Changes in hunger and fullness in relation to gut peptides before and after 8 weeks of alternate day fasting

Clin Nutr. 2016 Dec;35(6):1380-1385. doi: 10.1016/j.clnu.2016.03.011. Epub 2016 Mar 30.


Background & aims: Alternate day fasting (ADF; 25% energy intake "fast day", alternated with an ad libitum intake "feed day") is effective for weight loss. Whether or not ADF modulates hunger, fullness and gut peptides in a way that enhances dietary compliance and weight loss, remains unknown. Accordingly, this study examined the effect of ADF on postprandial appetite ratings and gut peptides.

Methods: Obese subjects (n = 59) participated in an 8-week ADF protocol where food was provided on the fast day.

Results: Body weight decreased (P < 0.0001) by 3.9 ± 0.6 kg after 8 weeks of diet. Reductions (P < 0.05) in fat mass (-2.2 ± 0.2 kg), fat free mass (-1.4 ± 0.2 kg), visceral fat mass (-0.1 ± 0.1 kg), and resting metabolic rate (RMR; -104 ± 28 kcal/day) were also observed. Fasting leptin and insulin decreased (P < 0.05), while AUC ghrelin levels increased (P < 0.05). Despite these metabolic changes, there was no increase in subjective hunger by the end of the study. Furthermore, fullness and PYY increased (P < 0.05). Fat free mass and RMR were not related to hunger or ghrelin at any time point.

Conclusion: These findings suggest that the absence of a compensatory increase in hunger in conjunction with an increase in sensations of fullness may contribute to the weight loss efficacy of an 8-week ADF regimen.

Keywords: Alternate day fasting; Calorie restriction; Fullness; Gut peptides; Hunger; Obese adults.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Basal Metabolism
  • Blood Glucose / metabolism
  • Body Composition
  • Body Mass Index
  • Body Weight
  • Diet
  • Diet Records
  • Exercise
  • Fasting*
  • Female
  • Ghrelin / blood*
  • Humans
  • Hunger*
  • Insulin / blood*
  • Leptin / blood*
  • Male
  • Middle Aged
  • Patient Compliance
  • Peptide YY / blood*
  • Satiation*


  • Blood Glucose
  • Ghrelin
  • Insulin
  • Leptin
  • Peptide YY