The Hidden Risks of Intermittent Fasting: What Eating Disorder Therapists in Philadelphia Want You to Know

Written by Dr. Colleen Reichmann, psychologist and clinical director of Wildflower Therapy

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At Wildflower Therapy, our Philadelphia-based group practice specializing in eating disorder therapy, we spend a lot of time having honest conversations with clients about food trends. And right now, one of the most common topics that comes up in our therapy rooms? Intermittent fasting (I bet a decent amount of you out there called that, huh?)

Intermittent fasting (frequently referred to as IF) is everywhere right now. Often touted as a life-changing way to “improve wellness” or “give your body a break,” it’s praised by celebrities, athletes, and health influencers alike. Proponents of IF claim that it boosts metabolism, improves longevity, and even sharpens your focus.

But beneath the shiny promises lies what can often turn into a significantly harmful practice, especially for those predisposed to disordered eating and eating disorders. In this blog, we’re breaking down what intermittent fasting truly is, why it can be dangerous for certain people, and what we recommend instead for those seeking to build a peaceful, sustainable relationship with food and their bodies.

If you’re searching for eating disorder therapy in Philadelphia (or in the main line towns and Pennsylvania at large) know that you’re not alone- support is available, and it is possible to feel better than this.

What Is Intermittent Fasting?

Intermittent fasting is essentially a pattern of eating that alternates between set periods of eating and fasting. Some of the most popular versions include:

• 16:8 -Eating within an 8-hour window and fasting for 16 hours.

• 5:2 - Eating normally for five days a week and drastically reducing calories on two non-consecutive days.

• OMAD (One Meal A Day) -Consuming all daily calories in a single meal.

While it’s often framed as a “lifestyle” rather than a diet, intermittent fasting functions very much like a diet (and if we are being real, in our humble opinion, it mainly functions like actual disordered eating). Because IF encourages people to ignore natural hunger cues, rigidly control eating times, and often unintentionally moralize when food is "allowed" or "off-limits."

And for individuals already at risk for developing an eating disorder, whether due to genetics, personal history, personality traits like perfectionism, or cultural pressures- intermittent fasting can quietly slide from a “wellness habit” into a dangerous pattern.

Why Intermittent Fasting Can Be Harmful — Especially in Eating Disorder-Prone Populations

1. It Teaches People to Distrust Their Natural Hunger Signals

One of the central pillars of eating disorder recovery (and of a peaceful relationship with food in general) is learning to listen to and honor your body’s natural hunger and fullness cues. Intermittent fasting essentially encourages people to do the exact opposite: to suppress, ignore, and override hunger, even when the body is clearly asking for nourishment.

Over time, this can cause a disconnection from internal cues, leading people to eat based on external rules rather than biological needs. At our eating disorder therapy practice in Philadelphia, we see this pattern again and again. Clients describe feeling numb to hunger, only to later experience intense cravings, binges, or obsessive thoughts about food. Some people actually begin to experience confusion about what hunger and fullness actually feel like.

2. It Can Trigger Disordered Eating Behaviors

For those predisposed to eating disorders like anorexia, bulimia, orthorexia, or binge eating disorder, intermittent fasting can act as a socially acceptable gateway into restrictive, obsessive, or compensatory behaviors.

Skipping meals, ignoring hunger, obsessing over timing, and avoiding social eating situations are classic warning signs in the eating disorder world, but the scary thing is that intermittent fasting markets these very behaviors as signs of discipline and health. It normalizes patterns that, in a different context, would raise serious concerns.

At Wildflower Therapy, we regularly work with clients throughout Philadelphia and Pennsylvania who initially tried intermittent fasting “for health” and quickly found themselves trapped in cycles of guilt, anxiety, restriction, and loss of control. And we want people to release any shame there. It is so not your fault if your genetics of brain chemistry turns things that other people call “health promoting” against you in an unexpected way.

3. It May Disrupt Hormonal and Physical Health

While intermittent fasting is often touted as a wellness hack, research on its effects-especially in women and individuals assigned female at birth-is still limited. What we do know is that prolonged fasting can suppress key hormones involved in reproductive health, metabolism, and mood regulation.

Many clients who engage in intermittent fasting report irregular menstrual cycles, disrupted sleep, mood swings, and heightened anxiety. Teenagers and young adults are especially vulnerable, as their bodies and brains are still developing and are highly sensitive to fluctuations in nourishment and energy availability.

There is some research to suggest that intermittent fasting can contribute to conditions like hypothalamic amenorrhea (loss of menstruation), decreased bone density, and gastrointestinal issues in young women and girls.

