Intermittent fasting: what really happens to your body

The advantages of intermittent fasting could extend beyond just weight loss.

Intermittent fasting concept featuring a dinner plate with an illustrated clock face

Updated on January 12, 2024.

Diet trends come and go. Few of them stay popular for long, and even fewer are real keepers—healthy, sustainable eating plans designed to help you with weight management and promote good health. In that latter sense, intermittent fasting (IF) has potential.

During IF, you either voluntarily stop or greatly limit eating and drinking for set periods. There are no special meals or work-intensive prep—you just avoid food at certain times. Devotees often find that IF takes unwanted excess weight off quickly while revving energy.

But, as scientists increasingly suspect, there could be other advantages of IF. Some early studies, mostly on animals, suggest that IF may offer a range of health benefits, including a lower risk of many chronic diseases. More research is needed, though, to confirm these findings.

If you’re going to try IF, you should follow certain rules, says Ahmet Ergin, MD, an endocrinologist at St. Lucie Medical Center in Port St. Lucie, Florida. He says if you do it right, it may improve your wellbeing, but “if you do not, it may actually harm you.”

Here’s what we know about IF—what it is and how it affects your body, along with tips to consider if you choose to try it.

Your body on intermittent fasting

Fasting isn’t new. Humans have been doing it for ages, often as part of cultural celebrations or religious observances, such as the Muslim holy month of Ramadan. We also fast for medical reasons before certain tests and procedures.

While different types of fasting have different rules, intermittent fasts typically follow the same basic principles: Restrict your calorie intake during some periods and eat normally at other times. Like any diet, this decreases your overall calorie count—but it promotes weight loss in another way, too.

Here’s how it works: Whenever you eat, you get energy from the glucose (sugar) in your food. Insulin, the hormone produced in the pancreas, helps deliver glucose to your body’s cells. There, glucose is either used immediately for energy or stockpiled to access later.

“When you do not ingest carbohydrates or any sort of energy, your body immediately reduces insulin production,” says Dr. Ergin. If your insulin levels drop far enough, after several hours without carbohydrate ingestion, your body uses the stored glucose in your cells for energy. Once those are gone, it starts feasting on fat. In addition, a reduced carbohydrate intake and reduced insulin levels may help reduce insulin resistance—which is a precursor to diabetes.

Many people do drop pounds on IF, at least at first. The typical weight loss, however, may be fairly minimal. And as with all diets, the weight tends to come back once the diet is over.

Popular types of IF

There’s no single way to do IF, and it’s not certain that any method is more effective than another for short-term weight loss. That said, many people choose one of these approaches, or some variation of them:

  • Time-restricted diet: You fast for a large chunk of the 24-hour day, but eat as you usually do during a specific block of time, such as 10 a.m. to 4 p.m. Since we naturally fast when we sleep at night, prolonging those hours is an easy way to accomplish this.
  • 5:2 diet: This plan typically involves limiting yourself to, say, 500 calories two days per week. The other five days, you eat like you normally would or eat normally within a certain time window. The low-calorie days are spread out, so you’re never fasting two days in a row.
  • Alternate-day fast: You switch up no- or low-calorie days with regular eating days.

Those interested in IF should know: Long periods of deprivation could make it harder to stick to IF than other diets. Though some people find IF tolerable, a 2017 study published in JAMA Internal Medicine found a dropout rate as high as 38 percent.

There’s also concern people may overeat when a fasting period ends. That’s not healthy, Ergin says, “and you are basically negating all the benefits you have collected by fasting.”

Finally—and perhaps most significantly—research hasn’t shown that IF is better for weight loss than other calorie restriction eating plans. In studies, people tend to lose the same amount of weight on either type of diet. For example, the results of a randomized controlled trial published in 2023 in Annals of Internal Medicine showed that participants on IF lost an average of about 12 pounds in 12 months. People who simply restricted calories dropped around 10 pounds over the same period.

How IF may improve your health

Some experts believe IF could boost health in multiple ways, but research on humans is early and limited. Most studies on the health effects of IF have so far focused on animals.

What’s more, it’s often unclear how much benefit comes from IF’s effects on body chemistry versus how much comes from weight loss. In general, there isn’t much evidence that IF is better for your health than other weight-loss plans.

That said, IF may help the following:

  • Your heart: Some studies show that doing IF regularly may improve certain heart disease risk factors. Ergin says you could see “significant improvements” in cholesterol, triglycerides, blood pressure, and inflammation levels.
  • Your brain: Based on animal data, some researchers suspect IF could boost memory and safeguard against degenerative conditions like Alzheimer’s and Parkinson’s disease.
  • Your liver: Drawing again from studies on animals, some experts believe IF may help reduce the odds of nonalcoholic fatty liver disease, a serious issue that may lead to scarring (cirrhosis) and eventually liver cancer or liver failure.
  • Your insulin sensitivity: Prediabetes and type 2 diabetes occur in individuals who have a low sensitivity to insulin—that is, people who are insulin resistant. Intermittent fasting may increase that sensitivity.
  • Your cancer risk: Currently, there are no data on the effects of IF on cancer rates in humans, and more research is needed. Some early studies on rats and mice, however, suggest IF may be associated with fewer cancers of certain types in those animals.

