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Intermittent fasting (IF) has gained widespread attention in recent years for its potential benefits on metabolism, weight management, and overall health. Dr. Mikhail Kogan, chief medical officer for the GW Center for Integrative Medicine in Washington, DC, is among the physicians who actively incorporate time-restricted eating (TRE), a form of intermittent fasting, into their patients’ treatment plans. According to Kogan, TRE can significantly improve metabolism and help the body transition from burning sugar to burning fat.
The Science Behind Intermittent Fasting
Intermittent fasting refers to dietary approaches that alternate between eating and fasting periods. Common IF methods include alternate-day fasting, the 5:2 diet (eating normally for five days and restricting calories for two days), and TRE, which involves consuming food within a set window of time. According to a 2019 review in The New England Journal of Medicine, IF can trigger metabolic changes that benefit weight management and overall health.
Dr. Mark Mattson, a leading researcher in the field, explains that IF works by prompting a metabolic switch from glucose to ketone-based energy, which typically occurs after about 12 hours of fasting. Over time, this adaptation may reduce hunger and promote fat-burning without the persistent hunger associated with traditional calorie-restricted diets.
Weighing the Benefits and Limitations
Studies on IF have yielded mixed results. A recent Nature Medicine study involving 197 overweight and obese individuals found that TRE led to greater weight loss than dietary changes alone. However, Dr. Scott Kahan, director of the National Center for Weight and Wellness, remains cautious. He emphasizes that while IF is not necessarily worse than traditional calorie tracking, it may not be significantly better either.
Other experts, such as Dr. Mihir Patel from the University of Maryland School of Medicine, see IF as an adjunct strategy rather than a primary intervention. He encourages patients to focus on overall dietary quality and portion control while incorporating principles of intermittent fasting. Similarly, Dr. Andreas Michalsen, an internist and professor at Charité Medical University Berlin, uses a stepwise approach, recommending fasting-mimicking diets followed by TRE to promote gradual weight loss and metabolic health improvements.
A Complementary or Alternative Approach to GLP-1 RA Medications?
With the rising popularity of glucagon-like peptide 1 receptor agonist (GLP-1 RA) medications like Wegovy and Zepbound, some physicians question whether IF remains a relevant strategy for obesity management. While IF may take longer to show results, nephrologist Dr. Jason Fung argues that it can be a viable, low-risk alternative for patients with type 2 diabetes and metabolic disorders. He has observed significant improvements in his patients and believes the potential benefits outweigh the risks.
Who Should and Shouldn’t Try IF?
While IF can be a useful tool for many, it is not suitable for everyone. Experts caution against its use in children, underweight individuals, pregnant or breastfeeding women, and those with eating disorders or gallstones. Patients with type 1 diabetes should also avoid IF due to potential health risks.
The Verdict
Intermittent fasting remains a topic of debate within the medical community. While some healthcare providers advocate for its benefits in weight management and metabolic health, others stress the need for more robust, large-scale studies. For now, IF can be considered a potential tool for certain patients, especially when personalized to fit individual health needs and lifestyle factors.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Patients should consult a healthcare professional before starting any new dietary regimen, including intermittent fasting.
