The effect of intermittent fasting on hedonic hunger: a pilot prospective cohort study based on Ramadan intermittent fasting

Abstract

Objective: This study aims to evaluate the changes in hedonic hunger (HH) during Ramadan intermittent fasting (RIF) and to investigate the role of HH as a factor influencing adherence to intermittent fasting (IF) regimens. Methods: This prospective cohort study was conducted between February 24 and March 29, 2025, with 122 participants aged between 20 and 25. The study data were collected through face-to-face interviews using a questionnaire that included sociodemographic information and the power of food scale (PFS), administered 1 week before the beginning of Ramadan, and during the first, middle period and final weeks of the month. The PFS comprises three subscales: food available, food present, and food tasted. In general, mean scores of the PFS and its subdimensions exceeding 2.5 are interpreted as indicating a high tendency toward HH. Results: During the first week of Ramadan, participants’ scores for food available (p = 0.016), food tasted (p = 0.002), and the PFS mean score (p = 0.048) were found to be significantly higher compared to the pre-Ramadan scores. However, no statistically significant differences were observed in the PFS mean and subscale scores between the pre-Ramadan period and the final week of RIF. Compared to the pre-Ramadan period, participants exhibited a mean reduction of 0.6 ± 1.51 kg in body weight (p < 0.001) and 0.3 ± 1.20 kg/m2 in BMI (p = 0.003) following RIF. A statistically significant but weak negative correlation was observed between changes in participants’ body weight and the scores of food available (r = −0.203, p = 0.025), food present (r = −0.340, p = p < 0.001), food tasted (r = −0.319, p < 0.001), and the PFS mean score (r = −0.323, p = p < 0.001). A statistically significant and weak negative correlation was found between changes in BMI and the scores of food present (r = −0.181, p = 0.046), food tasted (r = −0.216, p = 0.017), and the PFS mean score (r = −0.208, p = 0.021). Conclusion: This study suggests that higher levels of HH may be experienced at the onset of RIF practices; however, over time, individuals appear to adapt, returning to their pre-fasting levels of HH. Within the limited observation period of this study, the influence of RIF–a form of IF–on HH appears to be transient, suggesting that longer-term studies with larger sample sizes are needed to clarify its persistence.