Intermittent fasting tips, tricks—and warnings

Speak with a healthcare provider (HCP) before starting IF. They can help you decide whether IF is the right plan for you and give you a heads-up about potential pitfalls and health hazards. Let your HCP know if you’re on medications as well, since IF can affect them.

If you try IF, experts recommend starting slowly and working your way up to longer periods without food. Some people may experience side effects like headaches, lightheadedness, or mood changes at first, but fans claim they should disappear as you get used to it.

Remember to stay hydrated during your fast, Ergin says, since people who eliminate meals may neglect drinking water: “That can lead to dehydration and kidney problems, especially in patients already having baseline kidney problems.”

Also, follow a nutritious eating plan at times you aren’t fasting. Emphasize wholesome foods like produce, lean protein, legumes, whole grains, and healthy fats. Try to avoid binging on junk food when a fasting period ends.

Be aware: Though IF is likely safe for most of us in the short term, skipping meals and slashing calorie intake can be harmful to some, including:

  • Growing children and adolescents
  • Pregnant or nursing women
  • People with diabetes
  • People who take medication requiring food
  • People taking medication for heart disease or blood pressure
  • People with a history of eating disorders

Finally, know that the long-term safety and effects of IF aren’t yet well understood. And, says Ergin, “No matter what diet you go on, if it’s short-term and it’s not maintained, it has no long-term benefits.” So if you attempt IF, do so with your eyes open—and an HCP by your side.

Article sources open article sources

Harvard Health Publishing. Not so fast: Pros and cons of the newest diet trend. July 31, 2019.
Patterson RE, Sears DD. Metabolic Effects of Intermittent Fasting. Annu Rev Nutr. 2017;37:371-393. 
Harvard T.H. Chan School of Public Health. Diet Review: Intermittent Fasting for Weight Loss. Accessed March 17, 2022.
Collier R. Intermittent fasting: the science of going without. CMAJ. 2013 Jun 11;185(9):E363-4.
Harvard Health Publishing. Intermittent fasting: The positive news continues. February 28, 2021.
National Institute on Aging. Calorie Restriction and Fasting Diets: What Do We Know? August 14, 2018.
NIH News in Health. The Power of Your Pancreas. February 2017.
Ganesan K, Habboush Y, Sultan S. Intermittent Fasting: The Choice for a Healthier Lifestyle. Cureus. 2018;10(7):e2947. Published 2018 Jul 9.
Cioffi I, Evangelista A, Ponzo V, et al. Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials. J Transl Med. 2018;16(1):371. Published 2018 Dec 24.
Schübel R, Nattenmüller J, Sookthai D, et al. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. Am J Clin Nutr. 2018;108(5):933-945
Regmi P, Heilbronn LK. Time-Restricted Eating: Benefits, Mechanisms, and Challenges in Translation. iScience. 2020;23(6):101161. 
Lin S, Cienfuegos S, Ezpeleta M, Gabel K, et al. Time-Restricted Eating Without Calorie Counting for Weight Loss in a Racially Diverse Population : A Randomized Controlled Trial. Ann Intern Med. 2023 Jul;176(7):885-895. 
Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev. 2017;39:46-58.
Mayo Clinic. Fasting diet: Can it improve my heart health? October 8, 2022.
Bartholomew CL, Muhlestein JB, May HT, Le VL, et al. Randomized controlled trial of once-per-week intermittent fasting for health improvement: the WONDERFUL trial, European Heart Journal Open, Volume 1, Issue 2, September 2021, oeab026.
Malinowski B, Zalewska K, Węsierska A, Sokołowska MM, et al. Intermittent Fasting in Cardiovascular Disorders-An Overview. Nutrients. 2019 Mar 20;11(3):673. 
Mattson MP, Duan W, Guo Z. Meal size and frequency affect neuronal plasticity and vulnerability to disease: cellular and molecular mechanisms. J Neurochem. 2003;84(3):417-431
Ezpeleta M, Gabel K, Cienfuegos S, et al. Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease: A randomized controlled trial. Cell Metabolism. January 2023. 35(1); P56-70.E3.
Pavlou V, Cienfuegos S, Lin S, et al. Effect of Time-Restricted Eating on Weight Loss in Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(10):e2339337.
Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab. 2018;27(6):1212-1221.e3.
Trepanowski JF, Kroeger CM, Barnosky A, et al. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial. JAMA Intern Med. 2017;177(7):930–938.
Centers for Disease Control and Prevention. Insulin Resistance and Diabetes. Accessed March 17, 2022. 
NIH: National Institute on Aging. Calorie restriction and fasting diets: What do we know? August 24, 2018.
Johns Hopkins Health. Intermittent Fasting: What is it, and how does it work? Accessed March 17, 2022.

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