Energy balance and obesity
Open accessAbstract
T his article describes the interplay among energy intake, energy expenditure, and body energy stores and illustrates how an understanding of energy balance can help us develop strategies to reduce obesity.First, reducing obesity requires modifying both energy intake and energy expenditure, not simply focusing on either alone.Food restriction alone will not be effective in reducing obesity if human physiology is biased toward achieving energy balance at a high energy flux (ie, at a high level of energy intake and expenditure).In previous environments, a high energy flux was achieved with a high level of physical activity, but in today's sedentary environment, it is increasingly achieved through weight gain.Matching energy intake to a high level of energy expenditure will likely be more feasible for most people than restricting food intake to meet a low level of energy expenditure.Second, from an energy balance point of view, we are likely to be more successful in preventing excessive weight gain than in treating obesity.The reason is that the energy balance system shows stronger opposition to weight loss than to weight gain.Although large behavior changes are needed to produce and maintain reductions in body weight, small behavior changes may be sufficient to prevent excessive weight gain.The concept of energy balance combined with an understanding of how the body achieves balance may be a useful framework for developing strategies to reduce obesity rates.
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Long-term weight loss requires a sustained calorie deficit, but calorie quality is equally important for adherence, satiety, and metabolic health.
“Long-term weight loss requires a sustained calorie deficit, but calorie quality is equally important for adherence, satiety, and metabolic health [95].”
From Obesity: Clinical Impact, Pathophysiology, Complications, and Modern Innovations in Therapeutic Strategies (2025) · cites this paper as [95]
The “Food Restriction Alone Is Not the Answer” section says restricting intake produces weight loss, while the “Treatment Versus Prevention” section says maintaining that loss requires lasting behavior change as energy needs fall. The paper does not establish that calorie quality is equally important for adherence, satiety, or metabolic health. It also describes maintenance as matching intake to expenditure at a lower body weight, not sustaining a calorie deficit indefinitely. (LLM, conf=0.88)
Experimental — accuracy not yet measuredObesity results from a prolonged state of positive energy balance.
“Obesity is caused by prolonged positive energy balance1,2.”
From Total daily energy expenditure has declined over the past three decades due to declining basal expenditure, not reduced activity expenditure (2023) · cites this paper as [2]
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- Authors
- Hill, J. O., Wyatt, H. R., & Peters, J. C.
- Affiliations
- University of Colorado Anschutz (US)
- Venue
- Circulation
- Published
- 2012-07-03
- Volume
- 126
- Issue
- 1
- Pages
- 126-132
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3401553
- OpenAlex
- W2118733706
- Cited by
- 1,317
- References
- 47
- Citations by year
- 2026: 59 · 2025: 92 · 2024: 95 · 2023: 121 · 2022: 135 · 2021: 166 · 2020: 135 · 2019: 108 · 2018: 111 · 2017: 77 · 2016: 80 · 2015: 59 · 2014: 46 · 2013: 26 · 2012: 3
- FWCI
- 40.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (DK48520, R01DK042549, DK-42549, R37DK042549, P30DK048520)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- energy balance, obesity, energy intake, energy expenditure, dietary restriction, physical activity, sedentary lifestyle, weight gain prevention, weight loss, obesity prevention strategies
- MeSH terms
- Animals, Eating, Energy Metabolism, Humans, Obesity, Caloric Restriction
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