Does intermittent fasting lead to eating disorders?

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

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.

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.

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.

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.