Health Journal Online

Tag: Calorie

  • New Research Finds Semaglutide Users Held Lower Calorie Intake For More Than A Year

    New Research Finds Semaglutide Users Held Lower Calorie Intake For More Than A Year

    What the Study Measured

    A question that comes up constantly in weight management clinics now has a direct measurement behind it: if the hunger comes back, has the drug stopped working?

    Penn Medicine researchers ran a 60-week trial in 120 adults who were overweight or had obesity, assigning them to once-weekly semaglutide at 2.4 mg or placebo, with regular lifestyle counseling in both groups. The design’s strength is that it did not rely on what people said about their appetite. It measured what they ate.

    At baseline and again at weeks 20, 40, and 60, participants completed a five-hour laboratory assessment. After a standardized breakfast, they were offered lunch and told to eat until they felt comfortably full. Researchers weighed and counted the calories consumed.

    Across those follow-up assessments through week 60, participants taking semaglutide ate about 24 to 30 percent fewer calories than those on placebo, according to Penn Medicine. Weight followed. The semaglutide group lost an average of 15.1 percent of initial body weight at week 60, against 3.4 percent for placebo.

    The Gap Between Feeling Hungry and Eating More

    The finding that makes this study useful is the mismatch between what people reported and what they did.

    During the first 20 weeks, participants on semaglutide reported less hunger, greater appetite control and fewer thoughts about food, the sensation many patients call food noise. By weeks 40 and 60, the differences between the semaglutide and placebo groups on many of those subjective measures were no longer statistically significant.

    The calorie difference persisted anyway.

    “This study highlights an important distinction between people’s perceptions of their appetite and how they actually eat,” said Thomas A. Wadden, PhD, a professor of psychology in psychiatry and former director of Penn’s Center for Weight and Eating Disorders. “People taking semaglutide for weight loss often notice dramatic reductions in hunger and food noise when they begin this treatment. If those sensations gradually become less noticeable, some may incorrectly assume the medication is no longer effective.“

    Lead author Jena S. Tronieri, PhD, a senior research investigator at the center, framed the practical consequence directly. “Many patients worry that their medication has stopped working if they notice some return of hunger after the first several months,” she said. “Our findings show that even when people feel some of those sensations returning, semaglutide continues to help them eat less. That sustained reduction in calorie intake appears to be a key reason why weight loss is maintained over time.“

    There is a plausible explanation for the divergence that the study does not settle. Subjective hunger ratings are relative to a person’s own recent experience, and a body 15 percent lighter has different baseline sensations than it did a year earlier. Feeling hungrier than you did at week four is not the same as eating as you did before treatment.

    What This Does Not Tell You

    Several limits deserve to sit here rather than at the end, because they bound what the result can be used for.

    The single largest one is that this study says nothing about stopping. Every participant analyzed was on treatment. It does not measure what happens to calorie intake after discontinuation, which is the question behind most of the current anxiety about these drugs. Separate research has consistently found weight regain after stopping.

    The sample was 120 people. That is adequate for a controlled laboratory feeding study and small for drawing conclusions about population-level behavior. The trial also ran 60 weeks, so it does not describe year three or year five.

    The laboratory meal is a proxy, not real life. Participants ate a standardized breakfast in a research setting and then a single test lunch under observation. That design controls variables well and does not capture evening eating, weekend eating, restaurant portions, stress eating or the social context in which most calories are actually consumed.

    Both groups received lifestyle counseling throughout, so the comparison is semaglutide plus counseling against placebo plus counseling, not against no intervention.

    The study was supported in part by a Novo Nordisk research grant through the company’s Investigator Sponsored Studies Program. Penn states that Novo Nordisk played no part in the conception, conduct, analysis, or reporting of the study.

    Why It Matters for People Considering Stopping

    The clinical relevance here is a decision, not a data point.

    Patients who conclude their medication has quit working sometimes stop taking it, sometimes stop refilling because they no longer see the point of the cost, and sometimes ask for a dose increase they may not need. This study suggests at least one of those inferences may rest on a misreading of the evidence available to the patient, which is their own sense of hunger.

