K, Kearney ML, et al. Dietary weight loss-induced improvements in metabolic function are enhanced by exercise in people with obesity and prediabetes. Nat Metab. 2023;5(7):1221-35.
Li M, Li J, Xu Y, Gao J, Cao Q, Ding Y, et al. Effect of 5:2 Regimens: Energy-Restricted Diet or Low-Volume High-Intensity Interval Training Combined With Resistance Exercise on Glycemic Control and Cardiometabolic Health in Adults With Overweight/Obesity and Type 2 Diabetes: A Three-Arm Randomized Controlled Trial. Diabetes Care. 2024;47(6):1074-83.
Sukkriang N, Buranapin S. Effect of intermittent fasting 16:8 and 14:10 compared with control-group on weight reduction and metabolic outcomes in obesity with type 2 diabetes patients: A randomized controlled trial. J Diabetes Investig. 2024;15(9):1297-305.
Silver HJ, Olson D, Mayfield D, Wright P, Nian H, Mashayekhi M, et al. Effect of the glucagon-like peptide-1 receptor agonist liraglutide, compared to caloric restriction, on appetite, dietary intake, body fat distribution and cardiometabolic biomarkers: A randomized trial in adults with obesity and prediabetes. Diabetes Obes Metab. 2023;25(8):2340-50.
Nowosad K, Sujka M. Effect of Various Types of Intermittent Fasting (IF) on Weight Loss and Improvement of Diabetic Parameters in Human. Curr Nutr Rep. 2021;10(2):146-54.
Suchacki KJ, Thomas BJ, Ikushima YM, Chen KC, Fyfe C, Tavares AAS, et al. The effects of caloric restriction on adipose tissue and metabolic health are sex- and age-dependent. Elife. 2023;12.
Pammer A, Obermayer A, Stadler JT, Pferschy PN, Tripolt NJ, Habisch H, et al. Effects of dietary interventions and intermittent fasting on HDL function in obese individuals with T2DM: a randomized controlled trial. Cardiovasc Diabetol. 2024;23(1):339.
Schroor MM, Joris PJ, Plat J, Mensink RP. Effects of Intermittent Energy Restriction Compared with Those of Continuous Energy Restriction on Body Composition and Cardiometabolic Risk Markers - A Systematic Review and Meta-Analysis of Randomized Controlled Trials in Adults. Adv Nutr. 2024;15(1):100130.
Umphonsathien M, Rattanasian P, Lokattachariya S, Suansawang W, Boonyasuppayakorn K, Khovidhunkit W. Effects of intermittent very-low calorie diet on glycemic control and cardiovascular risk factors in obese patients with type 2 diabetes mellitus: A randomized controlled trial. J Diabetes Investig. 2022;13(1):156-66.
Ezzati A, Rosenkranz SK, Phelan J, Logan C. The Effects of Isocaloric Intermittent Fasting vs Daily Caloric Restriction on Weight Loss and Metabolic Risk Factors for Noncommunicable Chronic Diseases: A Systematic Review of Randomized Controlled or Comparative Trials. J Acad Nutr Diet. 2023;123(2):318-29.e1.
Hooshmandi H, Ghadiri-Anari A, Ranjbar AM, Fallahzadeh H, Hosseinzadeh M, Nadjarzadeh A. Effects of licorice extract in combination with a low-calorie diet on obesity indices, glycemic indices, and lipid profiles in overweight/obese women with polycystic ovary syndrome (PCOS): a randomized, double-blind, placebo-controlled trial. J Ovarian Res. 2024;17(1):157.
Rinaldi R, De Nucci S, Donghia R, Donvito R, Cerabino N, Di Chito M, et al. Gender Differences in Liver Steatosis and Fibrosis in Overweight and Obese Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease before and after 8 Weeks of Very Low-Calorie Ketogenic Diet. Nutrients. 2024;16(10).
Barazzoni R, Gortan Cappellari G, Zanetti M, Klaus KA, Semolic A, Johnson ML, et al. Higher unacylated ghrelin and insulin sensitivity following dietary restriction and weight loss in obese humans. Clin Nutr. 2021;40(2):638-44.
Guo Y, Luo S, Ye Y, Yin S, Fan J, Xia M. Intermittent Fasting Improves Cardiometabolic Risk Factors and Alters Gut Microbiota in Metabolic Syndrome Patients. J Clin Endocrinol Metab. 2021;106(1):64-79.
Ealey KN, Togo J, Lee JH, Patel Y, Kim JR, Park SY, et al. Intermittent fasting promotes rejuvenation of immunosenescent phenotypes in aged adipose tissue. Geroscience. 2024;46(3):3457-70.
He S, Wang J, Zhang J, Xu J. Intermittent Versus Continuous Energy Restriction for Weight Loss and Metabolic Improvement: A Meta-Analysis and Systematic Review. Obesity (Silver Spring). 2021;29(1):108-15.
Siles-Guerrero V, Romero-Márquez JM, García-Pérez RN, Novo-Rodríguez C, Guardia-Baena JM, Hayón-Ponce M, et al. Is Fasting Superior to Continuous Caloric Restriction for Weight Loss and Metabolic Outcomes in Obese Adults? A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients. 2024;16(20).
Silver DT, Pekari TB. A Review of Intermittent Fasting as a Treatment for Type 2 Diabetes Mellitus. Med J (Ft Sam Houst Tex). 2023(Per 23-4/5/6):65-71.
Eriksson JW, Pereira MJ, Kagios C, Kvernby S, Lundström E, Fanni G, et al. Short-term effects of obesity surgery versus low-energy diet on body composition and tissue-specific glucose uptake: a randomised clinical study using whole-body integrated (18)F-FDG-PET/MRI. Diabetologia. 2024;67(7):1399-412.
Moriconi E, Camajani E, Fabbri A, Lenzi A, Caprio M. Very-Low-Calorie Ketogenic Diet as a Safe and Valuable Tool for Long-Term Glycemic Management in Patients with Obesity and Type 2 Diabetes. Nutrients. 2021;13(3).
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Akif Saeed Ch, Naheed Shah, Shaikh Khalid Muhammad, Rozina Jalaluddin, Muhammad Naseeb Ullah Khan, Mariam Akhtar , Bashir Ahmed, Asmat Nawaz , Fahad Asim (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.