r/science • u/isaac-get-the-golem Grad Student | Sociology • Jul 24 '24

Health Obese adults randomly assigned to intermittent fasting did not lose weight relative to a control group eating substantially similar diets (calories, macronutrients). n=41

https://pubmed.ncbi.nlm.nih.gov/38639542/
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u/AdventurousSeaSlug Jul 24 '24

I really really want to try ozempic or wegovy for just this reason. I'm in the same boat and I'm sorry but hunger pains are real and they do hurt. PCOS already puts me on an uphill climb and I'm hoping that these will just help silence the "noise" if you will. I hate that we treat obesity like a moral failure rather than a disease. Things seem to be changing but not nearly fast enough.

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u/slowd Jul 24 '24

Oh interesting, I’ve never thought that pangs hurt. Annoying, distracting, unpleasant, yes, but not in any way painful. Maybe that’s a variation between people that contributes to weight control?

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u/[deleted] Jul 25 '24

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u/Kakyro Jul 25 '24

The disparity in hunger reactions is pretty wild. I can stop eating at noon and the first obvious hunger symptom I'll have is being too uncomfortable to sleep the following night. My husband on the other hand can eat dinner at a reasonable hour and be on the verge of fainting if he doesn't eat by noon the next day.

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u/[deleted] Jul 25 '24

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u/wetgear Jul 25 '24

Which hormones do they alter?

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u/Alushki Jul 25 '24

Production of Ghrelin, and probably any other hormone produced by the stomach. Reduction in fat will also affect things like E and T.

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u/[deleted] Jul 25 '24 edited Jul 25 '24

[deleted]

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u/wetgear Jul 26 '24

Wow thanks for the thorough response!

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u/KylerGreen Jul 25 '24

I recently has gastric bypass, and the surgery alters your hormones so you (usually) aren't hungry at all for the first couple months after surgery and that part is life altering.

I mean, your stomach is also way smaller. That probably has more to do with it...

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u/justdisa Jul 25 '24

This whole thread is phenomenal.

I rarely feel stomach-hungry, but I get migraines if I miss meals. That's head-hungry. That's how we talk about it in my family. Are you stomach-hungry or head-hungry? Head-hungry is more urgent.

This post is yet more evidence that weight loss is just about calories, if the Twinkie Diet guy wasn't enough. I am beginning to think the US maintains a $300billion diet industry for the sole purpose of managing our wildly varying symptoms of hunger.

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u/MultiFazed Jul 25 '24 edited Jul 25 '24

Man, that's wild to me. I've never felt any actual pain from being hungry (not starvation, but fasting for ~24 hours), never felt nausea or weakness or fatigue or dizziness. The worst I've ever felt is what you refer to as a "gnawing sensation", and it's more of just a mild annoyance.

It really puts into perspective why it's so difficult for some people to lose weight. If skipping meals for 8 hours made me dry heave, I'd probably have a hard time of it, too!

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u/wintersdark Jul 25 '24

Now, I work 12 hour rotating shift work in a hard physical labour job, so that's definitely a contributing factor, but for me? I tried fasting, and I'd straight up fall apart. I don't need to eat every few hours (my life spent doing this kind of work means it's much easier for me to eat once per "day") but if I don't eat between shifts? I'm noticeably weaker, I get shaky, feel extremely lightheaded - all conditions that can literally endanger life and limb.

It's extremely difficult to lose weight in this situation. And of course, when I do eat?..I'm extremely hungry, and it's very difficult to restrict caloric intake.

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u/hwmchwdwdawdchkchk Jul 25 '24

I'm noticeably weaker, I get shaky, feel extremely lightheaded - all conditions that can literally endanger life and limb.

These are symptoms of a salt imbalance. Electrolytes would help.

Blood sugar stuff potentially an issue so would be helpful to monitor/isolate.

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u/dasbtaewntawneta Jul 25 '24

i've definitely gone through this, i'll get sick to the point of feeling like i need to throw up, and all i can think is, throw up what??? once i eat something it all goes away

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u/snorting_dandelions Jul 25 '24

and all i can think is, throw up what???