    “Our results suggest that patients may experience a partial return of appetite sensations over time, without losing the medication’s benefit of continuing to reduce calorie intake, which is needed to maintain their new, lower body weight,” Tronieri said. “Understanding that can help set realistic expectations and may encourage people to stay on treatment long term, as approved by the U.S. Food and Drug Administration and recommended by the treatment guidelines of numerous professional societies.”

    That framing comes from researchers whose work is partly industry-funded, and readers should weigh it accordingly. It is also consistent with how obesity is defined in current clinical guidance, as a chronic condition managed rather than cured.

    What Patients Should Take From It

    Nobody should start, stop or change a dose based on this study, and the most useful action it supports is a conversation rather than a decision.

    If your hunger has returned somewhat after several months on semaglutide, that is a documented pattern and not automatically a sign of treatment failure. Weight trajectory, waist measurement, blood pressure, lipids and glucose are more reliable indicators of whether the medication is doing its job than the subjective sense of appetite.

    If weight has plateaued or is climbing, that is worth raising with a prescriber, who can look at dose, adherence, other medications, sleep, alcohol and activity before concluding anything about the drug.

    Anyone considering stopping because of cost, side effects, or coverage changes should have that conversation before stopping rather than after, since abrupt discontinuation carries a well-documented pattern of regain.

    The next questions researchers will need to answer are what calorie intake looks like beyond 60 weeks, what it looks like after discontinuation, and whether the same pattern holds for tirzepatide and the newer oral agents. MedicalDaily will report follow-up analyses as they publish.

    Frequently Asked Questions

    What did the study find? Adults taking semaglutide ate 24 to 30 percent fewer calories than those on placebo at laboratory assessments through week 60, and lost 15.1 percent of body weight versus 3.4 percent.

    Does hunger really come back? Reported hunger, appetite control and food noise differed clearly from placebo at 20 weeks, but many of those differences were no longer statistically significant by weeks 40 and 60.

    So has the drug stopped working if I feel hungrier? Not necessarily. In this trial, calorie intake stayed lower even as subjective appetite differences faded. Weight trend is a better indicator than hunger.

    How big was the study? 120 adults with overweight or obesity, over 60 weeks.

    Does this tell me what happens if I stop? No. Everyone analyzed was on treatment. The study does not address discontinuation.

    Who funded it? It was supported in part by a Novo Nordisk research grant. Penn states the company had no role in the study’s conception, conduct, analysis or reporting.

    Should I change my dose? Not on your own. Discuss weight trajectory and any concerns with your prescriber.

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  • New Study Finds Intermittent Fasting Produces Similar Weight Loss to Calorie Counting

    New Study Finds Intermittent Fasting Produces Similar Weight Loss to Calorie Counting

    Intermittent fasting produced comparable weight loss to traditional daily calorie restriction over 18 months — but people following intermittent fasting did so without the same constant feeling of needing to monitor and limit their food intake, according to a new study from Adelaide University published in the journal Clinical Nutrition.

    That distinction may matter more than the weight loss numbers alone. Difficulty sticking to a diet — not the diet’s biological effectiveness — is the primary reason people abandon calorie-restriction programs, researchers said. And the study, led by Professor Leonie Heilbronn of Adelaide University’s School of Medicine and the South Australian Health and Medical Research Institute, found that intermittent fasting could offer an alternative pathway specifically for people whose eating behaviors make sustained calorie counting feel impossible.

    Why This Matters

    Calorie counting — the most widely recommended dietary strategy for weight loss — asks people to track every gram of food consumed, stay below a daily energy target, and resist overeating at every meal, every day, indefinitely. That cognitive and emotional workload is substantial, and research consistently shows it is the primary reason people abandon the approach.

    “While many diets can result in weight loss, they may be difficult to stick to and this makes keeping that weight off long-term more challenging,” Professor Heilbronn said in an Adelaide University release.

    More than 100 million Americans are estimated to be living with obesity, and the vast majority have attempted dietary interventions at some point. The repeated cycle of dieting, initial weight loss, and gradual regain is one of the most common and frustrating experiences in clinical weight management. A strategy that produces comparable results through a different behavioral mechanism — without the constant cognitive burden of restricting every meal — could be more sustainable for specific types of patients.

