Don't count on eating breakfast or 16:8 intermittent fasting to control your weight; choose meal times you can keep up long term

Cost

Free. What you save is the effort of wrestling with meal times every day.

What you get

First, the claim that “skipping breakfast makes you eat more later.” A meta-analysis pooled 13 randomized trials. People assigned to eat breakfast took in 259.79 kcal more a day than those who skipped it (95% CI 78.87–440.71, the plausible range). Their weight was 0.44 kg higher (0.07–0.82). People who skipped breakfast did not make it up at lunch and dinner. These trials followed people only briefly, an average of 7 weeks for weight and an average of 2 weeks for intake. Next, 16:8 and similar approaches that allow eating only within set hours. One study had 116 overweight adults do it for 12 weeks. The group that ate only from 12 noon to 8 p.m. and the group that ate three regular meals a day differed in weight by −0.26 kg (−1.30 to 0.78), not significant. Another, in Guangzhou, had 139 patients with obesity followed for 12 months. Time-restricted eating plus calorie control lost 1.8 kg more than calorie control alone (−4.0 to 0.4), also not significant. Finally, does long-term skipping breakfast do harm. In a pooled analysis of 2.38 million (238万) people, those who skipped breakfast had about 17% higher heart and blood vessel disease risk (OR 1.17, 1.09–1.26) and about 49% higher cardiovascular death (OR 1.49, 1.20–1.84). But these are studies that only record and do not assign groups. In the original study that followed people for 17 to 23 years, the hazard ratio for death from all causes was 1.19 with a plausible range of 0.99 to 1.42, which crosses 1 and does not count as a difference.

Notes

Dispute. The 17% for heart and blood vessel disease comes from studies that only record and do not assign groups. People who skip breakfast are already more likely to smoke, drink, sit a lot and have low income, and those factors cannot be adjusted out cleanly. So how much of that 17% is caused by breakfast itself cannot be said. The all-cause death result crosses 1 to begin with. 16:8 is disputed too: a pooled analysis of 30 trials with 1341 people, with both groups eating the same amount, found the time-restricted group lost 1.46 kg more (−2.65 to −0.26), at the cost of losing 0.41 kg more lean mass. But most of these trials were very short, and the longest and most rigorous one, a twelve-month trial, found no difference. Long fasting hours are also tied to the gallbladder. In a cross-sectional survey of 6,547 people, for each hour later the first meal of the day, the share found to have gallstones was about 5% higher (OR 1.05, 1.02–1.08); those whose first meal came between 9:00 and 14:00 were about 49% higher than those who ate earlier (OR 1.49, 1.24–1.77). The mechanism is that the longer bile sits in the gallbladder, the more easily stones form. But this is a survey at one point in time, and it may also be that gallbladder problems came first and the eating habit changed afterward. In China's Kailuan cohort, followed for 5.6 years with 369 cases of digestive tract cancer: people who skipped breakfast had 2.32 times the risk of colorectal cancer (1.34–4.01) and 5.43 times the risk of gallbladder and extrahepatic bile duct cancer (1.34–21.93). The plausible range for the latter number is as wide as 21.93, which means there were too few events, and it can only be taken as a lead. Taken together, as far as weight control goes, the effect of meal timing is very small, so don't spend effort on it. As for whether skipping breakfast entirely over the long term is good or not, all the current evidence is association and cannot prove cause, but the direction is consistently unfavorable, so if you want to be safe, eat normally, just don't count on it to help you lose weight. The main cause of gastritis and stomach ulcers is not an empty stomach but Helicobacter pylori and long-term use of painkillers; for what to get checked, see §1.23 (test for Helicobacter pylori and eradicate it if positive). For what to do if a checkup finds gallstones but you have never had pain, see §6.20 (gallstones found at a checkup without ever having pain: don't have the gallbladder removed as a precaution). For controlling weight, what really has evidence is what you eat and how much; see §2.27 (eat 5 servings of fruit and vegetables a day), §2.28 (eat less ultra-processed food) and §2.32 (keep BMI between 20 and 25). This does not apply to people with diabetes, people taking blood-sugar-lowering drugs, or pregnant women; skipping a meal can cause low blood sugar, so follow your doctor's orders. Extreme fasting and induced vomiting are a different matter; see §28.1 (don't use extreme dieting, fasting or induced vomiting to control weight).

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. Sievert K, Hussain SM, Page MJ, 等 (2019). Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ. https://doi.org/10.1136/bmj.l42
2. Lowe DA, Wu N, Rohdin-Bibby L, 等 (2020). Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2020.4153
3. Liu D, Huang Y, Huang C, 等 (2022). Calorie Restriction with or without Time-Restricted Eating in Weight Loss. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2114833
4. Zhang H, Zhang S, Liu Y, 等 (2025). The association between skipping breakfast and cardiovascular disease: a meta analysis. Frontiers in Cardiovascular Medicine. https://doi.org/10.3389/fcvm.2025.1565806
5. Rong S, Snetselaar LG, Xu G, 等 (2019). Association of Skipping Breakfast With Cardiovascular and All-Cause Mortality. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2019.01.065
6. Fernandes-Alves D, Teixeira GP, Guimarães KC, Crispim CA (2026). Systematic Review and Meta-analysis of Randomized Clinical Trials Comparing Time-Restricted Eating With and Without Caloric Restriction for Weight Loss. Nutrition Reviews. https://doi.org/10.1093/nutrit/nuaf053
7. Sun T, Zhang L, Lu Y, 等 (2024). Non-linear relationship between the first meal time of the day and gallstone incidence in American adults. Frontiers in Nutrition. https://doi.org/10.3389/fnut.2024.1521707
8. Liu T, Wang Y, Wang X, 等 (2023). Habitually Skipping Breakfast Is Associated with the Risk of Gastrointestinal Cancers: Evidence from the Kailuan Cohort Study. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-023-08094-7

Translated from the Chinese original. Original book, section 6, tip 26. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer