In fact, if anything, intermittent fasting may actually inadvertently sabotage your attempts at weight loss: Weiss’ study also found that the weight the time-restricted eaters shed was mainly lean mass, including muscle, not body fat. “This is more worrisome for people over 50, since maintaining muscle mass as you age gets harder,” he explains. Preserving muscle is key in this age group, not only to keep your metabolism percolating (which in turn helps keep weight off) but also because it helps improve balance and reduces risk of falls. “Before recommending to my older patients, I would want to see more research on the effects on lean mass,” adds Weiss, who had been following time-restricted eating himself since 2014.
One problem his patients run up against with intermittent fasting, says Aronne, is that it’s difficult to stick to long term. A 2017 study published in the JAMA Internal Medicine found that almost 40 percent of people fall off the fasting wagon within six months. “Some people find themselves so ravenously hungry after 16 hours of not eating, or a day of fasting, that they end up consuming thousands of calories, which defeats the purpose,” he explains. If you have diabetes, you should know that the combination of fasting and the medications you may take could cause your blood glucose levels to get dangerously low.
The benefits of intermittent fasting
That’s not to say this kind of restricted eating can’t have value. Intermittent fasting may in fact work for certain people, Aronne adds, especially if they don’t want to be bothered with calorie tracking and food records. “It’s not my first choice for weight loss,” he says, “but I have found that in a select group of patients struggling to lose weight, having them eat all their food in an eight-hour period works for them, because it’s easy and they don’t have to think about it: They just do it.”
For everyone, it still makes sense more generally to eat to maximize your circadian rhythms — your body’s inner clock that guides you to wake and sleep — as much as possible, advises Michael Roizen, M.D., chief wellness officer of the Cleveland Clinic and author of What to Eat When. “Our bodies evolved to be primed for food during the day, so that we have plenty of energy for survival,” he says. As a result, your body is most sensitive to insulin, a hormone that moves glucose from your blood into cells for energy and storage, during the day, and most resistant to it at night. Ignoring these rhythms and eating at the wrong times — say, late at night — can raise blood sugar, a risk factor for type 2 diabetes, according to a study led by researchers at Harvard University as well as Brigham and Women’s Hospital.
Take an approach instead where you make breakfast (or, if you can’t stomach eating a lot that early, lunch) the main meal of the day, and make your last meal a light one after the sun goes down. “This carries many of the same benefits of intermittent fasting, since you’re generally not eating within a 12-hour window, but it’s much easier,” explains Roizen.