Handbook of Eating Disorders: Physiology, Psychology, and Treatment of Obesity, Anorexia, and Bulimia

By Kelly D. Brownell; John P. Foreyt | Go to book overview

2
Physiological Aspects
of Obesity

John S. Garrow


Regulation of Energy Balance

At the end of the last century, W. O. Atwater and F. C. Benedict performed a beautiful series of experiments in a basement room of the Orange Judd Hall of the Wesleyan University in Middletown, Connecticut.4 Their laboratory assistant and janitor, a Mr. E. Osterberg, permitted himself to be sealed into a well-insulated box for periods of four days at a time while exact measurements were made of the food he ate, the amount of heat he produced, and the change in his body stores of protein and fat. Over a series of six four-day experiments, the difference between the observed heat generated by Mr. Osterberg and that which would have been predicted from the energy content of the diet which he ate was -1.6 ± 2.2 percent. For sheer technical virtuosity these experiments have not been excelled by any recent investigators, although we now have computer‐ controlled calorimeters that do the same work with much less arduous labor. The pioneering work of Atwater and Benedict, and all subsequent investigations, confirmed beyond doubt that the laws of thermodynamics apply to man as well as to the rest of nature. The energy stores in the human body accurately reflect the balance between energy input (from food and drink) and energy expenditure.

This is the physiological basis of obesity. Obesity is a condition in which the energy stores of the body (mainly fat) are excessively large. If a normal person weighs 70 kg, and an obese person of similar height, age, and sex weighs 110 kg, we can be fairly sure that the obese person has energy stores that contain 280,000 kcal (1,170 megajoules) more than those of the normal person. The uncertainty arises because the ratio of

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