    What We Know So Far

    The Adelaide University trial enrolled more than 200 adults with obesity over an 18-month period and randomized them into three groups: intermittent fasting with time-restricted eating, daily calorie restriction, or a control group receiving standard healthy-eating advice.

    The intermittent fasting protocol used in the study was specific: participants ate 30% of their normal daily energy intake during a window between 8 a.m. and noon on three non-consecutive days per week, followed by a 20-hour fast. On the remaining four days, they ate normally. The calorie-restriction group reduced their total daily intake by approximately 30% every day.

    Both dietary intervention groups lost similar amounts of weight over the study period. The key divergence was behavioral: calorie restriction participants reported consciously having to monitor their eating, avoid overeating, and restrain themselves at meals — and that improved dietary control accounted for approximately 15% of their weight loss. Intermittent fasting participants did not report the same need for constant behavioral restraint to achieve comparable results.

    The study found no evidence that intermittent fasting caused the concerns sometimes cited against it: participants did not report increased irritability, obsessive thoughts about food, or binge eating on non-fasting days, according to research coverage by ScienceDaily.

    “Psychological and behavioral effects have a major influence on people’s abilities to adhere to diets,” Professor Heilbronn said. “Intermittent fasting may help people achieve weight loss through ways that are less dependent on consciously restricting intake.”

    Where the Benefit Is Most Relevant

    The study’s findings are most applicable to people who:

    • Have tried calorie-counting diets and found the constant monitoring unsustainable
    • Repeatedly lose and regain weight (sometimes called “yo-yo dieting”)
    • Struggle with eating restraint at every meal but can manage structured fasting windows
    • Are not in a clinical category that makes fasting dangerous (see risks below)

    “If someone finds it difficult to improve eating behaviors, intermittent fasting might be better to help them still lose weight,” Professor Heilbronn told Healthline. “Previous research shows that people who improve their relationship with food and gain better control over cravings lose more weight — regardless of the specific diet they undertake.”

    What Researchers Say

    Professor Heilbronn, who has led multiple randomized trials of intermittent fasting protocols over more than a decade, was careful to frame the study’s findings as an option for specific patients rather than a universal recommendation. “Future trials should be designed to identify individuals who struggle to improve eating behaviors, as they may do better with intermittent fasting diets, enabling more personalized weight management,” she said.

    “Although intermittent fasting is a popular diet, experts agree that it’s not for everyone,” Heilbronn told Healthline. People with a history of eating disorders, those who are pregnant or nursing, people with diabetes who take insulin or sulfonylureas (where skipping meals can cause hypoglycemia), and people with certain medical conditions should discuss any significant dietary change with a clinician before starting.

    What the Evidence Shows — and What It Does Not

    This study was designed primarily to examine the psychological and behavioral effects of the two diets — eating behaviors, mood, sleep, and quality of life — rather than weight loss magnitude as its primary outcome. That design choice means the study provides strong insight into how people experience the diets differently, but does not change the existing evidence base on the magnitude of weight loss produced by each approach.

    The weight loss outcomes were comparable between groups — the study was not designed to determine whether one approach is numerically superior. The key new finding is the behavioral mechanism: the two diets appear to work through different psychological pathways, which has practical implications for patient selection.

    The protocol used — intermittent fasting on three non-consecutive days per week with a specific morning eating window — is one of several intermittent fasting approaches. Results may not apply to other IF formats such as 16:8 daily fasting, alternate-day fasting, or the 5:2 protocol.

    MedicalDaily Evidence Check

    • Study type: Randomized controlled trial
    • Published: Online May 15, 2026, Clinical Nutrition (DOI: 10.1016/j.clnu.2026.106686); ScienceDaily coverage July 8, 2026
    • Institution: Adelaide University School of Medicine; South Australian Health and Medical Research Institute
    • Protocol: 3-day intermittent fasting (30% intake 8am–noon, 20h fast) vs. 30% daily calorie restriction vs. control; 18 months; 200+ adults with obesity
    • What it found: Both groups lost similar amounts of weight; intermittent fasting participants showed less reliance on conscious eating restraint; no increase in irritability, food obsession, or binge eating in IF group
    • What it did not find: Evidence that IF produces more weight loss than calorie restriction; evidence that any IF protocol is universally superior to all other approaches
    • Key limitation: One specific IF protocol tested; results may not apply to all IF approaches; conducted in Australia with predominantly Australian participants
    • What readers should know: IF may be a viable alternative for people who struggle to sustain daily calorie counting; not appropriate for everyone; consult a clinician before significant dietary change

