Intermittent fasting has been a popular trend in the health and wellness world since British journalist Michael Mosley’s BBC documentary, “Eat, Fast and Live Longer,” aired in 2012. Mosley’s 5:2 diet, which involves two days of limited eating (600 calories or less) and five unrestricted days, gained widespread attention for its simplicity and potential health benefits.

Fast forward to 2017, and the 5:2 diet was still making waves when Australian clinician Natalie Lister noticed that some of her adolescent patients with obesity were experimenting with intermittent fasting. Curious about the effects of fasting in young people, Lister and her colleagues conducted a pilot study and later a randomized clinical trial to investigate the impact of intermittent fasting and other diets on teenagers with obesity-related health issues.

Published in JAMA Pediatrics, the results of the study suggested that supervised diets, including intermittent fasting, could help adolescents with weight-related health problems. Furthermore, the study found that well-managed diets could lower the risk of eating disorders and mental health issues in this population. These findings have significant implications for clinicians working with adolescents struggling with obesity and related health issues.

While some clinicians are wary of using obesity medications in children and adolescents, Lister and her collaborator, Hiba Jebeile, wanted to explore the safety and efficacy of diet interventions in this vulnerable population. The study involved 141 teenagers who followed a very-low-energy diet for the first month, followed by either an intermittent fasting diet or a continuous energy-restricted diet for nearly a year.

The results showed that both groups experienced weight loss, with minor improvements in liver function and insulin resistance. However, there were no significant differences in weight loss between the two diets. One participant developed gallstones, which was potentially related to the diet. The researchers emphasized that these intensive interventions are designed for adolescents with serious health conditions and should not be used for general weight loss.

In addition to the physical benefits, the study also highlighted the mental health benefits of structured weight management programs for adolescents. Participants showed less concern about shape and weight, reduced disordered eating behaviors, and increased dietary restraint. The consistent guidance and support from healthcare professionals played a crucial role in improving the participants’ mental well-being.

Despite the positive outcomes, concerns remain about the long-term risks of intensive diet interventions in adolescents. Some experts caution that these diets, especially the restrictive phases, may resemble the diets of individuals with eating disorders. As such, close monitoring and support from healthcare providers are essential to mitigate the risks of developing eating disorders.

Lister and Jebeile emphasize the importance of strict medical supervision when implementing these diets in adolescents. They stress that these interventions should not be widely used and require specialized care from dietitians, pediatricians, and obesity specialists. More research is needed to tailor interventions to those who would benefit most and advocate for comprehensive care programs for adolescents with obesity-related health issues.