PEDIATRICS Vol. 95 No. 1 January 1995, pp. 131-132
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Obesity: A Game of Inches

Rudolph L. Leibel MD1

1 The Rockefeller University, 1230 York Avenue, New York, NY 10021-6390

Obesity, like baseball, is a game of inches. Weight gain cannot occur unless energy intake exceeds energy expenditure. Such positive energy balance is a sine qua non for normal growth in the child, and for obesity in the adult. Very small excesses of intake over expenditure can make a big difference if present over a long period of time. Consider the children in the study reported by Klesges et al1 elsewhere in this journal (pages 126-130). At about 4frac12 years of age, these children were estimated (by diet history) to have been ingesting about 2000 kcal per day. This is almost certainly an overestimate of the actual caloric intake of these children (see below).

Submitted on November 15, 1994
Accepted on November 17, 1994




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