According to James O. Hill, PhD, "This analysis indicates that to create and maintain substantial weight loss (ie, obesity treatment), large behavioral changes are needed. This is in stark contrast to primary obesity prevention in which small behavioral changes can eliminate the small energy imbalance that occurs before the body has gained substantial weight. Because the body has not previously stored this 'new' excess energy, it does not defend against the behavioral strategies as happens when the body loses weight."

The energy gap concept is useful for individualizing behavioral strategies for weight loss maintenance. For example, if the energy gap for a given weight-loss maintenance is estimated to be 300 kcal/day, this can lead to a specific individually tailored goal for changing diet and physical activity rather than generic advice to eat less and exercise more. This could be 300 kcal/day of additional physical activity, a reduction of 300 kcal/day from usual energy intake, or a combination of tactics such as adding 150 kcal/day of physical activity and reducing 150 kcal/day from usual energy intake.

Source: Elsevier Health Sciences