    Who This Finding Is Most Relevant For

    The study’s implications are most directly relevant to:

    • People with obesity who have repeatedly attempted calorie-counting diets without sustained success
    • People who find constant meal monitoring cognitively or emotionally burdensome
    • Individuals without medical contraindications to meal timing changes (diabetes on insulin, eating disorder history, pregnancy, certain medications)

    For people who are already successful at calorie counting and maintaining weight loss, there is no evidence from this study that switching to intermittent fasting would produce additional benefit.

    For people currently prescribed GLP-1 medications for obesity management, dietary strategy remains an important complement to medication — whether that is calorie restriction or intermittent fasting. This study’s findings do not change medication recommendations.

    Intermittent Fasting: Who Should Be Cautious

    Not all people should attempt intermittent fasting without medical guidance. Consult a clinician before starting if you:

    • Have Type 1 or Type 2 diabetes and take insulin or sulfonylurea medications (risk of hypoglycemia during fasting windows)
    • Have a history of eating disorders or disordered eating patterns
    • Are pregnant or planning to become pregnant
    • Take medications that require food to be taken with them
    • Are underweight or have a history of malnutrition
    • Have kidney disease, liver disease, or other conditions where meal timing and nutrient intake are closely medically managed

    What You Can Do Now

    • Identify your pattern. If you have repeatedly started calorie-counting diets and found the constant monitoring unsustainable, the adherence advantage of IF may be relevant to you.
    • Consider the specific protocol tested. This study used a 3-day-per-week approach with eating limited to the morning hours (8 a.m. to noon) on fasting days. This is different from the popular 16:8 approach. Both exist; the evidence for this specific protocol is what this trial tested.
    • Talk to a clinician before starting, particularly if you have any of the conditions listed above.
    • Don’t combine IF with severe restriction on non-fasting days. The protocol tested involved eating normally on non-fasting days. Extreme restriction on all days defeats the behavioral advantage the study identified.
    • Be realistic about weight loss magnitude. Intermittent fasting produced comparable weight loss to calorie restriction — roughly 3% to 5% of body weight over months in most trials. It is not a rapid weight loss strategy.
    • Pair dietary change with physical activity. All randomized weight loss trials produce better outcomes when participants also increase moderate exercise.

    Cost and Access: What Patients Should Know

    Intermittent fasting costs nothing in terms of products or services. It requires no meal replacement products, supplements, apps, or program subscriptions to implement. However, for people with obesity seeking medical support for weight management, several resources are available:

    • Primary care physicians can refer patients to registered dietitians, who can support implementation of either dietary approach
    • Most insurance plans cover at least one visit per year with a registered dietitian when a medical diagnosis (such as obesity or pre-diabetes) is present
    • Free dietary guidance is available through the 2020–2025 Dietary Guidelines for Americans and the CDC’s Healthy Weight resources

    What Happens Next

    Professor Heilbronn’s research team has called for future trials designed to identify specific patients who are most likely to benefit from intermittent fasting versus calorie restriction — a step toward more personalized dietary prescribing. That research has not yet been announced or registered.

    The existing evidence base on intermittent fasting continues to grow across multiple research groups. Future meta-analyses pooling this and other trials will provide stronger evidence on who benefits most and under what protocols.

    The Bottom Line

    An 18-month Adelaide University trial found that intermittent fasting and calorie restriction produce comparable weight loss — but through meaningfully different behavioral pathways. Calorie counters rely heavily on conscious restraint; intermittent fasters do not. For people who have repeatedly failed to sustain calorie-counting diets because of the cognitive burden, this study suggests intermittent fasting may offer a more tolerable path to the same destination. It is not a universal solution and is not appropriate for everyone — but the evidence that adherence, rather than biology, is the primary obstacle to sustained weight loss points clearly toward a more personalized approach to dietary counseling.

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