re: Any negatives to fasting 20+ hours on the weekends?

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I’ve been doing this about a year and I have a BMI of just below 25. I lost 30 or so pounds initially and continued to lose a few more pounds gradually over time. I think it’s an extremely healthy and flexible way of weight control.

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It can be healthy for sure. If you're doing it intentionally.

If the entire goal of OMAD is being hungry all day so you can binge eat without any guilt, that's not healthy. That's obviously not your situation.