Intermittent Versus Continuous Energy Restriction for Weight Loss and Metabolic Improvement: A Meta‐Analysis and Systematic Review
Open accessAbstract
Objective: This study aimed to evaluate the effects of intermittent energy restriction (IER; only for 2‐3 d/wk) versus continuous energy restriction (CER) on weight loss and metabolic outcomes in adults with overweight or obesity. Methods: Methods included searching databases from the last decade to December 18, 2019, for randomized controlled trials (RCTs) that assessed weight loss and metabolic outcomes in IER and CER. RevMan version 5.3 software was used for statistical analysis of the data. The effect sizes were expressed as weight mean differences and 95% CI. Results: This review included 11 RCTs (n = 850). Meta‐analysis showed that IER had greater effects on absolute weight loss, the percentage of weight loss, and improving insulin sensitivity than CER. In the subgroup analysis, short‐term (2‐3 months) intervention (P < 0.0001) was associated with weight loss. Conclusions: This systematic review shows that IER (2‐3 d/wk) had greater effects on short‐term weight loss than CER and that IER results in comparative metabolic improvements. Furthermore, longer RCTs are needed to validate these findings.
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Existing systematic reviews and meta-analyses have conducted pairwise comparisons but have not yielded conclusive evidence regarding the optimal caloric restriction regimen.
“To date, existing systematic reviews and meta-analyses have conducted pairwise comparisons, such as STF versus CER [22], IER versus CER [23], and STF versus CER [24, 25]. However, these studies have not yielded conclusive evidence regarding the optimal regimen.”
From Comparing caloric restriction regimens for effective weight management in adults: a systematic review and network meta-analysis (2024) · cites this paper as [25]
The ADF finding is consistent with several systematic reviews and Elortegui et al.'s network meta-analysis.
“consistent with several systematic reviews [25, 81, 82] and Elortegui et al.'s [82] network meta-analysis.”
From Comparing caloric restriction regimens for effective weight management in adults: a systematic review and network meta-analysis (2024) · cites this paper as [25]
Another meta-analysis indicated that most continuous energy restriction interventions lasting at least 3 months achieve reductions exceeding 5% of baseline body weight.
“Another metaanalysis indicated that most CR interventions lasting at least 3 months achieve reductions exceeding 5% of baseline body weight [29].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [29]
In one study, alternate day fasting led to greater weight loss (1.66 kg) compared to continuous energy restriction in less than 3 months.
“An exception is one study in which ADF led to greater weight loss (1.66 kg) compared to CR in less than 3 months [29].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [29]
Most studies comparing intermittent energy restriction with continuous energy restriction do not demonstrate significant differences in effectiveness beyond 6 months.
“Most studies comparing IER with CR do not demonstrate significant differences in effectiveness beyond 6 months [28,29,31].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [29]
Comparative data indicate that, with a balanced energy intake, CR and IER lead to similar weight loss.
“Comparative data indicate that, with a balanced energy intake, CR and IER lead to similar weight loss [28,29,31].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [29]
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- Authors
- He, S., Wang, J., Zhang, J., & Xu, J.
- Affiliations
- First Affiliated Hospital of Nanchang University (CN)
- Corresponding author
- Xu, Jixiong
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2020-12-21
- Volume
- 29
- Issue
- 1
- Pages
- 108-115
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W3115884582
- Cited by
- 60
- References
- 48
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 14 · 2023: 10 · 2022: 12 · 2021: 5
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- intermittent energy restriction, continuous energy restriction, weight loss, overweight, insulin sensitivity, metabolic improvement
- MeSH terms
- Adult, Humans, Insulin Resistance, Obesity, Weight Loss, Caloric Restriction, Overweight
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