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This study compared intermittent fasting and protein pacing (IF-P) versus a heart-healthy caloric restriction (CR) diet, matched for energy intake and physical activity energy expenditure, on body weight, total and visceral fat mass, and cardiometabolic health outcomes in adults with obesity.IF-P (n = 21) and CR (n = 20) were assessed pre- (week 0), mid- (week 5), and post- (week 9) intervention.Both groups reduced (p 0.05) weight, total and visceral fat mass, blood pressure and lipids, and desire to eat food and increased proportion of fat-free mass. IF-P resulted in greater (p 0.05) reductions in weight (-9% vs. -5%), total (-16% vs. -9%) and visceral (-33% vs. -14%) fat mass, and desire to eat (-17% vs. 1%) and increased fat-free mass percent (6% vs. 3%) compared with CR. These improvements were despite similar weekly total energy intake (IF-P, 9470 ± 550 vs. CR, 9095 ± 608 kcal/wk; p = 0.90) and physical activity energy expenditure (IF-P, 300 ± 150 vs. CR, 350 ± 200 kcal/d; p = 0.79).IF-P and CR optimize weight loss, body composition, cardiometabolic health, and hunger management, with IF-P providing greater benefits.