Short Wave｜Intermittent fasting doubts, AI & mental health

RACHEL CARLSON: OK, Mary Louise, where should we start?

MARY LOUISE KELLY: I want to hear all three of these. OK, I have not had time to get lunch today. So I'm kind of doing intermittent fasting.

CARLSON: Oh, no.

KELLY: So let's start there. This is-- just to explain, this is where you restrict the times you eat, right, rather than what you eat?

CARLSON: Yeah, so some people might fast every other day. Others might eat between the hours of 10: 00 to 6: 00, but do a 16-hour fast outside of that. The idea is that these short periods of fasting will cause your body to start burning through stored fat reserves.

REGINA BARBER: The issue is we don't have a big long-range study on how it compares with other types of dieting. So an international team of scientists did the next best thing. They looked at 22 smaller studies that compared intermittent fasting to other dietary interventions, like eating less or eating specific types of foods. They also compared intermittent fasting to doing nothing.

KELLY: And what did they find?

CARLSON: They concluded that intermittent fasting did not work for weight loss in overweight or obese adults, as compared to either traditional dietary advice, or even doing nothing.

KELLY: Huh. OK, so it doesn't work. Case closed?

BARBER: Well, not quite. So we asked Matthew Steinhauser about it. He does metabolic research at the University of Pittsburgh. He wasn't involved in this research. And he said that the small size of all the studies within this larger review makes it hard to know for certain.

MATTHEW STEINHAUSER: But it does suggest that there's not a huge effect on body weight, and certainly nothing approaching what we see with the GLP-1 drugs, for example, where patients can lose 10% to 20% of their body weight over the course of a few months to a year.

KELLY: I suppose worth pointing out, people who may choose to fast may choose to change their diet for reasons that go well beyond weight loss, right?

CARLSON: Yeah, that's exactly right. The results of this literature review really focused in on weight loss as the standard. But like you said, that's not the only reason people choose to try intermittent fasting. And no matter what, Matthew told us that in medicine, very few things are risk-free. So definitely talk to your doctor before making any big changes to your diet.

KELLY: Good evergreen advice there. Always talk to your doctor. OK, second story. This is about chatbots and mental health. I want to mention we are about to discuss suicide. Gina, there have been a number of high-profile cases to do with chatbot suicide mental health.

BARBER: Yeah, it's really scary for a parent like me. Last year, a number of parents testified to Congress about the dangers of AI chatbots. A couple of those families believe that AI chatbots pushed their teenage sons to kill themselves. Our colleague, Rhitu Chatterjee, reported that one family testified that one of the chatbots, ChatGPT, even offered to help write their son's suicide note.

CARLSON: OpenAI owns ChatGPT. They told Rhitu at the time that it's redesigning its platform to be safer for minors. One intervention some parents and others have advocated for is chatbots regularly reminding users that they're talking to an artificial intelligence agent and not a human. Laws in California and New York require AI chatbots to send these regular reminders every three hours.

KELLY: Every three hours. But do those reminders work?

BARBER: So some social scientists argue that at best, these reminders probably don't work. And at worst, they might be harmful. One of the authors of a recent opinion piece is social scientist Linnea Laestadius at the University of Wisconsin-Milwaukee. She says the idea that reminders could be a big solution--

LINNEA LAESTADIUS: Struck us as a bit naive, in some ways, and potentially dangerously unrealistic in others, and also, not engaging with potential downsides of reminders.

KELLY: Potential downsides. Like what?

CARLSON: So Celeste Campos-Castillo co-wrote that opinion piece in Trends in Cognitive Sciences with Linnea. She warns that if someone already feels lonely or if they're struggling with their mental health, a reminder that they're not talking to a real person could destabilize them and make them feel more isolated.

KELLY: Huh. So if these reminders pinging you you're actually talking to AI, not a human, if those don't work, if they may even be-- make things worse, what's the way forward?

CARLSON: Yeah, it's a good question. Celeste and Linnea are urging these companies to share their data more openly so they can study these interventions better and hopefully help shape more effective policy.

And, Mary Louise, thank you so much for joining us today.

KELLY: It was my total pleasure, as always. Looking forward to the next one.

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