Hot flashes may be the biggest challenge experienced by women around the time of menopause, but another, less-discussed concern for many are the stubborn pounds that gather around the waist and won’t disappear.

Some women successfully lose this extra weight when they start cutting calories or turn to a more healthful way of eating, such as the widely recommended Mediterranean diet.

But other women say traditional diet plans aren’t sufficient to dislodge these excess pounds in midlife — a phenomenon some have termed the “menopot.” That’s why many are turning to a popular eating plan known as intermittent fasting (IF).

Intermittent fasting refers to a variety of dietary schedules, all of which involve eating for a certain number of hours in a day and restricting calories in others. The method forms the cornerstone of a weight loss diet directed at menopausal women known as the Galveston diet.

But the decision about whether IF is right for women over 40 needs to take into account a number of factors.

What Are the Types of Intermittent Fasting?

There are many different approaches to IF. Some people pick one to three days during the week when they eat minimally, if at all. Another technique, known as a fasting mimicking diet, severely restricts calories for five days in a month.

One of the more common IF approaches recommended for weight loss involves what is called 5:2 fasting, in which you eat normally for five days in a week but seriously restrict calories, down to around 500 a day for women (600 for men), for any of the remaining two.

Other people use a time restricted eating (TRE) process, eating normally during any 8 to 12 consecutive hours in a day and fasting for the remaining hours. A TRE plan that prohibits food during a 16-hour window — and leans heavily on healthy fats during the 8 hours of eating — known as 16/8, is what the Galveston diet recommends for midlife women.

Certain liquids are always allowed — indeed are encouraged — during fasting hours when little to no food is consumed. These include black coffee, teas (especially herbal tea), and water.

What Are the Weight Loss and Health Claims of Intermittent Fasting?

The Galveston diet touts IF as a whole-health panacea in addition to a weight loss tool. According to the website, IF prevents obesity, lowers heart risks, improves insulin resistance, decreases chronic inflammation, and boosts memory, mood, and energy.

The website claims that many of these proposed benefits come because IF brings about a process known as “metabolic switching,” when the body stops consuming its normal glucose for fuel and burns fat from storage instead.

Over the years, people have attributed other benefits to intermittent fasting, everything from cholesterol and blood pressure reductions to taming Alzheimer’s disease and even boosting longevity.

Does the Evidence Show Intermittent Fasting Helps Midlife Women Lose Weight?

IF eating plans are not the magic bullets some tout them as online. Still, some research on intermittent fasting in adults (both men and women) has shown that they may facilitate moderate weight loss.

In a review published in JAMA Network Open in December 2021, researchers evaluated 11 published meta-analyses, which cumulatively analyzed 130 separate randomized controlled trials. They found that many of the IF eaters did indeed lose weight.

Digging deeper into the analysis, the researchers concluded that it was only the 5:2 or a similar modified alternate-day fast that was associated with “a statistically significant weight loss of more than 5 percent in adults with overweight or obesity.” They did not find that time-restricted eating, like the kind used in the Galveston diet, yielded similar results.

Additionally, IF seemed to be most successful during the first one to six months, after which people often experienced a weight plateau.

Another review, published in Biological Research for Nursing in May 2022, examined 42 studies of overweight people using IF as a weight loss strategy. It found that in the majority of these short-term studies, the technique did indeed result in lost weight. But the authors found that other calorie-restricting eating plans were equally effective.

A review of research published in October 2021 in Annual Review of Nutrition concluded that TRE, as well as alternate-day fasting and 5:2 eating, all led to weight loss, which the researchers, from the University of Illinois at Chicago, said was mild to moderate (1 to 8 percent lower than baseline weight). They observed that IF seems to result in the same amount of weight loss as the traditional calorie-restriction diet that trims roughly 500 calories a day.

