Intermittent Fasting: Surprising Update
- By Monique Tello, MD, MPH, Contributor
Theres a ton of incredibly promising intermittent fasting research done on fat rats. They lose weight, their blood pressure, cholesterol, and blood sugars improve but theyre rats. Studies in humans, almost across the board, have shown that IF is safe and incredibly effective, but really no more effective than any other diet. In addition, many people find it difficult to fast.
But a growing body of research suggests that the timing of the fast is key, and can make IF a more realistic, sustainable, and effective approach for weight loss, as well as for diabetes prevention.
Intermittent Fasting Is Organized Disordered Eating
Intermittent fasting is normalized eating disorder behavior.
@counselorkate, Counselor Kate
Many people have found great success with intermittent fasting for weight loss and overall health improvement. Although, I encourage you to look into the evidence behind this practice as a method of weight loss . But for me, it was just an organized way to participate in disordered eating patterns. It was so easy for me to start intermittent fasting because my body remembered these disordered patterns and it was at home. And at the same time, thats why it was so difficult for me to stop, because it was the comfort of disordered eating that Ive used to cope with before.
Micromanaging food intake stunts our natural intuitive eating that goes along with what our body needs. Basically, intermittent fasting trains you to not listen to what your body actually needswater, substance, fueland restrict yourself from an external source. Plenty of psychological research out there demonstrates that restricting your body of food when you feel hunger leads to anxiety surrounding food and eating. This same type of restriction can lead to binge eating, a type of disordered eating familiar to me from restrictive diets in the past.
Intermittent Fasting Is Disordered Eating Behavior
**CW: Please skip this article if you are in active eating disorder recovery and/or content about diets is triggering.**
I posted this meme yesterday and its gotten a lot offeedback so today Im unpacking where my reasoning came from and some researchbehind it:
First, I want to be very clear about a few things:
IF is a way of eating in which folks cycle between times ofeating and not eating . Fasting involves not eating any food orbeverages with caloric value. The idea behind IF is that some studies show it may increase metabolism, lower weight, help with insulinresistance and cancer, and increase lifespan. There are a few versions:
Why do I find IF problematic ?
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Lack Of Scientific Data
The thought behind intermittent fasting is that after the body is depleted of carbohydrates, it starts to burn fat. This starts to occur around 12 to 24 hours after starvation. Therefore, starving the body of food for 12 to 24 hours will potentially lead to weight loss which can improve health. However, most of the studies done on this topic have been performed on animals over a short period and have measured glucose levels rather than long-term health outcomes.
Yes, it is possible to lose calories, fat and weight from this popular diet. However, it is also possible to quickly gain the weight back, develop low energy stores which can result in a depressed mood, have problems sleeping and even develop organ damage if the fasting is extreme.
The following are reasons why individuals should avoid intermittent fasting:
I Had To Get In All Of The Food I Wanted To Enjoy Before The Clock Expired At 6 So I Ate As Quickly As I Could As If The Food Would Actually Disappear
I dutifully quit eating at 6, my stomach distended and a sugar headache pounding on my brain, wondering if maybe stretching my fast an extra couple of hours until noon the next day would help undo the damage. So I did that, only when noon hit, I skipped the healthful breakfast food I normally eat and picked up a large fast food meal, complete with a milkshake. I continued scavenging the pantry that afternoon, and it wasnt until my kids were winding around my feet begging for dinner at 6 pm that I realized that it hadnt occurred to me to actually make dinner and feed my babies because I was in a full blown binge eating cycle. Let that sink in.
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If Is A Diet In Disguise
If it walks like a duck and quacks like a duck, then it is adiet. Intermittent fasting is just another culturally normative diet cloaked inbuzzwords such as wellness and productivity. Like all diets, there arerules of when you can and cant eat, and we know from overwhelming researchthat diets are NOT sustainable long term and will eventually be abandoned. Bummer!
Why is our culture soOBSESSED with being healthy?
Dieting for the majority of folks is a great way to distractand cope with and from existential anxiety, anti-aging anxieties and otherareas in our lives where we have no sense of control.
Never underestimate the inclination to bolt. Pema Chodron
What Buddhist teacher Pema Chodron means by, neverunderestimate the inclination to bolt, is that humans are really bad atsitting with discomfort . We just arent good at identifying andsitting with our emotions- especially that more ambiguous ones such as fear,anxiety and grief. Dieting serves as an immediate and effective bypass to thesedifficult emotions so that we dont have feel our existential pain. If we focuson pounds lost or miles logged in the fit bit, we gain an immediate sense ofcontrol and mastery over of life. We have tangible results that itsworking and that everything will be okay once we hit x on the scale or x onthe tracker
But I want to be healthy!
Intermittent Fasting: The New Eating Disorder Or The New Fountain Of Youth
Intermittent fasting has been around for several years, butlike all diets, they tend to recycle themselves. Now it appears IF is all therage again! Its popular for those who want to lose weight and feel better/healthier. Some even claim that fasting will prevent diabetes, cancer,Alzheimers and heart disease. Fans of IF declare it to slow the aging process anddecrease inflammation.