4. It Increases Anxiety and Preoccupation Around Food

Rather than freeing people from food worries, intermittent fasting often heightens them. People describe becoming fixated on when they can next eat, whether they’ve “ruined their fast,” or how to navigate social events outside of their designated eating window.

This kind of rigid, food-centric thinking is a hallmark of disordered eating and orthorexia (an unhealthy obsession with “clean” or “perfect” eating). It can also fuel isolation, as people may avoid dinners with friends, family brunches, or spontaneous outings if it doesn’t align with their eating window.

In therapy, we often hear from clients who feel ashamed or anxious about breaking their fast or feel intense guilt for eating at “the wrong time.” This kind of lens continuously reinforces a shame-based cycle that can be hard to escape from once you are in it.

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Why Are Certain People More at Risk?

Not everyone who tries intermittent fasting will develop an eating disorder, but certain groups are more vulnerable, including:

• Women and teenage girls, particularly those navigating body image pressures and hormonal changes

• Individuals with a personal or family history of eating disorders

• People prone to perfectionism or black and white thinking (who may also thrive on external validation and rigid rules)

• Those experiencing anxiety or depression, which can increase susceptibility to control-based coping mechanisms like food restriction

• Athletes, dancers, and performers, where body control is often tied to performance and success

At Wildflower Therapy, we specialize in working with these populations, offering compassionate, individualized care throughout Philadelphia and the greater Pennsylvania region.

What We Recommend Instead

While diet culture loves a quick fix, real, sustainable well-being isn’t found through restriction, deprivation, or controlling hunger. We tend to recommend these other approaches (not as a starting point but as goal posts)

1. Intuitive Eating

Intuitive eating is an evidence-based, anti-diet approach that encourages people to reconnect with their body’s natural hunger, fullness, and satisfaction cues. It fosters body trust, reduces food obsession, and removes moral value from food choices.

We often introduce intuitive eating principles in our eating disorder therapy sessions in Philadelphia, tailoring them to each client’s history, needs, and recovery goals.

2. Gentle Nutrition

Once clients have rebuilt trust with their bodies, we explore gentle nutrition — focusing on adding nourishing, satisfying foods in a way that feels supportive rather than restrictive. The goal isn’t perfection, but care, balance, and flexibility.

3. Social and Emotional Connection

Food isn’t just fuel; it’s culture, pleasure, and connection. Restrictive eating patterns like intermittent fasting can isolate people from shared meals and spontaneous experiences. We support clients in reclaiming food as a source of joy and connection in their lives.

4. Mechanical Eating, Especially for Those Who are Neurodivergent. Mechanical eating means eating whether or not you feel hungry or full, and using timers and other accommodations to help. (The idea of mechanical eating can be useful if your hunger cues are absent more often than not.) In mechanical eating, eating can be viewed as more of an “end goal” vs something that needs to be incredibly pleasurable. We also are very big on the legalization of safe foods for people who are neurodivergent and feel pulled towards eating a smaller variety due to sensory issues.

5. Professional Support

If food has become a source of stress, guilt, or fear, it’s worth reaching out for help. Eating disorder therapy can be life-changing, whether you’re navigating full-blown symptoms or disordered patterns that don’t yet have a label.

At Wildflower Therapy, we offer specialized eating disorder therapy in Philadelphia, the Main Line, and throughout Pennsylvania, providing compassionate, individualized care for anyone of any age struggling with eating disorders or disordered eating.

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When to Seek Help

You don’t have to wait for things to get “bad enough” to ask for support. Consider reaching out to an eating disorder therapist in PA if you notice:

• Preoccupation with food, fasting, or body image

• Anxiety or guilt around eating

• Avoidance of social meals or spontaneous eating

• Rigid rules about what, when, or how much you can eat

• Physical symptoms like fatigue, missed periods, or digestive issues

The earlier disordered eating patterns are addressed, the easier they are to disrupt — and the sooner a calmer relationship with food and body becomes possible.

Final Thoughts

Intermittent fasting might be trendy, but that doesn’t mean it’s healthy or harmless. For those at risk for eating disorders, it can quietly reinforce harmful behaviors, disconnection from body cues, and anxiety around food.

At Wildflower Therapy, we’re passionate about helping clients throughout Philadelphia and Pennsylvania break free from diet culture and build kinder, more sustainable relationships with food and their bodies.

If you’re curious about how eating disorder therapy in Philadelphia or Pennsylvania could support you or a loved one, we’d be honored to be part of your journey.

Ready to start your healing process?

Contact Wildflower Therapy today for a free consultation or explore our services to learn more about our eating disorder therapy in Philadelphia and PA.



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