Adding a fasting window didn't cut hunger further

Appetite is the usual reason diets fail, so any intervention that lowers hunger has a practical advantage over one that does not. Time-restricted eating is often promoted as an appetite-taming add-on, but whether it adds anything once calories and carbohydrates are already restricted is unclear. There is also a separate worry that restrictive eating patterns might provoke binge eating, particularly in people managing weight alongside type 2 diabetes. This trial looked at both sides of that question in the same participants.

One hundred and twenty overweight or obese adults with type 2 diabetes were randomised to three groups of 40: calorie-carbohydrate restriction, time-restricted eating combined with calorie-carbohydrate restriction, or a control group. Both intervention groups also received structured exercise and behavioural education built on the Information-Motivation-Behavioural Skills model. Appetite perceptions — hunger, satiety, desire to eat and prospective food consumption — plus binge eating, assessed with the Binge Eating Scale and counts of objective binge episodes, were measured at baseline, week 12 and week 24. Linear mixed models were used for the analysis.

Both intervention groups significantly improved subjective appetite compared with control at 12 and 24 weeks. By 24 weeks hunger had dropped by -24.1 mm in the calorie-carbohydrate restriction group and -32.7 mm in the group that added time-restricted eating, while satiety rose by 21.7 mm and 29.4 mm respectively. Desire to eat and prospective food consumption also fell significantly. Crucially, no significant differences were detected between the two intervention groups, and changes in Binge Eating Scale scores and objective binge episodes did not differ between groups at any time point.

The findings support the idea that structured calorie and carbohydrate restriction, combined with exercise and behavioural support, meaningfully reduces hunger over months rather than provoking it. They push back on the notion that a restricted eating window is an appetite lever in its own right once intake is already controlled. The null on binge eating may reflect a sample without much room to improve, which the authors flag as a target for future work. Whether the same pattern holds in people without type 2 diabetes is untested here.

This is a reason to think that if you already restrict calories and carbohydrates with proper support, adding a fasting window may not make you feel any less hungry. It is also reassuring that in this trial restriction did not appear to worsen binge eating measures, though it did not improve them either. Appetite ratings here are subjective and collected within a supported programme, so they describe a structured setting rather than unsupported dieting. The trial says nothing about which approach is easier to sustain long term.