When researching for this article, I met some folks thatseem to be doing IF for legit medical reasons: they have Lyme disease and arehelping to heal a leaky gut or other GI conditions. These folks are notinterested in weight loss per se, but in actually improving specific health indicatorsas well as more immediate relief from various symptoms. The majority of folksdoing IF however are likely doing it for superficial reasons such as weightloss, and or more ambiguous reasons such as to feel better, or be moreproductive.
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Avoid Intermittent Fasting If You Are At Risk For An Eating Disorder
Intermittent fasting has a high association with bulimia nervosa, and as a result, individuals who are susceptible to an eating disorder should not undergo any diet associated with fasting. Risk factors for an eating disorder include having a family member with an eating disorder, perfectionism, impulsivity and mood instability.
Inside Gwen Shamblin Laras Creepy Weight Loss Cult
As the much-hyped diet plan promoted by the rich and famous of Hollywood and Silicon Valley, intermittent fasting has reached peak popularity in recent years.
But experts fear that the restrictive regimen a quasi-religion followed by the likes of Twitter CEO Jack Dorsey and actresses Jennifer Aniston and Vanessa Hudgens can be a dangerous cover for an eating disorder.
Its a wolf in sheeps clothing, registered dietitian Tammy Beasley told The Post. I wish intermittent fasting had a warning stamped on it.
The buzzy fad, touted as a weight-loss and maintenance strategy, suggests people eat only at certain times of the day or, in one of its stricter forms, the week. It was the and the second-most-searched diet, after keto, in 2020.
According to a 2019 review published in the New England Journal of Medicine, the program leaves folks lighter and improves their health, but more recent research published last year by JAMA Internal Medicine found it no more effective than the average diet for fighting flab.
Its a wolf in sheeps clothing. I wish intermittent fasting had a warning stamped on it.
Tammy Beasley, dietitian
The intense habits of the 44-year-old billionaire partly inspired event planner Kristin White to try intermittent fasting in November 2018.
Im easily influenced and thought: If it works for a high-flying businessman like him, I should do it too, said the 54-year-old Seattle resident.
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Is Fasting An Unhealthy Behavior
Some experts say that intermittent fasting by definition is an unhealthy eating behavior because it involves restricting how much you eat, skipping meals, and being rigid about how you eat food .
If youre narrowing the timeframe in which youre allowed to eat and completely ignoring your hunger cues outside of that timeframe, it could be an unsafe approach, especially for those in eating disorder recovery, Samantha DeCaro, Psy.D., assistant clinical director at The Renfrew Center of Philadelphia, told Livestrong .
And what many people dont realize when starting an intermittent fasting schedule is that it can also take time for their body to adjust, so the urge to overeat at the end of a fasting period can be tough to overcome. If a person gets stuck in a cycle of fasting and overeating, this can lead to a condition known as binge-eating disorder.
This is a serious condition that can make you feel like you dont have any control of how much you eat. People who struggle with binge-eating disorder often eat when they arent hungry or continue to eat even if they feel uncomfortably full. After they finish eating, they are typically overwhelmed with guilt, shame, or disgust .
Without the help of professionals, regaining control of how, when, and why you eat can be challenging once you have developed a condition such as binge-eating disorder.
If You Or Anyone You Know Needs Help With An Eating Disorder:
There is science to fasting, although its not as solid as its advocates would claim. Research has found that intermittent fasting may help weight loss, , lower the risk of type 2 diabetes, and reduce blood pressure and cholesterol.
What’s often discounted, is that these results only apply to a relatively moderate fasting cycle of around 12-36 hours nothing like the seven day water diets being pushed by some.
Added to this is the danger of triggering an eating disorder.
Juliette Thomson, a psychologist who manages the Butterfly Foundation’s national eating disorder helpline, told Hack fasting weight loss and deprivation can together cause an eating disorder.
“A person fasting is more at risk of losing weight, which we know is one of the biggest risk factors for eating disorders,” she said.
“But it’s also that the longer you don’t have food affects how your brain and body are going to respond to thoughts about food.
When you start reintroducing food that might trigger a starve-binge mentality.
This doesn’t mean all forms of intermittent fasting is dangerous to everyone. It all depends on the period of fasting as well as on the individual.
Some people have an elevated risk of developing an eating disorder, and this is down to genetic and other factors being a perfectionist increases the risk, for example.
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Dangers Of Intermittent Fasting
Often missing from conversations about intermittent fasting is a nuanced look at its potential dangers. As is so common in diet culture, the weight loss associated with the trend is celebrated as a universal good. The general public considers it a worthwhile pursuit in the name of health, promoting it before research has established its efficacy, sustainability, or safety.
