Background: Sustained weight loss is critical for chronic disease management but remains challenging due to physiological adaptations that promote weight regain, including increased appetite. The Minimising Adaptive Thermogenesis And Deactivating Obesity Rebound study (MATADOR 2) study demonstrated that intermittent energy restriction (ER) improved weight loss outcomes; however, its effects on appetite regulation and eating behaviours are unclear.
Aim: To compare the effects of intermittent and continuous ER on appetite and eating behaviours in females with obesity.
Methods: Fifty-three women aged 25–55 years with obesity (BMI 30–40 kg/m²) were randomised to either continuous ER (CONT; 12 weeks) or intermittent ER (INT; six 2-week periods of ER interspersed with five 2-week periods of energy balance). Appetite responses to standardised test meals were assessed using validated visual analogue scales, and eating behaviours were measured using the Three-Factor Eating Questionnaire. Outcomes were evaluated post-intervention and at 6-month follow-up.
Results: Both INT and CONT significantly increased cognitive restraint (both p<0.001) and reduced disinhibition (INT: p=0.005; CONT: p<0.001) and perceived hunger (INT: p=0.045; CONT: p=0.02), with no between-group differences. Improvements in eating behaviours were maintained at 6-month follow-up. Neither intervention significantly altered subjective appetite responses or ad libitum test meal intake (p>0.05).
Conclusions: Intermittent ER did not improve appetite control beyond continuous ER, which may reflect both modest differences in weight loss achieved between interventions and sensitivity of subjective appetite assessments to detect subtle physiological differences. However, given comparable longer-term outcomes, dietary prescription may be guided by individual preference and adherence.