Therapeutic fasting in morbid obesity

Area of Science:

• Metabolism and Endocrinology
• Obesity Research
• Clinical Nutrition

Background:

• Morbid obesity is a significant global health concern requiring effective, sustainable interventions.
• Prolonged fasting has emerged as a potential strategy for substantial weight reduction in obese individuals.

Purpose of the Study:

• To evaluate the efficacy of prolonged fasting for weight loss in morbidly obese patients.
• To assess long-term weight maintenance and factors influencing weight regain after fasting.

Main Methods:

• A cohort of 207 morbidly obese patients underwent prolonged fasting for varying durations.
• Weight loss, attainment of near-normal weight, and weight regain were monitored.
• Follow-up data over 7.3 years were collected for 121 patients.

Main Results:

• Significant mean weight loss was observed, with longer fasts yielding greater initial reductions.
• Over 50% of patients in the longest fasting group achieved near-normal weight.
• Weight regain was substantial, with 50% regaining to original weight within 2-3 years.
• Childhood-onset obesity was associated with lower fasting tolerance and higher rates of weight regain.

Conclusions:

• Prolonged fasting can achieve significant short-term weight loss in morbidly obese patients.
• Long-term weight maintenance remains a major challenge, with most patients regaining weight.
• Early-onset obesity may present unique challenges for sustained weight management after fasting.