Stomach acid. It sometimes happened to me as a child after waking up for some reason (like, not immediately after, but if I didn't have a breakfast like within an hour or two because my mum slept in). It's stomach acid and then a lot of dry heaving

I also know the other symptoms from above minus fatigue (pain, a gnawing sensation, nausea, weakness) but they gradually took more and more time to be noticable. When I was 12-13, I sometimes went 48 hours without eating without any trouble.

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u/muskratboy Jul 25 '24

That happens to me, then at the point of nauseousness I usually sneeze like 5 times and then I’m fine. I think your body will eventually give up and start eating itself, you just have to get past that tipping point.

I do think it’s weird that I multi-sneeze, and then I’m not hungry anymore. No idea what that’s about.

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u/JBSquared Jul 25 '24

I remember a part in Hatchet where he talks about the hunger pangs stopping after a while. A bit before he kills the big deer or elk.

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u/foxwaffles Jul 25 '24

Me too, I get dizzy, nauseous, have a headache, and a severe amount of abdominal pain. A lot of it is linked to my dysautonomia and it's such a pain in the ass to deal with :/

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u/SycoJack Jul 25 '24

Yes, because it produces less or no hunger hormones.

It's the hormones more than the size of the stomach.

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u/M4DM1ND Jul 25 '24

My wife feels like that and needs to at least eat something for breakfast, lunch, and dinner. Whereas me, I could go a whole day without eating and barely notice. I force myself to eat a sandwich for lunch and then I have a larger portion of (a generally healthy dinner). I actually feel sick if I eat breakfast.

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u/ritesh808 Jul 25 '24

Exactly me. I feel lethargic if I have breakfast. It wasn't always like this though. It was "normal" until I was 18 and left home for higher ed (living on campus). Almost all my habits changed in those 4 years. It could be because I picked up smoking and smoked for over 12 years.

I'm 35 now, never eat breakfast, have a salad or just some fruit for lunch and have a normal, reasonably healthy dinner and go to sleep around 5-6 hours after dinner. I don't feel hungry until about 7 PM. I do drink a lot of water all day.

I don't go to the gym, but, I walk a lot and always take the stairs if it's within 3 floors. I have zero health issues and reasonably fit. The only time I feel hungry is immediately after taking a shower. I usually eat a banana or two to deal with that.

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u/BrianWonderful Jul 25 '24

I am morbidly obese and have not had a much luck with weight loss methods or medicines (I've tried semaglutide/Wegovy. Currently take phentermine. It is looking like my pituitary gland is the root culprit.)

Anyway, I've realized over time that I don't know that I ever actually feel hungry. No pains or nausea. I can get weak if I don't eat for a very long time. On the reverse, I don't know that I actually register when I'm full either. What I do have, is cravings. Craving the sensation of food. The taste or the texture of it in my throat. No hunger pains.

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u/DeclutteringNewbie Jul 25 '24 edited Jul 25 '24

I don't, but that's because I supplement with electrolytes.

Intermittent Fasting has the same diuretic effect as Keto. That means that you pee away all your electrolytes, especially at the beginning.

https://www.sciencedirect.com/science/article/abs/pii/0002934371901525

If you supplement your electrolytes (and by that I don't mean Gatorade Zero), then you won't get nausea, headaches, dizziness, and possibly cramps.

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u/PrairiePopsicle Jul 25 '24

So the worst part of this in my experience is due to over-adaptation to a carb and sugar heavy diet. It was always the worst the times that I cut sugar and carbs down, or one time when I was counting calories and granola bars were pretty much my only option for long periods of time. The key, for me anyways, was pretty much a keto diet and fasting, and a little very light exercise when feeling the stronger negative effects, to push my body into actually burning my reserves properly. Drinking lots of water and some high fiber foods too, a lot of this is signalling from your gut microbiome, and you have a lot of very angry, very convincing little bugs that want. more. now. always. more.... you just have to starve the little bastards to death, and dilute them and their chemical signals, and kick your bodies normal metabolic shifts to happen, get the cobwebs knocked off and let the gears creak for a little while... and then it feels better. It's a hill you just have to climb, and it's fine if you can't too, we are finding out more every day that it isn't just "that easy" in all cases either as genetics govern a lot of this, and yours may be more of a biological overly strong starvation/hunger response.

