Upsetting the Energy Balance Paradigm

Some concerned parties, like nutritionist and nutrition science writer Maria Cross MSc, are unable to get behind the energy balance thing, or at least not the part where all calories are created equal. There is nothing wrong with the “eat less and move more” philosophy, but eating less and moving more are just the bare minimum starting points.

Cross explains how this mindset assumes that obesity is an energy-balance disorder, and that an energy surplus causes the body to store the excess energy as fat. An energy deficit should result in loss of fat. So, why does “dieting” inevitably lead to long-term weight gain? Cross describes what sounds very much like the set point theory:

This apparent paradox is attributed to a decrease in resting energy expenditure and “adaptive thermogenesis”, as the body (the thyroid gland) adjusts its metabolic rate to match the reduction in calorie intake.

The human body, unlike an internal combustion engine, is a complex living organism, driven by ancient survival mechanisms. When you reduce your fat and calorie intake, you engage in a battle with your body, one that you cannot win.

A lot of things need three legs to stand. If an arrow is shot from a bow, how far and fast will it fly? Velocity and distance don’t tell the whole story. Gravity has something to do with it, too, because what if gravity was suddenly taken away? The energy balance equation, in the minds of many researchers, does not stand on two legs but includes a third factor that might be as big as gravity: the human psyche.

Parents, it’s on you

Apparently, the psychological element can no more be ignored than gravity. We have heard many times that the foundation of childhood obesity treatment is lifestyle modification. But then comes the Catch-22. In many cases, lifestyle cannot be modified until the mental/emotional state of a person is attended to. This is particularly the case with children. Children can be told, and parents can be told, that the snacking lifestyle is inimical to energy balance adjustment, because when snacks are in the picture, the caloric intake part of the equation goes off the rails.

Parents say, “Yes, we understand. We want what’s best for our child.” They nod their heads, say “Thank you,” and go home with the best intentions. But what is lurking at home? Their same old psychological style, which is not compatible with the kind of lifestyle modification that can really make a difference. Their old, ingrained psychological style says, when the child is sad, you give out a treat so she or he will feel better. Until that mechanism is modified, nothing changes.

And it’s not up to the kid. A child does not have the wherewithal to say, “Mom, Dad, it would be better if you don’t give me treats when I feel bad.” Generally, a child is not equipped to initiate lifestyle modification. It all falls on the parents.

Fun fact

This is only one of many Childhood Obesity News posts about the pros and cons of sticking to particular menus and eating plans. To really get immersed in the subject, see “The Long Strange History of Dieting Fads” for such knowledge as:

In 1558, Italian nobleman Luigi Cornaro restricted himself daily to 12 ounces of food and 14 ounces of wine. Rumor has it he lived to a ripe 102 years of age, earning his approach the nickname The Immortality Diet.

Your responses and feedback are welcome!

Source: “Why ‘eat less, move more’ doesn’t work for weight loss,”, 11/21/19
Source: “The long, strange history of dieting fads,”, 11/06/17
Image by franchise opportunities/CC BY-SA 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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