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Randomized trial · measured the question itself

12-month trial in 165 adults: 4:3 fasting lost more weight than daily calorie cutting

Catenacci and colleagues · Annals of internal medicine · 2025

Original title: The Effect of 4:3 Intermittent Fasting on Weight Loss at 12 Months : A Randomized Clinical Trial.

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What the study found

Points to benefit

At 12 months, 4:3 fasting gave greater weight loss than daily calorie cutting (mean difference, 2.89 kg [95% CI, 5.65 to 0.14 kg]; P = 0.040). 125 of 165 finished.

The study at a glance

Type of study
Randomized trial
Who or what was studied
165 people · adults aged 18 to 60 with overweight or obesity (BMI 27 to 46)
What was tested
cutting food 80% on 3 non-consecutive days a week (4:3 fasting), vs cutting daily food 34%, both with a behavior program, for 12 months
What it measured
The question itself: weight loss, compared with ordinary calorie cutting
How long
52 weeks
Trial registration
NCT03411356
Who has a stake
No disclosure in PubMed
No disclosure in PubMed; funded by NIDDK.
Journal
Annals of internal medicine, 2025
Source
PubMed record 40163873. 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.
  • •Medium size: 165 people.
  • ✓Long: about 1 year.
  • ✓Measured the question itself: weight loss, compared with ordinary calorie cutting.
  • •The PubMed record has no conflict-of-interest statement.
  • •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

    ↑ This study is the ringed dot

  2. Trials in people: other measures

    8

    4 benefit, 3 mixed, 1 no difference

  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 8 papers on the same step: 4 benefit, 2 mixed, 2 no difference. This one found benefit.

  • Quoted in “What we found”: Two year-long trials split: a daytime eating window added no clear loss to calorie cutting, while 4:3 fasting lost 2.89 kg more than daily cutting.
  • Part of the finding “Alternate-day fasting may edge ahead, short term”.
  • Marked as a key paper in the research timeline: Year-long trial: 4:3 fasting edged out daily cutting.
  • Open item for a person: No COI statement in PubMed for Liu 2022 and Li 2024; Catenacci 2025 only points to online disclosure forms.

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
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