A new clinical study suggests the popular 5:2 intermittent fasting approach—eat normally five days a week and limit calories on two non-consecutive days—may be the most adaptable and effective option for weight loss and blood glucose improvement in people with obesity and type 2 diabetes. Presented at the Endocrine Society’s ENDO 2025 conference in San Francisco, the research compared three dietary strategies and found that while all provide benefits, the intermittent approach offers unique advantages for those managing diabetes and weight.
Type 2 diabetes is a growing health challenge in Thailand and worldwide. Experts estimate that by 2050, nearly 10% of the global population could be affected, a trend reflected in Thailand’s urban and rural communities. Obesity remains a major risk factor for diabetes, and sustained weight loss is widely recognized as a key management strategy. Health authorities emphasize calorie reduction as a central tool to improve glycemic control and support weight loss.
In the study, 90 adults with obesity and type 2 diabetes were randomized to three diets: intermittent energy restriction (IER or 5:2), time-restricted eating (TRE), or continuous energy restriction (CER). All groups received carefully supervised weekly calorie targets. After 16 weeks, 63 participants completed the trial, and all groups showed meaningful improvements in both weight and blood sugar measures.
Results showed an average weight loss of about 7.5 kilograms (roughly 16.5 pounds) and a reduction in long-term blood glucose (HbA1c) by more than one percentage point across groups. Those following the 5:2 pattern achieved slightly greater improvements in fasting glucose, insulin resistance, and triglyceride levels, and reported better adherence at 85% compared with the other methods.
The study’s lead researcher highlighted the practicality of the 5:2 method, noting its flexibility: allowing normal eating on five days and calorie restriction on two non-consecutive days may be easier to sustain than strict daily limits. The fasting days in this trial limited intake to about 500–600 calories, while non-fasting days were unrestricted, a pattern mirrored by international adoption increasingly seen in health-conscious Thai communities. TRE involved a daily 10-hour eating window, while CER maintained a daily, constant low-calorie intake.
Commenting on the findings, Dr. David M. Cutler, a physician not involved in the study, noted no statistically significant difference among the three approaches for key outcomes, though all yielded benefits. He also observed that only 63 of 90 participants completed the study, underscoring real-world challenges in maintaining dietary restrictions, a challenge familiar to many Thai patients adjusting to new eating plans.
For Thai readers considering dietary changes, it is important to understand the study’s context. The trial occurred in China with younger adults (average age about 37) and a relatively short diabetes duration, which may differ from Thailand’s aging population of people living with diabetes. Still, the central takeaway—that sustainable calorie restriction, regardless of method, can yield meaningful improvements—aligns with local guidance from Thai healthcare providers emphasizing individualized plans.
The 5:2 approach may fit well with Thai social life, where family meals and gatherings are common. Thai nutrition experts caution that rigid daily restrictions are seldom sustainable amid the country’s vibrant food culture. A flexible plan allowing normal eating most days could reduce the sense of deprivation and help people maintain healthier habits over time.
While the trial reported high compliance with the 5:2 method, experts caution that no single plan fits everyone. The researchers advocate individualized choices based on patient preferences, lifestyle, and ability to adhere, ideally guided by registered dietitians.
Local and international evidence suggests that adherence to a dietary plan matters more for blood sugar and weight outcomes than the particular type of restriction. Any program that maintains a long-term calorie deficit can help manage or even reverse type 2 diabetes when sustained.
Thailand continues to see rising new diabetes cases, influenced by urbanization, processed foods, and changes in daily activity. Practical, culturally sensitive solutions are urgently needed. Historically, fasting practices tied to Buddhist observance resonate with Thai culture, and modern intermittent fasting could align with these traditions while meeting health goals. However, medical supervision remains essential for people with diabetes, as abrupt changes in caloric intake can affect medications and glucose stability.
Looking ahead, researchers and independent experts call for more research on long-term sustainability, psychological impacts, and effectiveness across broader, more diverse populations. Lifestyle changes must be personalized, considering age, diabetes duration, treatments, and cultural context.
For Thais considering dietary changes, the consensus is clear: choose a plan you can sustain. Those facing weight issues or a new diabetes diagnosis should discuss options with healthcare providers—whether the 5:2 diet, time-restricted eating, or traditional calorie reduction—and ensure appropriate nutritional support. Core principles—plenty of vegetables, reduced processed foods, and regular physical activity—remain foundational to diabetes management.
Practical tips for exploring the 5:2 approach include planning fasting days in advance, seeking social or family support, focusing on filling, low-calorie foods such as vegetables with dip, and monitoring blood sugar carefully, especially if on medications. Local public health centers and hospitals often offer diet support groups to help with motivation and accountability.
In summary, while no miracle diet exists, the latest research reinforces that various forms of calorie restriction, including the flexible 5:2 model, can help people with type 2 diabetes manage their condition and lose excess weight. Action, guided by diabetes specialists and nutrition professionals who understand Thailand’s food culture, remains the best step forward.
For more information on diabetes management options and support in Thailand, readers can consult resources from the Thai Association of Diabetes Educators or inquire at their nearest hospital.