Document Type

Article

Publication Date

2021

Abstract

Obesity is one of the most pressing public health issues in the United States (U.S.) today as it increases the risk of morbidity and mortality through chronic diseases, including cardiovascular diseases, type 2 diabetes, certain cancers, and mental health conditions (1). Defined by the Centers for Disease Control and Prevention as a body mass index greater than 30 kg·m−2, obesity is the second leading cause of preventable deaths (2). Projected estimates indicate that nearly one in two adults will have obesity and almost one in four adults will have severe obesity by 2030 (3). Further, existing disparities in obesity prevalence by race/ethnicity, socioeconomic position, and geographical region are expected to widen (3,4). Maintaining a healthy weight is determined by the balance of energy intake (food calories from dietary macronutrients) with total energy expenditure (TEE). TEE is composed of the energy cost of one’s basal metabolic rate, the thermic effect of digestion and assimilation of food, and total physical activity. When an individual overeats and/or is sedentary relative to TEE, a positive net energy balance is created, resulting in weight gain. Research indicates that clinical improvements in health outcomes begin to appear with even small amounts of weight loss (5). Programs combining diet and exercise have been shown to result in initial and sustained weight loss (6–8).

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