Indeed, though fasting has existed in religious traditions and scientific studies throughout history, research on modern-day fasting practices is limited. In their review of human and animal studies about intermittent fasting published in Behavioral Sciences, Harvie and Howell conclude that the long-term benefits or harm remain unknown:
We do not know conclusively whether long-term IER is a safe and effective method of weight control for subjects who are overweight or obese or whether IER may confer health benefits to people of any weight independent of weight loss.
The majority of studies on intermittent fasting include only small sample sizes tracked over a short span of time. And while many report a measurable physiological outcome like short-term weight loss, they generally ignore any mental and emotional health effects.
What Are Clients Actually Telling Us When They Say They Want To Try If
What are clients hoping to achieve through fasting? The idea that this rigid ritual of denying ones body of life-giving fuel somehow cleanses it and makes it well suggests something unfortunate about many of our clients relationships with food.
We know from history that wellness fads dont just go away unless something fundamental changes in our culture, IF will be replaced by something entirely different, and yet completely the same. Therefore, the focus must remain on intentionality when it comes to eating, and not on considering each variation of the same diet culture trap.
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What Does The Research Say
Intermittent fasting is a regimen that severely restricts calorie intake during certain days of the week or hours of the day. If done correctly, intermittent fasting can be beneficial to those struggling with obesity or for those trying to prevent diabetes and heart disease, since weight loss occurs as the body expends more energy than it takes in. Some research also suggests fasting can slow aging and reduce inflammation, but theres little to support the idea that this is linked to anything other than weight loss. For some people, it also comes with a mental clarity that can feel good. Fasting seems to let you harness the highs of self-starvation without getting an eating disorder, wrote Kat Stoeffel in Elle.
But the regimen is not right for everyonefasting for long periods of time can cause drops in blood sugar levels, which can lead to grogginess, dizziness, headaches, irritability, fatigue, and dehydration. Its difficult to generalize the effects of intermittent fasting, however, since studies on it tend to be short in duration and have small sample sizes.
When Is Fasting Diagnosed As An Eating Disorder
Mastela emphasized that any form of IF should be done under the supervision of a registered dietitian, and any diet that encourages a restrictive eating schedule really should be approached with caution from the start. Sondra Kronberg, MS, RD, CDN, CEDRD-S, and founder and spokesperson of National Eating Disorders Association , said this is where the line is drawn: “The degree to which one’s thoughts and activities and behaviors around food , weight, body, and exercise take up space inside one’s head and interfere with the quality of life, spontaneity, socialization, and health can be potentially fatal that is the degree one is suffering for disordered eating or an eating disorder,” she told POPSUGAR.
Jennifer Sommer-Dirks, MS, RD, CSSD, and nutrition manager at the Eating Recovery Center in Denver, CO, also added that disordered eating goes beyond food. “Someone who is fasting may also be suffering from an eating disorder if they are also struggling with body-image distress or if they are experiencing stress or anxiety when not able to follow the fast as planned,” Sommer-Dirks told us. Another sign is if he or she is using fasting as a coping mechanism to ease their anxiety, depression, or other life stresses.
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Productivity Bio Hacking And Control Lets Please Not Forget: We Live In Diet Culture
Proponents of IF can be very convincing. But really, its justanother trendy diet promoting disordered eating under the guise of wellness.Productivity, bio hacking, and controlare buzzwords in various online communities that glorify intermittent fasting. Accordingto Dr. Cynthia Bulik, the director of the Center for Excellence for EatingDisorders at the University of North Carolina,People who have extreme eating behaviors can have variants of anorexia nervosa or avoidantrestrictive food intake disorder and go undetected because they arepackaged as healthy or productivity-promoting.
How Intermittent Fasting Eased My Lifelong Eating Disorder
Like most people I ate breakfast my entire life. Not only did I eat breakfast I ATE breakfast! Unlike some who would wait until they were hungry in the morning to eat or would wait patiently for their parent to make them something nice, I would jump out of bed at 6:00am and head straight to the kitchen. Now my mom knew how to make decent waffles and pancakes as well as bacon and eggs, but I didnt have the patience to wait. I had to begin my daily emotional, binge eating relationship with food as soon as I woke. I headed straight for the cereal pantry Read Confessions of an Obese Child #8: The Locked Cabinet. I grabbed Fruity Pebbles, Coco Crisps, Captain Crunch or whichever sugar cereal my mom bought and promptly ate 3 bowls before my parents would notice me. Rinse, lather, repeat for about 17 years!
If you have read my Confessions of an Obese Child series you know that I suffered from a binge eating disorder. This blog is about how intermittent fasting eased my lifelong eating disorder. So lets give a little more history before getting to the present.
The Binge Cycle
The way I kept my weight off was Calorie In, Calorie Out. Running 5 miles a day, day after day, coupled with the starvation period during the week, kept my weight off. Was this binge/starve cycle and Chronic Cardio good for me? Of course not, but it kept my weight off and that is all I cared about.
The transition to Intermittent Fasting
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