Does intermittent fasting lead to eating disorders?

By Jules Murtha | Fact-checked by Anastasia Climan, RDN, CD-N
Published January 11, 2023

Key Takeaways

  • Intermittent fasting (IF) has been clinically proven to improve diabetes, cardiovascular disease, cancers, neurological disorders, and obesity in patients who try it.

  • As IF rises in popularity, researchers are finding that adolescents and young adults who engage in IF may also exhibit symptoms of eating disorders and psychopathology.

  • Patients who try IF and struggle with disordered eating may instead benefit from intuitive eating practices, which have been shown to mitigate unhealthy weight control behaviors.

Intermittent fasting (IF) is an eating trend that’s quickly growing in popularity. Those who do it must eat only within a certain period of time—such as a 6-hour window during daytime—and restrict food intake outside of that window, according to the National Institute on Aging (NIA).[]

Fasting, however, is a known behavior linked to disordered eating, and researchers publishing in Eating Disorders are concerned that IF could be, as well.[]

To help patients recover from behaviors associated with eating disorders, physicians can advise them to practice a method known as intuitive eating (IE).

IF perceived as wellness trend

IF may be seen by the public as a wellness trend, but there are only a few clinically significant reasons why.

According to the NIA article, hundreds of studies and clinical trials have shown that IF can be employed as a method to improve certain health conditions. Diabetes, obesity, heart disease, and neurological disorders are just a few on that list.

The NIA research also found that although IF isn’t used primarily as a form of weight loss, those who do it are likely to consume fewer calories as a result.

But despite evidence supporting IF as a healthy wellness trend, researchers are still unsure whether or not it promotes behaviors associated with eating disorders.

Related: Can fasting make you live longer?

Association between IF and disordered eating

The Eating Behaviors researchers looked at data from the Canadian Study of Adolescent Health Behaviors, which involved 2,762 Canadian adolescents and young adults.

The investigators employed several modified Poisson regression analyses to identify a connection between IF and eating disorder behaviors and psychopathology. They found that 47.7% of women, 38.4% of men, and 52% of transgender and gender non-conforming (TGNC) participants reportedly practiced IF within 12 months of taking the survey.

Analysis revealed that those who engaged in IF in both the past year and the past 30 days were likely to exhibit several eating disorder behaviors. For men, practicing IF in the past 12 months was strongly associated with compulsive exercise and fasting. Those who practiced it in the past 30 days also reported associated vomiting.

Overeating was reported by 71.4 % of men and TGNC participants. Vomiting and the use of laxatives, however, were most popular among TGNC participants.

The association between IF and eating disorders was arguably the most consistent and diverse among women. There was also a strong association between vomiting, use of laxatives, and compulsive exercise in women who practiced IF in the past month and year.

It's unclear whether fasting promotes disordered eating or if people who have eating disorders are more likely to try fasting. Nonetheless, IF can be a potential red flag indicating the need to screen patients for eating disorders.

Although this study shined a light on the potential dangers of IF, further research is needed to make any concrete conclusions about this wellness trend.

Related: Intermittent fasting for rapid weight loss may increase diabetes risk

Intuitive eating approach

What should a physician do if a patient tried IF and slipped into binge eating as a result

One way to reframe their relationship with food is by utilizing intuitive eating (IE), which is defined as “eating according to internal hunger and satiety cues.”

A study published by Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity looked at data from the population-based EAT (Eating and Activity over Time) study, which was conducted between 2010 and 2018.[]

According to the study findings, participants who practiced IE had lower odds of engaging in unhealthy weight-control behaviors, such as binge eating.

Those who practiced IE were 74% less likely to engage in binge eating at the 8-year follow-up point. They also exhibited lower rates of body dissatisfaction, depressive symptoms, and low self-esteem.

IE may serve as a tool for those struggling with psychological and behavioral health issues pertaining to eating disorders—and it could help keep them well-fed, too.

What this means for you

Although there is evidence supporting several health benefits of IF, research points to the possibility that it could be a sign of disordered eating. Individuals who engage in IF may exhibit disordered eating behaviors, such as binge eating, compulsive exercise, and vomiting. To help patients disengage from such behaviors and improve their body satisfaction, you can advise them to practice IE by eating based on their hunger and fullness cues.

Read Next: Here’s how intermittent fasting can be safe and effective
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