A comprehensive Cochrane systematic review evaluated randomized controlled trials comparing intermittent fasting protocols against standard dietary advice for overweight and obese adults. The analysis examined various fasting approaches including time-restricted eating and alternate-day fasting patterns across multiple studies through November 2024. This represents the gold standard of evidence synthesis, as Cochrane reviews are considered the most rigorous form of medical literature analysis. The timing is significant given intermittent fasting's explosive popularity despite limited high-quality evidence. Previous systematic reviews have been smaller in scope or focused on specific populations, making this broader analysis particularly valuable for clinical guidance. The practical implications extend beyond simple weight loss metrics to questions of sustainability and metabolic health markers. For health-conscious adults, this review addresses whether intermittent fasting offers advantages over traditional calorie restriction or represents merely another form of energy restriction with similar outcomes. The findings will likely influence medical recommendations, as physicians have lacked clear evidence-based guidance despite frequent patient inquiries. Given intermittent fasting's appeal as a potentially easier alternative to continuous calorie counting, understanding its true efficacy compared to established weight management approaches becomes crucial for evidence-based health decisions.