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Randomized trial · measured other health measures

16-week trial in 405 adults with diabetes: 5:2 fasting lost more weight than drugs

Guo and colleagues · JAMA network open · 2024

Original title: A 5:2 Intermittent Fasting Meal Replacement Diet and Glycemic Control for Adults With Diabetes: The EARLY Randomized Clinical Trial.

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What the study found

Points to benefit

Blood sugar (HbA1c) fell most with fasting: -1.9% vs -1.6% metformin and -1.5% empagliflozin. Weight fell -9.7 kg with fasting, -5.5 kg with metformin and -5.8 kg with empagliflozin.

The study at a glance

Type of study
Randomized trial
Who or what was studied
405 people · adults with overweight or obesity and early type 2 diabetes
What was tested
5:2 fasting with meal replacements vs metformin or empagliflozin (diabetes drugs), for 16 weeks
What it measured
Several kinds of outcomes
How long
16 weeks
Trial registration
ChiCTR2000040656
Who has a stake
No stake declared
No conflicts reported; no company funding listed.
Journal
JAMA network open, 2024
Source
PubMed record 38904963. This page is based on the abstract only.

How much this study counts

  • ✓Randomized: people were put into groups by chance, so the groups start out alike.
  • ✓Large: 405 people.
  • •Lasted 16 weeks.
  • •Measured several kinds of outcomes.
  • ✓No competing interests declared.
  • •Summarized from the PubMed abstract only. The full paper may hold details the abstract leaves out.

✓ Strength– Limit• Note

These points come from fixed rules about the type of study, its size and length, what it measured, and who has a stake. Every study on Digestery gets the same rules.

Where this study sits

Each dot is one on-topic paper on this question. Steps near the top answer the question more directly.

↑ Stronger evidence

  1. Trials in people: weight loss

    9

    5 benefit, 2 mixed, 2 no difference

  2. Trials in people: other measures

    8

    4 benefit, 3 mixed, 1 no difference

    ↑ This study is the ringed dot

  3. Trials in people: lab tests or safety

    1

    1 benefit

  4. Population studies

    0

    None among the papers we read.

  5. Blood levels and genes

    0

    None among the papers we read.

↓ Weaker evidence

  • Points to benefit
  • Mixed
  • No difference
  • No direction
  • Points to harm

How it fits with the other research

The short answer to “Does intermittent fasting help with weight loss?”

Yes, but about like calorie cutting.

Confidence: moderate. Based on 26 on-topic papers.

Read the full answer

Of the other 7 papers on the same step: 3 benefit, 3 mixed, 1 no difference. This one found benefit.

  • Marked as a key paper in the research timeline: Largest trial: 5:2 fasting beat diabetes drugs on weight.

Other papers on the same step

See all 26 studies on this question

How this page was made

Label

First read of the abstract
Claude Sonnet
Independent second read
Claude Haiku
Differences settled
The two reads agreed on every checked field. Claude Opus 5.5.
Headline
Claude Sonnet, from the checked study record. A script checked its numbers and wording.
Numbers
Checked against the abstract by a script
“How much this study counts”
Fixed rules, the same for every study
Source check by a person
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