Evidence map›Paper›PMID 35134825›Full record

ReviewThe American journal of clinical nutrition2022

The energy balance model of obesity: beyond calories in, calories out.

Kevin D Hall, I Sadaf Farooqi, Jeffery M Friedman, Samuel Klein, Ruth J F Loos, David J Mangelsdorf, Stephen O'Rahilly, Eric Ravussin, Leanne M Redman, Donna H Ryan and 2 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The American journal of clinical nutrition, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 151 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
151citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

151 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  19. Protein Decoys, Alcohol, and Energy Intake: Testing a Mechanistic-Ecological Model.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
    Review
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91 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Kevin D HallNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.ORCID 0000-0003-4062-3133
I Sadaf FarooqiWellcome-MRC Institute of Metabolic Science, University of Cambridge.
Jeffery M FriedmanThe Rockefeller University.
Samuel KleinWashington University School of Medicine in St Louis.
Ruth J F LoosWashington University School of Medicine in St Louis.
David J MangelsdorfUniversity of Texas Southwestern Medical Center.
Stephen O'RahillyWellcome-MRC Institute of Metabolic Science, University of Cambridge.
Eric RavussinPennington Biomedical Research Center.ORCID 0000-0003-2129-547X
Leanne M RedmanPennington Biomedical Research Center.ORCID 0000-0002-7267-7374
Donna H RyanPennington Biomedical Research Center.ORCID 0000-0001-8374-2277
John R SpeakmanShenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzen, China, and the University of Aberdeen, Aberdeen, United Kingdom.
Deirdre K TobiasBrigham and Women's Hospital and Harvard Medical School.

Funding

Washington University Nutrition Obesity Research CenterP30DK056341 · NIDDK · WASHINGTON UNIVERSITY · PI Dominic N Reeds · 1999 to 2026
$30.2M
Modeling interactions of diet, exercise, metabolism, and weight change in humansZIADK013037 · NIDDK · NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES · PI DARCEY, VALERIE · 2009 to 2025
$10.8M
Medical Research Council MC_UU_00014/1Medical Research Council MC_UU_12012/1NIDDK NIH HHS P30 DK056341
6 · The paper itself

Abstract

A recent Perspective article described the "carbohydrate-insulin model (CIM)" of obesity, asserting that it "better reflects knowledge on the biology of weight control" as compared with what was described as the "dominant energy balance model (EBM)," which fails to consider "biological mechanisms that promote weight gain." Unfortunately, the Perspective conflated and confused the principle of energy balance, a law of physics that is agnostic as to obesity mechanisms, with the EBM as a theoretical model of obesity that is firmly based on biology. In doing so, the authors presented a false choice between the CIM and a caricature of the EBM that does not reflect modern obesity science. Here, we present a more accurate description of the EBM where the brain is the primary organ responsible for body weight regulation operating mainly below our conscious awareness via complex endocrine, metabolic, and nervous system signals to control food intake in response to the body's dynamic energy needs as well as environmental influences. We also describe the recent history of the CIM and show how the latest "most comprehensive formulation" abandons a formerly central feature that required fat accumulation in adipose tissue to be the primary driver of positive energy balance. As such, the new CIM can be considered a special case of the more comprehensive EBM but with a narrower focus on diets high in glycemic load as the primary factor responsible for common obesity. We review data from a wide variety of studies that address the validity of each model and demonstrate that the EBM is a more robust theory of obesity than the CIM.

Indexed as

Energy IntakeObesityBody WeightEnergy MetabolismHumansInsulinInsulincarbohydratesenergy balancefood intakeinsulinobesity

Identifiers

PMID35134825
PMCPMC9071483

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.