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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



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.


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.


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).


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 ( with the IRCT identification number IRCT20190717044244N1.

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Fig. 1

Data Availability

Because of ethical restrictions on sharing a de-identified dataset (data contain potentially identifying or sensitive patient information), data from this study are available upon request. These restrictions were imposed by the Ethics Committee and principal investigator.


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The study was approved and financially supported by Ahvaz Jundishapur University of Medical Sciences (project number NRC-9806).

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Authors and Affiliations



The authors’ responsibilities were as follows—AZ and SAH: conceived and designed the experiments; MS and AZ: wrote the paper; MS and AM: performed the experiments; KAA: analyzed the data; AZ had primary responsibility for the final content.

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Correspondence to Ahmad Zare Javid.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

All procedures were reviewed and approved by the ethics committee of Ahvaz Jundishapur University of Medical Sciences and was registered on the Iranian Registry of Clinical Trials website; IRCT registration no. IRCT20190717044244N1, accessed at

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Informed consent was obtained from all individual participants included in the study.

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Sadeghian, M., Hosseini, S.A., Zare Javid, A. et al. 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 31, 2030–2039 (2021).

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  • Appetite
  • Continuous energy restriction
  • Fasting-mimicking diet
  • Weight loss