Obesity energetics: body weight regulation and the effects of diet composition
Open accessAbstract
Weight changes are accompanied by imbalances between calorie intake and expenditure. This fact is often misinterpreted to suggest that obesity is caused by gluttony and sloth and can be treated by simply advising people to eat less and move more. However, various components of energy balance are dynamically interrelated and weight loss is resisted by counterbalancing physiological processes. While low-carbohydrate diets have been suggested to partially subvert these processes by increasing energy expenditure and promoting fat loss, our meta-analysis of 32 controlled feeding studies with isocaloric substitution of carbohydrate for fat found that both energy expenditure (26 kcal/d; P <.0001) and fat loss (16 g/d; P <.0001) were greater with lower fat diets. We review the components of energy balance and the mechanisms acting to resist weight loss in the context of static, settling point, and set-point models of body weight regulation, with the set-point model being most commensurate with current data.
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For practical purposes, a calorie is a calorie for body fat and energy expenditure differences between controlled isocaloric diets varying in carbohydrate-to-fat ratio.
“and, for all practical purposes, “a calorie is a calorie” when it comes to body fat and energy expenditure differences between controlled isocaloric diets varying in the ratio of carbohydrate to fat49.”
From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [49]
Energy intake and energy expenditure are dynamic processes influenced by body weight and influence each other.
“energy intake and energy expenditure are dynamic processes influenced by body weight and influence each other”
From Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance (2021) · cites this paper as [11]
Interventions aimed at creating an energy deficit through diet are countered by physiological adaptations that resist weight loss.
“interventions aimed at creating an energy deficit through the diet are countered by physiological adaptations that resist weight loss”
From Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance (2021) · cites this paper as [11]
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References 124 · Cited by 367
- Authors
- Hall, K. D., & Guo, J.
- Affiliations
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- Corresponding author
- Hall, Kevin D.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 152
- Issue
- 7
- Pages
- 1718-1727.e3
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC5568065
- OpenAlex
- W2586756410
- Semantic Scholar
- d4f803f9f602b805d8fb55f92e6cb7c8a34ee76a
- Cited by
- 367
- References
- 124
- Citations by year
- 2026: 43 · 2025: 38 · 2024: 32 · 2023: 42 · 2022: 48 · 2021: 40 · 2020: 55 · 2019: 33 · 2018: 23 · 2017: 13
- FWCI
- 4.13
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institutes of Health
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- obesity, energy balance, body weight regulation, low-carbohydrate diet, isocaloric substitution, energy expenditure, fat loss, weight loss resistance, diet composition
- MeSH terms
- Body Weight Maintenance, Energy Intake, Diet, Energy Metabolism, Humans, Models, Biological, Obesity, Rest, Weight Loss, Exercise, Thermogenesis, Feedback, Physiological
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