Objective Data are mixed on whether intermittent fasting improves weight loss and cardiometabolic health. Here, the effects of time‐restricted eating (TRE) in participants who consistently adhered ≥5 d/wk every week were analyzed. Methods Ninety patients aged 25 to 75 years old with obesity were randomized to early TRE (eTRE; 8‐hour eating window from 07:00 to 15:00) or a control schedule (≥12‐hour window) for 14 weeks. A per‐protocol analysis of weight loss, body composition, cardiometabolic health, and other end points was performed. Results Participants who adhered to eTRE ≥5 d/wk every week had greater improvements in body weight (−3.7 ± 1.2 kg; p = 0.003), body fat (−2.8 ± 1.3 kg; p = 0.04), heart rate (−7 ± 3 beats/min; p = 0.02), insulin resistance (−2.80 ± 1.36; p = 0.047), and glucose (−9 ± 5 mg/dL; p = 0.047) relative to adherers in the control group. They also experienced greater improvements in mood, including fatigue and anger; however, they self‐reported sleeping less and taking longer to fall asleep. Conclusions For those who can consistently adhere at least 5 d/wk, eTRE is a valuable approach for improving body weight, body fat, cardiometabolic health, and mood. Further research is needed to determine whether eTRE's effects of shortening sleep but reducing fatigue are healthful or not.