Effect of Fasting-Mimicking Diet or Continuous Energy Restriction on Weight Loss, Body Composition, and Appetite-Regulating Hormones Among Metabolically Healthy Women with Obesity: a Randomized Controlled, Parallel Trial

Obes Surg. 2021 May;31(5):2030-2039. doi: 10.1007/s11695-020-05202-y. Epub 2021 Jan 9.


Background: Fasting-mimicking diet (FMD) has been recently promoted to achieve similar metabolic changes of fasting. The purpose of our study was to compare the effect of FMD versus continuous energy restriction (CER) on anthropometric measurements, body composition, glucose metabolism, and serum levels of leptin, neuropeptide Y (NPY), and total ghrelin.

Methods: A randomized controlled trial (RCT) was conducted on 60 women with obesity aged 18-55 years. Subjects received either a 5-day FMD (low in energy, sugars, and proteins, but high in unsaturated fats) or a CER (an average daily energy deficit of 500 kcal) for 2 months. Anthropometric and biochemical factors were measured at baseline and the end of the study. Serum levels of leptin, total ghrelin, and NPY were tested with an ELISA kit. Physical activity and dietary intakes were also recorded.

Results: There was no significant difference in weight loss between the two groups: mean weight change for CER was - 2.29 (standard deviation [SD], 1.95) kg compared to - 1.13 (2.27) kg for FMD (p = 0.06). There was more reduction in the basal metabolic rate (BMR) in the CER group (p = 0.045). Favorable effects on fat mass and muscle mass were only seen in the FMD group. Although insulin resistance was reduced in the FMD group compared to the CER group, results were not significant after adjustment. After controlling for potential confounders, there was a significant increase in serum levels of total ghrelin (p = 0.048) and NPY (p = 0.041) following CER; however, results for circulating leptin were not statistically significant (p = 0.48).

Conclusions: There was no significant difference in weight loss following FMD and CER. However, FMD was more effective at reducing insulin resistance and regulating appetite-regulating hormones as well as preserving muscle mass and BMR.

Trial registration: This trial was registered at the Iranian Clinical Trial Registry ( https://www.irct.ir/trial/40881 ) with the IRCT identification number IRCT20190717044244N1.

Keywords: Appetite; Continuous energy restriction; Fasting-mimicking diet; Weight loss.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Appetite
  • Body Composition
  • Caloric Restriction
  • Diet
  • Fasting
  • Female
  • Ghrelin
  • Humans
  • Middle Aged
  • Obesity
  • Obesity, Morbid* / surgery
  • Weight Loss*
  • Young Adult


  • Ghrelin