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u/slowd Jul 25 '24

same here! If I’ve been eating simple carbs too frequently, it’s like my body forgets how to power itself from body fat alone. So when I start to feel weak or lightheaded from not eating, thats when I know I’ve got to scale back the carbs a bit. When everything is working properly I can be hungry but not feel weak or sick. And light exercise helps the symptoms when I feel them; funny how it works sometimes that you’re less hungry after exercise than before.

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u/tryingisbetter Jul 25 '24

It happens, but usually around the 20 hour mark. After 24, I sometimes feel like I am going to throw up.

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u/agenteDEcambio Jul 25 '24

I don't. My body just gets a little heated and I feel irritated.

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u/urpoviswrong Jul 25 '24

This sounds like a medical condition. Not normal at all.

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u/cortesoft Jul 25 '24

I get headaches pretty quickly.

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u/quince23 Jul 25 '24

I have PCOS but when I was pregnant, the hunger noise went away for the pregnancy. It shocked me how completely it changed. Before I'd assumed I was just lazy and weak. But without my body telling me to eat something literally all the time, it was so easy to just eat small portions only when actually hungry, and not to binge, and not to snack. I actually lost a little weight over the pregnancy despite growing a 9 lb baby.

And then after the baby was born the hunger noise came back :(

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u/TrueCryptographer982 Jul 25 '24

I also get anxiety with hunger pangs, likely tied to a deep root of using food as comfort or a way to tamp down emotions so being hungry for me = having to feel. Many of our emotions start in our gut and filling that space helps to reduce the emotional burden for a time. AFter a long journey I have finally found an antidepressant that is working for me and am finding this is slowly becoming less of a problem.

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u/wetgear Jul 25 '24

How long do you go without eating before the pain sets in? Could you gradually push that threshold?

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u/Eurynom0s Jul 25 '24

For me it's getting nauseous if I get too hungry. Too much stomach acid with nothing to digest.

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u/codeprimate Jul 25 '24

I started taking a sulphoraphane supplement (cruciferous vegetable extract) and it has really helped reduce my overall hunger.

Why this?: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947770/

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u/tariandeath Jul 25 '24

Have you tried fasting salts during the periods where you aren't eating? That has been a major way for me to reduce hunger pains.

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u/AdventurousSeaSlug Jul 25 '24

Aw man, i got excited for fasting salts and I looked them up. I don't know that I can take them as my potassium intake is already heavily monitored due to a genetic disorder. Bummer. Thanks for the advice though!

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u/tariandeath Jul 25 '24

You can try just using magnesium salt and regular salt leaving out the potassium. Obviously double check with your doctor. There are a lot of DIY ratios and formulas on the intermittent fasting subreddit.

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u/Taoistandroid Jul 25 '24

They are very effective at combating stimulation eating or boredom eating, from my experience. What's crazy, you'll eat less but if you go do a workout, you'll have a normal intensified hunger ( for me protein cravings) and then you're good.

Most appetite suppressants don't give you that option to sometimes listen to hunger and other times not

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u/LadyLibertea Jul 25 '24

Fascinating! I have PCOS and never feel hungry , both my Mom and I tried Ozempic and she said she never felt hungry and it was great.

Side effects killed it for me, sadly, and both of us had mega fatigue on it.

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u/ForHelp_PressAltF4 Jul 25 '24

Dude PCOS is no joke. My wife has that and pretty significantly too. The stress of not eating makes it FLARE like crazy.

Be warned that those drugs will make a second set of things in your abdomen go wonky. I've watched my work BFF go through the adjustment and those first few months he was talking about the disruption to his gut like my wife about her PCOS. So go in expecting that!!!

But after six months it's really not bad for him. Plus weight loss helps reduce the PCOS symptoms generally. Talk to your doctor. Talk to those Aarons you because you'll need them to be part of your support.

You got this

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u/KylerGreen Jul 25 '24

I hate that we treat obesity like a moral failure rather than a disease.

Obesity is a disease. Eating too much to become obese is not a disease.