Most of the current research on intermittent fasting evaluated only a small number of people and didn’t follow them for long, says Ellen Liskov, RDN, a dietitian at Yale New Haven Hospital Center for Nutrition and Wellness in Connecticut. “These studies are not conclusive enough to say that intermittent fasting is a dietary plan that all people should employ,” she says.

Might Intermittent Fasting Help Women’s Heart Health?

Heart health is an important concern for midlife women, since heart disease risk rises during this time.

The JAMA Network Open researchers found several studies in which adults on IF diets improved their low-density lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, blood sugar, fasting insulin, insulin resistance, and blood pressure.

Many of these benefits occurred in people who were overweight or obese.

Similarly, the Annual Review of Nutrition analysis documented decreases in blood pressure and insulin resistance in some, as well as LDL cholesterol and triglyceride levels.

But the Biological Research for Nursing review found no significant differences in cardiometabolic or inflammatory markers in people on IF eating plans compared with those who ate more traditional calorie-restricting diets.

Is Intermittent Fasting Safe for Midlife Women?

“Intermittent fasting is generally safe and does not result in energy level disturbances or increased disordered eating behaviors,” the University of Illinois reviewers concluded.

One question about the use of intermittent fasting by women has been whether it might alter their hormones. But a study published in the journal Obesity in October 2022 tested hormone levels in a dozen post-menopausal women (as well as a dozen premenopausal women). After two months of a strict IF window eating either 4 or 6 hours daily, there were no changes in the post-menopausal women’s estrone, testosterone, and most other sex hormones.

Still, not every midlife woman should try this eating plan, the University of Illinois reviewers said. Those with a history of disordered eating, a body mass index (BMI) below 18.5, or people who need to take medication with food at regimented times should refrain.

Other experts say people with certain medical conditions may be poor candidates. Women with Crohn’s disease, for example, might do better on a different eating plan. And those with diabetes are also typically advised to refrain, especially when blood sugar isn’t well controlled.

What’s the Bottom Line for Midlife Women and Intermittent Fasting?

Yale’s Liskov says that for those who want to try IF, she favors a time-restricted eating plan known as 12/12, where food is eaten for half the day, generally between 7 a.m. and 7 p.m. “This pattern of eating has helped many people lower their energy intakes, lose weight, and reduce the amount of unhealthy nutrients eaten,” she says. A key reason is that many people eat healthy foods during the day but then devolve to snacks of sweets and chips before bedtime.

It’s important to be sure you’re eating healthy foods during the eating window, rather than filling up on nutritionally empty calories, says Carol Roberts, MD, a functional medicine physician in Naples, Florida, who recommends IF to some of her patients. “If you’re on a junk food diet, it’s not going to be good for you to eat for fewer hours. Better food selection is also important,” she says.

To work long-term, an IF eating plan has to mesh with your lifestyle, experts say. If you regularly go out socially for breakfast or eat dinner late at night, for example, trying to fast during these times is not sustainable.

While some people may benefit from an IF eating plan, “if you’re looking for a diet that’s more balanced and less restrictive, I’d choose a Mediterranean type of diet instead,” says Bonnie Taub-Dix, RDN, the author of Read It Before You Eat It: Taking You From Label to Table.

If You Try Intermittent Fasting, Ease In

Mary Claire Haver, MD, the obstetrician-gynecologist who created the Galveston diet, suggests women who want to try IF ease into it, such as by pushing the morning meal back every few days until it’s finally close to noon.

Dr. Roberts says IF dieters aiming for a 16/8 schedule can have a beverage in the morning. “A cup of black coffee goes a long way toward keeping people happy in the morning,” she says, adding that for most people on this plan the hardest part is not to snack at night.

If you have a medical condition, it’s important to check with your physician before beginning any IF diet. And if you’re unsure about how to implement it in a healthy way, arrange for a consultation with a dietitian.

For women who are healthy or who have gotten the all-clear, there seems to be little downside in giving IF a try. You might finally drop some of those stubborn midlife pounds that haven’t otherwise budged.

What Midlife Women Should Know About Intermittent Fasting